Cryotherapy / Electrocautery
Cryotherapy is used to freeze and destroy cells with liquid nitrogen. This is most helpful for viral warts. As with any tool, there are some considerations:
Benefits
- May not require sedation or even local anesthetic, depending on the patient's temperament, location of the lesion, size of the lesion, and initial discomfort
- Maybe able to address lesion that is in a location that is relatively difficult to cut
- Inexpensive
- Brief procedure, might only take 2-3 minutes for the freeze/thaw cycles
- Healing is relatively quick. The lesion dries up and scabs over. There is minimal, if any, bleeding.
Drawbacks
- There is a mild stinging sensation as the area is frozen
- In some cases, additional cryotherapy sessions may be necessary to fully treat the lesion
- There can be some mild scarring or pigment changes
- The lesion is not being submitted to a pathologist. If the lesion is concerning for cancer and/or if there is rapid regrowth after freezing, then biopsy a should be considered.
- Treatment failure is possible
Electrocautery is the use of heat to cut through and remove unwanted tissue. It is very useful for removing small benign skin masses or “skin tags” without the need for anesthesia or sedation.
Benefits
- Usually does not require sedation (a local anesthetic is used, as it is transiently painful)
- Can rapidly address multiple small lesions quickly
- Inexpensive
- Healing is relatively quick. The procedure typically creates a small wound that scabs over and heals in 1-2 weeks. There is minimal, if any, bleeding.
Drawbacks
- Is not appropriate for certain lesions, especially those very closely attached to the skin
- Is painful while heat is being applied (local anesthesia is needed)
- A wound is often created at the treatment site - antibiotic ointment may be needed for a few days.
- Benign lesions can grow back or new ones emerge (treatment may not be permanent)
- The lesion is not being submitted to a pathologist. If the lesion is concerning for cancer and/or if there is rapid regrowth after removal, then a biopsy should be considered.
