At ENRICH Clinic and DIV, we often use liquid nitrogen to freeze off skin spots in a process known as cryotherapy. In liquid form, nitrogen gas is very cold, sitting at -200°C. Many superficial skin lesions—including warts, actinic keratoses, seborrhoeic keratoses and selected benign growths—can be treated using cryotherapy where clinically appropriate.
One of the major benefits of cryotherapy is that it seldom leaves scarring. We use liquid nitrogen every day at our clinic for a wide range of skin growths, as treatments are quick with often minimal discomfort and easy healing.
It’s important to have an experienced dermatologist performing cryotherapy to ensure the end result is smooth, clear skin.
What is liquid nitrogen used for?
A dermatologist uses liquid nitrogen treatments for skin growths and spots, including:
- Skin tags
- Warts
- Skin cancers (non-melanoma)
- Skin growths
- Precancerous growths like actinic keratosis
- Molluscum contagiosum
- Seborrhoeic keratoses
- Moles
- Sunspots
How Long Has Liquid Nitrogen Been Used in Dermatology?
Although liquid nitrogen may sound like a modern treatment, cryotherapy has been used in medicine for well over a century, with modern liquid nitrogen cryosurgery becoming a routine part of dermatology practice during the 1950s and 1960s.
Today, it remains one of the most commonly performed dermatological procedures worldwide. It has stood the test of time because it is quick, effective for many superficial skin lesions, and, when used appropriately, can often produce solid cosmetic outcomes with minimal downtime. As with any treatment, success depends on selecting the right lesion. An experienced dermatologist will first determine exactly what the spot is before recommending whether cryotherapy is the most appropriate treatment or whether another procedure may provide a better outcome.
Does cryotherapy hurt?
Usually, cryotherapy will cause mild stinging during treatment as the growth or spot is frozen and then thaws. However, discomfort is mild and lasts about five minutes. Most patients find cryotherapy to be a quick, tolerable procedure. You can take a paracetamol before or after the treatment if you feel you need it.
What happens to the spot after treatment?
Later in the day, 1-2 hours from treatment, the treatment site becomes a little swollen and red. At some stage, the treated growth will form a crust, scab or blister, which will fall off by itself over the coming two weeks, taking the growth with it. Then, finally, new, healthy skin emerges underneath the blister.
How to prepare for cryotherapy
There is no preparation for cryotherapy, except perhaps removing makeup, creams, rings, watches or powders from the treatment area. Then, your doctor will clean the area to sterilise the skin and prepare you for treatment.
How to support quick healing
There are some tips on how to help your liquid-nitrogen-treated area heal faster. It is advisable to allow the blistering, crusting and scabbing process to run its course, allowing the healthy skin underneath to form to avoid visible scarring.
Apply an ointment such as Vaseline twice per day, and cover with a Band-Aid if desired to protect the scab. In the event of bleeding, hold gauze or a tissue firmly onto the wound until bleeding stops.
Avoid putting anything onto the blister or scab as it heals, for example, rings or makeup, potions or lotions, but do feel free to apply the protective ointment as often as it needs it.
Don’t pop the blister that will form, as this could introduce infection and interrupt healing. Clear fluid may leak out of the blister, which can be absorbed using tissue.
Does cryotherapy leave a scar?
Liquid nitrogen treatments don’t typically leave a scar, but they may leave a mark of a different colour on the skin (usually whiter). This colour change usually resolves over time, but in some cases persists. This colour change is not dangerous and doesn’t mean your growth will come back, but depending on the location, it may be undesirable.
This colour mismatch may be more pronounced with deeper treatments, as more collagen is required to repair the patch. Cryotherapy may require greater consideration for darker skin tones, as it leaves a white mark that may not return to its normal skin tone even in time.
The white mark that can develop after cryotherapy is called post-inflammatory hypopigmentation (PIH) or simply hypopigmentation.
Hypopigmentation occurs because the extreme cold can temporarily—or occasionally permanently—damage the melanocytes, the cells responsible for producing melanin (the pigment that gives skin its colour). As a result, the treated area may appear lighter than the surrounding skin.
Sometimes spots may require a second treatment if the first didn’t quite do the trick. A second treatment is preferable to a deeper treatment initially, as it significantly reduces the risk of scarring. Sometimes,
Freezing skin cancers and precancerous growths using liquid nitrogen
At ENRICH Clinic in Melbourne, we often use cryotherapy on precancerous growths such as actinic keratoses, though less often for skin cancers. We may use cryotherapy to treat small squamous cell carcinoma in situ.
There are only certain circumstances where liquid nitrogen for skin cancer is appropriate, for example:
- In the first instance of skin cancer in that area
- Where multiple skin cancers need treatment
- The patient has a bleeding disorder, whereby excision is inappropriate
- Another procedure is unable to be considered for some reason
In some cases, when liquid nitrogen is the treatment of choice for skin cancers, cancer returns after treatment. However, one study found that cryotherapy had a strong clearance rate.
Suppose the growth requires a biopsy to test for cancer. In that case, it is not appropriate to remove it using cryotherapy as this method will destroy the growth, removing the possibility of testing it. Instead, excision is more beneficial for biopsy. Histopathology cannot be performed once a lesion has been destroyed by cryotherapy, which is why it is important to make an accurate diagnosis before starting any treatment. This is where your dermatologist is key.
Freezing off moles using liquid nitrogen
Some moles can be frozen off with liquid nitrogen, but it depends on how deep the mole’s roots or blood supply are. It might be more effective to cut the mole out to prevent it from growing back.
The process is the same for selected benign skin lesions, including some moles, where clinically appropriate, and they are removed using cryotherapy.
Not Every Spot Should Be Frozen
Although liquid nitrogen is an excellent treatment for many benign and precancerous skin lesions, it is not suitable for every lump, bump or mole.
Before recommending cryotherapy, your dermatologist will carefully examine the lesion and consider factors such as:
- Whether the diagnosis is certain
- The size and depth of the lesion
- Its location
- Your skin type
- Whether the lesion may require laboratory testing (biopsy)
If there is any uncertainty about the diagnosis, your dermatologist may recommend a biopsy or surgical removal instead of freezing the lesion.
Other Ways Dermatologists Remove Skin Spots
Cryotherapy is only one of several procedures used to treat skin lesions. Depending on the type of spot, its location and whether it requires testing, your dermatologist may recommend another treatment.
Surgical excision
For suspicious moles, skin cancers and some deeper benign growths, surgical excision may be the preferred option. Removing the lesion allows it to be sent to a pathology laboratory for examination while also treating the lesion.
Shave excision
Some raised moles, seborrhoeic keratoses and benign skin growths may be suitable for shave removal. This technique removes the raised portion of the lesion while often providing an excellent cosmetic result.
Curettage and cautery
Certain superficial skin lesions can be gently scraped away (curettage) before using heat (cautery) to control bleeding and destroy any remaining abnormal tissue.
Laser treatment
Laser technology may be appropriate for selected skin lesions, particularly some benign pigmented lesions, vascular lesions and sun-related pigmentation. Depending on the condition being treated, dermatologists may use different laser technologies to target pigment or blood vessels while minimising damage to surrounding skin. The most appropriate treatment will always depend on an accurate diagnosis and individual assessment.
At ENRICH Clinic, we have many methods for removing spots, depending on the nature and location. We work with patients experiencing pigmentation issues such as sunspots, moles and freckles, clearing or fading spots with lasers, excision, freezing or burning, as per the spot’s requirements.
Our dermatologists and medical team have extensive experience in diagnosing and treating a wide range of skin conditions using both medical and procedural dermatology.
Book a consultation to see how we can help you with your skin concerns.
ENRICH Clinic
Frequently Asked Questions
How long has liquid nitrogen been used?
Liquid nitrogen has been used routinely in dermatology for more than 60 years and remains one of the most widely performed treatments for benign skin lesions and some precancerous lesions.
Is cryotherapy safe?
When performed by an experienced medical practitioner after an appropriate diagnosis, cryotherapy is considered a safe and well-established treatment for many superficial skin lesions.
How long does a liquid nitrogen treatment take?
Most cryotherapy treatments take only a few minutes. The freezing itself usually lasts only seconds, although some lesions require more than one freeze cycle.
Will I need more than one treatment?
Sometimes. Larger, thicker or deeper lesions—including some warts and seborrhoeic keratoses—may require more than one treatment to achieve the desired result.
Can all moles be removed with liquid nitrogen?
No. Many moles are not suitable for cryotherapy. If a mole appears unusual or may require laboratory examination, surgical removal is generally preferred so it can be sent for pathology.
Can liquid nitrogen remove skin cancers?
Cryotherapy may be suitable for selected superficial precancerous lesions and certain non-melanoma skin cancers in carefully selected circumstances. However, many skin cancers are better treated with surgical excision to ensure complete removal and allow pathological examination.
What happens if the spot comes back?
Some lesions can recur after cryotherapy. If this happens, your dermatologist may recommend another cryotherapy treatment or a different treatment option depending on the diagnosis.
Can I shower after cryotherapy?
Yes. Normal showering is fine. Simply pat the treated area dry afterwards and follow your dermatologist’s aftercare instructions.
Should I pop the blister?
No. Allow the blister to heal naturally whenever possible, as this helps reduce the risk of infection and supports normal healing.
When should I have a spot checked rather than frozen?
Any new, changing, bleeding, painful or unusually coloured skin lesion should be assessed by a dermatologist before treatment. An accurate diagnosis is the most important step in choosing the right treatment.
