Cryosurgery for Acne Scar Treatment

Acne is one of the most common chronic skin disorder affecting millions of people across the globe.

It is characterized by the outbreak of pimples, whiteheads, blackheads, and inflammations along with redness and marks on the skin.

There are a lot of methods that have been developed to do away with scarring, including
Laser treatments and skin needling, among others.

This article shall discuss the effectiveness of cryosurgery towards the same.

What is Cryosurgery?

Cryosurgery involves using extreme cold to eliminate abnormal, diseased or infected tissues.

It uses the process of necrosis to kill the already damaged cells and stimulate new growth in its place.

It has been used to treat a number of diseases and disorders, especially malignant skin conditions that are also benign and according to one report has been one of the most used procedures after skin excision

Though liquid nitrogen is the most commonly used chemical for this method, there are other chemicals also that can be put to use.

These chemical are:

• Liquid nitrogen: It is the most commonly and widely used chemical and requires  spraying on the diseased tissue with the help of a cryoprobe or simply applied on the affected area using a cotton ball
• Carbon dioxide: It is not used very frequently. Doctors recommend using carbon dioxide snow trapped in a cylinder or mixed with acetone to be applied directly on the affected area
• Argon: This involves using the Joule-Thomson effects for affecting ice formation from argon gas. Ultra thin 17 gauge cryoneedles are required for this method
• Dimethyl ether and propane: A mixture of the two is used and stored in an aerosol spray. This can be sprayed onto a cotton ball which when soaked in this can directly be applied to the affected area.

How does Cryosurgery Heal Acne Scars?

The most simplistic explanation of its mechanism of action towards acne scars is that it freezes the top layer of the skin, causing it to blister and in the process reduces the size of the scar along with promoting new skin growth which is damage free

The course of its action can however be divided into three phases, which are as follows:

Heat transfer

This involves transferring heat from the skin to some heat sink usually liquid nitrogen, which has a boiling point of -196 degree Celsius.

When the liquid nitrogen is sprayed on the affected area, it tends to absorb the heat of the skin and evaporate almost immediately causing the cells to freeze.

This action is usually targeted at the destruction of the damaged cells and works on the principal of different temperatures of skin and the vehicle used.

Cell injury

As the temperature of the skin goes down, it causes the cell membrane to freeze causing further extra-cellular damage.

Ice crystals usually form at -5 degrees to -10 degrees Celsius.

This damage will stimulate collagen formation as an immunity response which will induce new cell growth and repairing.

Different tissues require different freezing points for destruction.

Whereas keratinocytes require -50 degrees Celsius, melanocytes require only -5 degrees Celsius because of their delicacy.

Malignant cancer requires -50 degrees Celsius while benign lesions require only -25 degrees Celsius.

Inflammation

This is the last stage and is caused as a result of cell death and further facilitates local cell damage.

The damage that cryosurgery causes, induces immediate collagen formation in response.

This further facilitates the new cell growth making the skin smoother and more firm and tight.

Different Methods Cryosurgery

There are different ways in which cryosurgery can be performed. They are as follows:

• Dipstick: It is used for superficial lesions and uses a cotton-tipped applicator for application on the affected area
• Sprays: Sprays containing liquid nitrogen is available commercially and can be used for benign and malignant lesions and also superficial ones
• Confined spray: This is usually used when sensitive skin areas like the eyes are near the affected area. It has a cone attached to it which directs the spray only at the affected area
• Cryoprobe: This is a pre cooled metal instrument applied against the lesion. It is usually used for round lesions on flat surfaces.

Cost of cryosurgery treatment

The cost has been estimated to be anywhere between 75$ to 150$ per scar and it usually requires 1 to 2 rounds for proper treatment.

Benefits and limitations of cryosurgery

The benefits of cryosurgery have been enumerated below:

• It is a quick treatment and does not require hospitalization. All physical activities can be resumed within 24 hours
• It results in fewer side effects than a laser treatment could have caused
• It is a relatively inexpensive method
• It does not cause hardening of non cellular material around the skin

Possible side effects of cryosurgery

cryosurgery has been known to be effective in patients who are elderly or otherwise with minimal side effects.

Though rare, cryosurgery can result in the under mentioned side effects:

• Might cause bacterial infection or otherwise especially around the lower legs where healing is comparatively slow
• There are possibilities of hypo pigmentation and hyper pigmentation after cryosurgery . It is however temporary and fades away after the initial stages
• In very rare cases, nerve damage has been reported in areas that are close to the surface of the skin like fingers and wrist. This however tends to heal after some months.
• A complete cryosurgery can cause basement membrane separation resulting in the formation of blisters

Precautions while undergoing the treatment

Though the side effects are minor, temporary and rare, care must be taken to avoid those.

It can be done by observing the following precautions:

• This treatment should not be done on sensitive skin areas like those covering the nerves, area where the skin folds, skin near the tip of the eye, skin near the nostrils.
• Malignant melanoma lesions should not be treated with cryosurgery. Also, the site of a former tumor surgery should not be exposed to cryosurgery
• In case of ambiguity, a tissue can be tested to see if the growth is malignant or benign, before starting the treatment
• People who have diabetes and other circulation problems, should avoid going for cryotheraphy for growths on their lower legs or ankles as healing process becomes rather slow and dangers of infection might increase.
• The area to be treated must be clean and dry before the procedure
• The area should be washed 3 or 4 times a day after the treatment is over, while the liquid continues to ooze out, for a period of 5 to 15 days

Summary

Cryosurgery as a treatment for scars has been in use since a long time and has proved quiet effective.

It is an easily applicable and does not necessarily require hospitalization.

This treatment can easily be carried out in your house and even used in combination with your daily moisturizer to use the same mechanism in your daily routine.

It will not cause the side effects that might result from exposure to ultraviolet light in the laser treatment and have very less risk factor.