Does cryotherapy (cryosurgery) result in the removal of seborrheic keratoses (seborrheic keratosis)?

From the Guidelines

Cryotherapy is an effective treatment for removing seborrheic keratosis, with a success rate of up to 75%. This procedure involves freezing the growth with liquid nitrogen, which causes the lesion to blister and eventually fall off within a few days to weeks after treatment, as supported by guidelines for the management of similar skin lesions 1. The process works by creating ice crystals within the abnormal skin cells, causing cellular damage and death of the targeted tissue. Cryotherapy is typically performed in a dermatologist's office and usually takes only a few minutes. Patients may experience some discomfort during the procedure, followed by redness, swelling, and blister formation. After the treated area heals, there may be temporary or permanent lightening of the skin at the treatment site. Some key points to consider when using cryotherapy for seborrheic keratosis include:

• The potential for scarring, particularly for thicker lesions 1
• The effectiveness of cryotherapy compared to other treatments, such as photodynamic therapy, which may have better cosmetic results but higher costs 1
• The need for multiple sessions for complete removal of larger or thicker lesions
• The importance of considering the potential side effects, including infection and changes in skin pigmentation, when deciding on a treatment plan.

From the Research

Efficacy of Cryotherapy for Seborrheic Keratosis

• Cryotherapy is a treatment method for seborrheic keratosis, with studies showing its efficacy in removing the lesions 2, 3, 4, 5.
• A randomized controlled trial compared the efficacy of plasma exeresis and cryotherapy for treating seborrheic keratosis, finding that cryotherapy resulted in a lower clearance rate of lesions at week 3, but the difference was not significant (p-value: 0.06) 3.
• Another study compared the efficacy and safety of electrodesiccation, cryotherapy, CO2 laser, and Er:YAG laser in the treatment of seborrheic keratosis, finding that the improvement rate was significantly higher in the CO2, Er:YAG lasers and electrodesiccation group compared to the cryotherapy group (p < 0.001) 4.
• A blinded randomized clinical trial study compared the efficacy and safety of cryotherapy and electrosurgery in the treatment of seborrheic keratosis, finding that seborrheic keratosis responded better to cryotherapy 5.

Safety of Cryotherapy for Seborrheic Keratosis

• Cryotherapy is generally considered safe, but it may cause side effects such as hypopigmentation, depigmentation, and erythema 3, 4, 5.
• A study found that hypopigmentation and depigmentation occurred in 2 (3.1%) and 4 (6.3%) of the cryotherapy cases, respectively 5.
• Another study found that the pain and burning severity after cryotherapy were negligible, and prolonged erythema was not observed in any of the cases 4.

Comparison with Other Treatment Methods

• Cryotherapy has been compared to other treatment methods, including plasma exeresis, electrodesiccation, CO2 laser, Er:YAG laser, and electrosurgery 3, 4, 5.
• The efficacy of cryotherapy varies depending on the study and the comparison group, but it is generally considered a safe and effective treatment method for seborrheic keratosis 2, 3, 4, 5.