Seeking Justice

There are several treatment options available for keratosis but the most frequently used is cryotherapy, which involves extremely low temperatures, also called cryosurgery. According to reliable research, cryotherapy follows surgical procedures in the ranking of treatments most frequently performed to remove skin lesions due to its availability in the doctor’s office.

During the process of cryotherapy, extreme cold is applied to the affected area of the body to freeze off bothersome skin lesions including warts, actinic and seborrheic keratosis. However, this treatment process is recommended only for superficial, flattened or slightly palpable skin lesions for it has not always been successful in removing deeper lesions.

Now, let us try to understand the mechanism of cryotherapy! 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. The site then receives decreased blood flow due to this process, commonly referred to health professionals as vasoconstriction. Due to restricted blood supply, the cells cannot receive the nutrients that they need from the blood including oxygen. Eventually, the resulting effect is cell death or necrosis.

Liquid nitrogen, carbon dioxide snow and DMEP or dimethyl ether and propane, are some of the substances used to generate extremely cold temperatures which are known as cryogens. The cryogen that physicians most commonly use is liquid nitrogen due to its low boiling point and therefore, its efficiency in freezing off lesions.

To begin the treatment, the physician directly applies the liquid nitrogen onto the skin of the patient using a cotton-tipped applicator, a cryospray or a cryoprobe. In the span of a minute, heat from the skin transferring to the liquid nitrogen causes it to disappear instantly. Following this brief freezing period is the thawing process which lasts longer. This eventually causes leaking out of the cell’s contents which signal the beginning of the actual cell injury. Lastly, cell inflammation, characterized by skin redness, edema or swelling, pain and warmth, occurs as the cells’ final response to cell death.

There are generally minimal adverse effects when the physician performs the treatment according to the guidelines. But like many other procedures, complications can and will arise in some cases. Such is the effect of prolonged freezing by the liquid nitrogen which shows as a lighter skin color of the area treated than the surrounding skin, commonly referred to as hypopigmentation.

Due to its dangerous effect on skin exposed through direct contact, liquid nitrogen is still considered highly dangerous despite not making it under the Resource Conservation and Recovery Act’s list of hazardous materials. People are exposed to liquid nitrogen either through inhalation or through direct contact. Inhalation effects are not as serious as the direct contact effects of liquid nitrogen unless vast amounts of liquid nitrogen are spilled, therefore causing reduced oxygen levels. Workers involved in its transportation must therefore adhere to transportation safety protocols.

Eye contact with liquid nitrogen can occur during its transfer to smaller containers. Direct contact with the skin can also happen unexpectedly.

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. People without the first line of defense from liquid nitrogen should leave an area exposed to leaks. In cases of direct contact, soak the skin in water that has a temperature of 41-46 degrees Celsius then consult a doctor.

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Filed under: technology by Robert