Post-Cryotherapy Care Instructions
Apply topical antibiotic ointment and non-adherent dressings to all treated sites for several days after cryotherapy to prevent secondary bacterial infection, which occurs in approximately 25% of cases. 1, 2
Immediate Post-Treatment Care (First 24-48 Hours)
- Expect normal inflammatory responses including vesicle formation, erythema, swelling, and burning pain at treatment sites—these are expected outcomes, not complications. 1, 3, 2
- Apply cold compresses (not ice directly on skin) to reduce discomfort and swelling if needed. 2
- Pain management: Most patients experience mild pain for approximately one day; use over-the-counter acetaminophen or ibuprofen as needed. 1, 2
- Do not apply ice directly to the treated area as it can produce tissue ischemia. 1
Wound Care Protocol
- Clean gently with saline solution or clean water once daily. 2
- Apply topical antibiotic ointment (bacitracin or mupirocin) to all treated sites daily to prevent secondary bacterial infection. 1, 2
- Cover with non-adherent dressings, especially for head and neck lesions, for the first several days. 2
- Change dressings daily or as needed if they become wet or soiled. 2
Expected Healing Timeline
- Eschar (crusted scab) formation will occur within 1-3 days—this is normal and expected. 1, 3, 2
- Do not pick or remove the eschar; allow it to fall off naturally, typically within 2-4 weeks. 2
- Average healing time is 35-46 days, though lower leg lesions may take up to 90 days (median). 1, 2
- Initial appearance: Expect redness and oozing before crusting develops. 1, 2
Site-Specific Considerations
- Facial lesions generally heal well, but areas near eyelids, lips, nose, and ears require more careful monitoring due to higher complication risk. 1, 3
- Genital warts: Keep the area clean and dry after treatment. 1
- Lower leg lesions: Be prepared for significantly slower healing (median 90 days) compared to other body sites. 1
- Head and neck lesions: Avoid tight collars or clothing that may rub against treated areas during healing. 2
Pigmentation Changes (Common and Expected)
- Both hypopigmentation and hyperpigmentation commonly occur after cryotherapy, especially in patients with darkly pigmented skin. 1, 3, 2
- Timeline for improvement: Most pigmentary changes improve within 6-12 months, though some may be permanent. 1, 3, 2
- Darker skin tones: Pigmentary changes are typically more pronounced and persistent in these patients. 1, 2
Activity Restrictions and Sun Protection
- Avoid direct sun exposure to treated areas for at least 4-6 weeks. 2
- Use broad-spectrum sunscreen (SPF 30+) once wounds have re-epithelialized. 2
- Avoid swimming, hot tubs, or prolonged water immersion until fully healed. 2
- Gentle hair washing is acceptable for head lesions, but avoid scrubbing treated areas. 2
- Avoid shaving over treated areas until completely healed. 2
Warning Signs Requiring Immediate Medical Attention
- Signs of secondary bacterial infection (occurs in ~25% of cases): increasing pain after 48 hours, spreading redness, purulent drainage, fever, or red streaking from the wound. 2
- Excessive bleeding or wound dehiscence. 2
- Signs of allergic reaction to topical medications. 2
- Difficulty breathing or other concerning systemic symptoms. 1
What NOT to Do
- Do not use hydrogen peroxide or alcohol directly on wounds—these delay healing. 2
- Do not apply heat to treated areas, as this worsens inflammation. 2
- Do not use topical corticosteroids on treated sites unless specifically instructed. 2
Follow-Up Schedule
- Return for evaluation in 3-4 weeks to assess healing and determine if additional treatment is needed. 2
- Repeat treatments may be necessary at 3-week intervals for incomplete responses. 4, 3, 2
- Annual skin examinations are recommended for surveillance of new lesions. 2