Keratosis Treatment | Beware Of Liquid Nitrogen

July 27, 2010


There exists several treatment modalities for keratoses but the most notable is cryotherapy, which uses extremely low temperatures and which is also called cryosurgery. Studies reported that it is the second-most common procedure next to surgical procedures such as skin excision and it can easily be performed in the doctor’s office.

Various annoying skin lesions such as warts, actinic keratosis or seborrheic keratosis are frozen off from the body through the employment of very low temperatures – the process named as cryotherapy. However, this treatment process is recommended only for superficial, flattened or slightly palpable skin lesions for it has not always been successful in removing thicker lesions.

Are you being inquisitive on how cryotherapy works? Cryotherapy constricts the blood vessels at the site of the injury or in the case of keratoses, at the lesions’ site. This blood vessel constriction, most commonly referred to as vasoconstriction in medicine, results to a reduction in the blood flow to the site. In the absence of adequate blood supply, nutrients such as oxygen, which are very much needed by the cells, will not reach the cells. This finally results to necrosis or cell death on the lesions.

Liquid nitrogen, carbon dioxide snow and DMEP or dimethyl ether and propane, are some of the materials utilized to produce extremely cold temperatures and which are termed as cryogens.   But amongst the three, liquid nitrogen is the most commonly utilized cryogen by physicians primarily because of its low boiling point, making it a highly effective cryogen.

At the beginning of the treatment, the physician directly applies the liquid nitrogen onto the skin using a cotton-tipped applicator, a cryospray or a cryoprobe. Then, the heat from the skin instantly transfers to the liquid nitrogen making it evaporate quickly, usually within a minute or so. After this brief period of freezing comes the thawing of the lesions. This is the time that the actual cell injury starts to occur – when the intracellular contents begin to leak out. Cell inflammation, the last step of the process, finally sets in making the skin reddish, swell, painful and warm.

There are generally minimal adverse effects when the physician performs the treatment according to the guidelines. But complications are always a part of any procedure, be them low-risk or high-risk. To illustrate, prolonged freezing by the liquid nitrogen results to hypopigmentation or change in the skin color, specifically a lighter color.

Even though the Resource Conservation and Recovery Act does not consider liquid nitrogen hazardous, it still poses deleterious effects on humans who come in direct contact with it for this will result to rapid freezing of the tissues or even tissue death. There are two types of exposure to liquid nitrogen: inhalation and direct contact. Inhalation exposure is considered to be critical only if a huge amount of liquid nitrogen, reducing the oxygen levels in the air, is spilled. In order to prevent accidental exposure to liquid nitrogen, strict compliance to safety protocols, particularly in its transportation, must be observed.

When transferring liquid nitrogen probably into smaller containers, it can splash into the direction of the eyes causing injury such as cryogenic burn. Or there can be accidental direct contact with the skin.

Everyone must therefore conform to safety protocols 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 oxygen should leave an area exposed to liquid nitrogen leaks. And if liquid nitrogen ever comes in contact with the skin, and not during a cryotherapy, the frozen skin should be soaked in water that is 41-46 degrees Celsius in temperature before immediately consulting a doctor.

{ 4 comments… read them below or add one }

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