FREEZPEN – FAQs  

What is Cryosurgery?

Cryosurgery is a form of cryotherapy, specifically a procedure that uses extreme cold to destroy tissue. The process is cryonecrosis, i.e. tissue destruction by freezing.

How are tissues destroyed during cryosurgery?

Tissue destruction occurs when cells are rapidly brought down to a temperature of at least -80°F / -62°C and ice crystals form. The ice crystals break the cell membrane, destroying the cell organelles and protein matrices. Water then rushes into the surrounding area causing a blister and a disruption of the local blood supply.

How is freezing achieved?

The Joule-Thomson (JT) effect is a thermodynamic process that occurs when a fluid expands from high pressure to low pressure. The Freezpen works with very practical cartridges containing nitrous oxide (N20) at 725 psi. The cryogen is accurately applied to the lesion where it expands at -127°F / -89°C, rapidly resulting in an in-tissue temperature of -113°F / -80°C.

Liquid nitrogen is colder

Cell destruction in all benign tissues is achieved at  -80°F / -62°C. N2 (liquid nitrogen at –320°F / -196°C) and N20 (nitrous oxide at –128°F / -89°C) both achieve an in-tissue temperature of -113°F / -80°C within seconds. However, the excessive power of N2 is not required and may be damaging in many cases, such as for precise cryosurgery of verrucae and molluscum contagiosum, especially in children, and treatment of esthetic imperfections.

What are the quality criteria for cryosurgery treatment and the effect on the treatment?

It starts with the clinical evaluation of the size and the depth of the lesion. The better your tools are adapted to the individual situation, the better will be the outcome of the treatment.

How is cryosurgery better than other methods of removing skin lesions?

Cryosurgery requires no anesthesia and causes little or no scarring – certainly far less scarring than other techniques of skin lesion removal. And it requires minimal post-treatment care. Treatment is very fast and can be easily integrated into daily practice.

What types of lesions should not be frozen?

All melanomas and recurrent basal cell carcinomas.

Melanoma can spread by any of several means including local, lymphatic and blood. Additionally, melanoma will change to a much more aggressive form if part of the lesion is left behind undetected.

Basil cell carcinoma is typically spread by local extension and you may need more extensive surgery if recurrence is suspected.

Where on the body can skin abnormalities be removed from?

Care should be taken in sensitive areas of very thin skin and in areas in which color may be cosmetically important. For example, the face, ears, scrotum and lateral surface of fingers.

Can anyone have cryosurgery?

Yes, although skin type and location should be carefully considered prior to deciding on freeze times. People with high levels of cryoglobulins should be treated with caution. People with very dark skin may not want to have cryosurgery, as it will destroy the melanocytes around the treated area, making the skin in that area lighter.

Can the Freezpen be used on children?

Yes. The most common use of the Freezpen on children is for the treatment of verrucae and molluscum contagiosum.

The key advantages of the Freezpen in these cases are that lesions can be treated with extreme accuracy, no pain and no stress, in a single session.

What are the features of the Freezpen to achieve this quality?

Freezpen instrument is delivered with multiple interchangeable applicators that will precise  freezing of the lesion only. Various applicators will respond to the different sizes of lesions you will be confronted with. Treatment of the healthy tissue can easily be avoided which makes it a stress free procedure. When necessary patients will accept longer and deeper treatment which will promote more effective treatment and reduce time consuming repeat visits.

How many lesions can I treat with one cartridge?

2 cartridge sizes are available: 8g with 100 seconds and 16g with 200 seconds of constant flow time. In the event of a 2mm deep lesion, treatment time will be 10 seconds. You will do 10 of those lesions out of an 8g cartridge.

How permanent is the cure?

For most lesions, cryotherapy is a permanent removal. Some lesions are harder to remove than others. In more delicate places a shorter freeze time with repeat procedures may be required to get a final result with the least damage to the surrounding skin. In other instances a deep lesion may take several aggressive treatments to get final results. It is important to have an instrument that is capable of adapting to variable dosing of power.

Will there be permanent discoloration or hyper coloration?

Since melanocytes are the most sensitive cell type, persons with dark pigmentation or prolonged freeze times in any individual may cause extremely long color recovery or permanent color loss, even after the lesion is healed in other respects. It is important to will be careful when dealing with pigmented spots on dark color skin. Extreme attention is required in patients with apparent high shifts of pigment activity (many spots). The risk of post-inflammatory hyper-pigmentation is high in these patients. Always test-wise treat one spot and continue treatment at a checking of the positive result after 3 weeks. Best possible attention should be addressed to the protection against the sun of all treated areas in all cases, disregard the season of the year.

Will patients activities be limited, and for how long, after the procedure?

There are no limitations on activity except to protect the treated area from damage or abrasion. Swimming and showering is not a problem.

What are the most common complications after cryotherapy?

The treated area is shifting skin and can potentially become damaged and infected if not cleaned properly.

What type of skin abnormalities are most appropriate to freeze?

Almost any unwanted skin lesions are appropriate such as warts, skin tags, actinic keratosis, seborrheic keratosis, lentigos, dermatofibromas, hemangiomas and other benign skin imperfections.