What is the role of cryotherapy in the treatment of keloids and hypertrophic scars?

Updated: May 29, 2020
  • Author: Brian Berman, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Cryosurgical media (eg, liquid nitrogen) affects the microvasculature and causes cell damage via intracellular crystals, leading to tissue anoxia. Generally, 1, 2, or 3 freeze-thaw cycles lasting 10-30 seconds each are used for the desired effect. Treatment may need to be repeated every 20-30 days. Cryotherapy can cause pain and permanent depigmentation in selected patients. As a single modality, cryosurgery led to total resolution with no recurrences in 51-74% of patients after 30 months of follow-up observation.

Newer methods of application of liquid nitrogen include the insertion of a lumbar puncture needle through the long axis of the keloid, from one side to the other, passing the liquid nitrogen with an intravenous drip set for 2 freeze-thaw cycles of 20-30 seconds each for 5-10 sessions. Flattening was achieved in 75% of the patients. [84] A single treatment with an intralesional cryoprobe was used to treat 10 earlobe keloids in 10 white patients, obtaining a statistically significant reduction in the scar volume of 67.4% after 18 months of follow up compared with baseline measurements. Zero recurrences were reported. Other scar parameters also improved. [85]

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