Keratosis Treatment | Beware Of Liquid Nitrogen

The use of cryogens or cryotherapy, curettage, laser therapy, electrocautery or surgical excision all assist in treating keratosis – the first being the most popular. Studies reported that it is the second-most common procedure next to surgical procedures such as skin excision and it can easily be performed in the doctor’s office.

In cryotherapy, extreme cold is applied to a specific area of the body to freeze off unwanted skin lesions including warts and keratosis, both actinic and seborrheic. Due to failed trials in removing deeper and thicker lesions, this regimen is advisable only for superficial or flat lesions.

Are you being inquisitive on how cryotherapy works? At the site of the injury, such as where the skin lesions can be found, cryotherapy constricts the blood vessels, including the arteries and the veins. This vasoconstriction, medical term for constriction of the blood vessels, reduces the blood flow into the site. In the absence of adequate blood supply, nutrients such as oxygen, which are very much needed by the cells, will not reach the cells. This finally results to necrosis or cell death on the lesions.

There are a few types of cryogens, substances used to obtain very low temperatures, namely, liquid nitrogen, carbon dioxide snow and DMEP or dimethyl ether and propane.   But the cryogen that doctors most commonly use is the liquid nitrogen due to its low boiling point and therefore, its efficiency in freezing off lesions.

The first stage of the treatment is when liquid nitrogen is directly anointed on the client’s skin using a cotton-tipped applicator, a spraygun or a probe. Then, the heat from the skin instantly transfers to the liquid nitrogen making it evaporate quickly, usually within a minute or so. Thawing of the skin lesions then ensues after this short freezing time. Then when the cell’s contents leak out into its surroundings called the interstitial space, rest assured the cryotherapy has begun the actual cell injury. To conclude the process, the client’s skin will demonstrate signs of inflammation – redness, swelling, pain and warmth – signaling the cells’ decompensation.

No one should be afraid to have cryotherapy since it is a generally safe procedure as long as treatment protocols are followed strictly. But complications are always a part of any procedure, be them low-risk or high-risk. To illustrate, prolonged freezing by the liquid nitrogen results to hypopigmentation or modification in the skin color, specifically a lighter color.

Although not listed as a hazardous material under the Resource Conservation and Recovery Act, liquid nitrogen is considered a highly dangerous chemical because any direct contact with it, especially prolonged contact, will result to rapid freezing and eventual tissue damage. There are two types of exposure to liquid nitrogen: inhalation and direct contact. Inhalation exposure is considered to be critical only if a immense amount of liquid nitrogen, reducing the oxygen levels in the air, is spilled. Extreme care must therefore be observed during its transportation.

Liquid nitrogen can splash into one’s eyes especially when transferring it to another storage device. Or there can be accidental direct contact with the skin.

Therefore, for both the medical practitioners and the laypersons alike: practice utmost safety when handling liquid nitrogen. Always wear goggles, face shields or masks, gloves, aprons or other encapsulating suits when handling any objects with liquid nitrogen or liquid nitrogen itself. When leaks are inevitable, remove anyone unprotected from possible exposure. In cases of direct contact, soak the skin in water that has a temperature of 41-46 degrees Celsius then consult a doctor.

Actinic Keratosis Further ReadingFurther Reading:


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