Cryotherapy

What Is It?

Cryotherapy uses liquid nitrogen to freeze scars. There are two main ways to use liquid nitrogen to freeze and destruct hypertrophic (raised) scars: (1) contact and (2) intralesional. The first method is the external application of liquid nitrogen on the outside of the scar. The second method involves injecting liquid nitrogen into the scar using cryosurgery needles.

Good or Excellent Response

Strength of Evidence
1
2
3
4
5
62% of patients achieved a good (>50%) or excellent (>75%) improvement in scarring after 1 - 6 sessions

Moderate Response

Strength of Evidence
1
2
3
4
5
77% of patients achieved at least a moderate (>25%) improvement in scarring after 1 - 6 sessions

Scar Height Reduction

Strength of Evidence
1
2
3
4
5
Average 76% reduction in scarring

Mean improvement in VSS total score

Strength of Evidence
1
2
3
4
5
Average 59% reduction in scarring

Mean improvement in VSS pigmentation score

Strength of Evidence
1
2
3
4
5
Average 42% reduction in scarring

Mean improvement in VSS height score

Strength of Evidence
1
2
3
4
5
Average 59% reduction in scarring

Mean improvement in VSS pliability score

Strength of Evidence
1
2
3
4
5
Average 84% reduction in scarring

Mean improvement in VSS vascularity score

Strength of Evidence
1
2
3
4
5
Average 45% reduction in scarring
  1. Zouboulis, C. C. & Zouridaki, E. Cryosurgery as a single agent and in combination with intralesional corticosteroids is effective on young, small keloids and induces characteristic histological and immunohistological changes: a prospective randomized trial. Dermatology 237, 396–406 (2021).
  2. Zouboulis, C. C., Wild, T., Zouboulis, V. A. & Har-Shai, Y. Intralesional cryosurgery of keloids: required treatment hold time. Br J Dermatol 184, 173–175 (2021).
  3. Salem, S. A. M., Abdel Hameed, S. M. & Mostafa, A. E. Intense pulsed light versus cryotherapy in the treatment of hypertrophic scars: a clinical and histopathological study. J Cosmet Dermatol 20, 2775–2784 (2021).
  4. Jacobs, C. & Wilmink, J. Combined versus single treatment regimens for keloid therapy using serial intralesional corticosteroid injections, surgical excision, silicone- and/or cryotherapy. JPRAS Open 29, 157–166 (2021).
  5. Muthanna, A. M. & Al-Qubati, Y. A. Cryotherapy: A Successful Monotherapy for Earlobe Keloids. Malays Fam Physician 15, 83–85 (2020).
  6. Kumar, B. P. et al. A comparative study of therapeutic efficacy between intralesional steroids and cryotherapy in the management of keloids. Journal of Dental and Medical Sciences 19, 19–24 (2020).
  7. Bijlard, E. et al. Intralesional cryotherapy versus excision with corticosteroid injections or brachytherapy for keloid treatment: randomised controlled trials. J Plast Reconstr Aesthet Surg 71, 847–856 (2018).
  8. Azimi Alamdari, H., Davarnia, G., Herizchi Ghadim, H. & Asal, S. Intralesional cryotherapy versus intralesional corticosteroid and 5-fluorouracil in the treatment of hypertrophic scars and keloids: a clinical trial. Crescent Journal of Medical and Biological Sciences 5, 215–221 (2018).
  9. Park, T. H. et al. Could -79 °C spray-type cryotherapy be an effective monotherapy for the treatment of keloid? Int J Mol Sci 18, (2017).
  10. Roitman, A., Luntz, M. & Har-Shai, Y. Intralesional cryosurgery for the treatment of keloid scars following cochlear implant surgery and removal of cholesteatoma. Eur J Plast Surg 39, 307–312 (2016).
  11. Mourad, B., Elfar, N. & Elsheikh, S. Spray versus intralesional cryotherapy for keloids. J Dermatolog Treat 27, 264–269 (2016).
  12. van Leeuwen, M. C. E. et al. Intralesional cryotherapy for treatment of keloid scars: a prospective study. Plast Reconstr Surg 135, 580–589 (2015).
  13. Jannati, P., Aref, S., Jannati, A. A., Jannati, F. & Moravvej, H. Comparison of therapeutic response of keloids to cryotherapy plus intralesional triamcinolone acetonide or verapamil hydrochloride. J Skin Stem Cell 2, (2015).
  14. Abdel-Meguid, A. M., Weshahy, A. H., Sayed, D. S., Refaiy, A. E. M. & Awad, S. M. I. Intralesional vs. contact cryosurgery in treatment of keloids: a clinical and immunohistochemical study. Int J Dermatol 54, 468–475 (2015).
  15. Chopinaud, M. et al. Intralesional cryosurgery to treat keloid scars: results from a retrospective study. Dermatology 229, 263–270 (2014).
  16. Har-Shai, Y. Intralesional cryosurgery for enhancing the involution of hypertrophic scars and keloid – a new fundamental adjunctive wound healing therapy based on experimental and clinical data. Cryobiology 66, 345–346 (2013).
  17. Anchlia, S., Rao, K. S., Bonanthaya, K. & Vohra, D. Keloidoscope: in search for the ideal treatment of keloids. J Maxillofac Oral Surg 8, 366–370 (2009).
  18. Har-Shai, Y. et al. Intralesional cryosurgery for the treatment of hypertrophic scars and keloids following aesthetic surgery: the results of a prospective observational study. Int J Low Extrem Wounds 7, 169–175 (2008).
  19. Sharma, S., Bhanot, A., Kaur, A. & Dewan, S. P. Role of liquid nitrogen alone compared with combination of liquid nitrogen and intralesional triamcinolone acetonide in treatment of small keloids. J Cosmet Dermatol 6, 258–261 (2007).
  20. Rusciani, L., Paradisi, A., Alfano, C., Chiummariello, S. & Rusciani, A. Cryotherapy in the treatment of keloids. J Drugs Dermatol 5, 591–595 (2006).
  21. Har-Shai, Y. et al. Intralesional cryosurgery enhances the involution of recalcitrant auricular keloids: a new clinical approach supported by experimental studies. Wound Repair Regen 14, 18–27 (2006).
  22. Zouboulis, C. C. et al. Modification of a device and its application for intralesional cryosurgery of old recalcitrant keloids. Arch Dermatol 140, 1293–1294 (2004).
  23. Har-Shai, Y., Amar, M. & Sabo, E. Intralesional cryotherapy for enhancing the involution of hypertrophic scars and keloids. Plast Reconstr Surg 111, 1841–1852 (2003).
  24. Yosipovitch, G., Widijanti Sugeng, M., Goon, A., Chan, Y. H. & Goh, C. L. A comparison of the combined effect of cryotherapy and corticosteroid injections versus corticosteroids and cryotherapy alone on keloids: a controlled study. J Dermatolog Treat 12, 87–90 (2001).
  25. Gupta, S. & Kumar, B. Intralesional cryosurgery using lumbar puncture and/or hypodermic needles for large, bulky, recalcitrant keloids. Int J Dermatol 40, 349–353 (2001).
  26. Layton, A. M., Yip, J. & Cunliffe, W. J. A comparison of intralesional triamcinolone and cryosurgery in the treatment of acne keloids. Br J Dermatol 130, 498–501 (1994).
  27. Zouboulis, C. C., Blume, U., Büttner, P. & Orfanos, C. E. Outcomes of cryosurgery in keloids and hypertrophic scars. A prospective consecutive trial of case series. Arch Dermatol 129, 1146–1151 (1993).
  28. Rusciani, L., Rossi, G. & Bono, R. Use of cryotherapy in the treatment of keloids. J Dermatol Surg Oncol 19, 529–534 (1993).

Side Effects

Medium-High
Medium-high side effects and adverse reactions

Reviews

0.0
0 Reviews