Cryotherapy aftercare

Cryotherapy aftercare is simple and in many cases, no specific aftercare treatment is necessary.

Cryotherapy is commonly used to treat solar keratoses (actinic keratoses) and some superficial basal cell carcinomas.

Many people leave the treated spots uncovered and allow them to heal naturally over the next few weeks. Discolouration of the skin is very common after cryotherapy. It’s not always avoidable, but to reduce the risk, we recommend simple steps to seal the wound and encourage healing.

What to expect as the skin heals

• First 24–48 hours — redness, swelling and sometimes blistering at the treated site. This is a normal response to treatment.
• Days 3–7 — blisters dry and flatten, or a scab forms over the treated area.
• 1–3 weeks — scab separates and new pink skin forms underneath.
• Several weeks onwards — redness gradually fades. Final appearance can take several months to assess. Pigment changes sometimes persist, and healing can take longer on sites such as the lower legs.

What is normal and what is not

Normal after cryotherapy:

• Blistering, scabbing or crusting at the treated site
• Redness and mild swelling
• Clear fluid weeping from a blister
• Small amount of bleeding into a blister
• Gradual healing over 1–3 weeks

Contact the clinic if you notice:

• Pain that is increasing after the first 1–2 days
• Spreading redness or warmth beyond the treated area
• Thick discharge or pus
• Fever or feeling generally unwell

Pain relief

During treatment, the pain of cryotherapy is an extremely cold, sharp, stinging sensation. This settles almost immediately to a milder pain which usually lasts a few minutes, but may persist for some hours. The treated area sometimes feels mildly irritated or itchy after this. Paracetamol can be used for mild discomfort if needed.

Headache can occur following cryotherapy to the scalp or forehead. This is a tension headache, caused by tightening of the scalp muscles in response to the treatment. The headache usually responds well to simple pain killers, warmth or massage and rarely lasts more than a few hours.

Managing the treated area

Dressings

If there are no sores, blisters or scabs in the treated area, no dressing is required.

If your treated area develops a sore or a blister, cover it with a Band-Aid or similar adhesive dressing for 3 days. If you don’t like the appearance of the treated area while it heals, you can cover it with a further dressing but this is optional.

Managing blisters

Blisters are a common result of cryotherapy treatment and may appear in the first few hours. Blistering reflects the skin’s response to freezing; it does not prove that the lesion has cleared. Blisters are usually painless, but they may weep a small amount of clear fluid.

In some cases, bleeding may occur into a blister. This is unsightly but not dangerous and will usually settle without treatment. Don’t puncture blisters. Punctured blisters are more painful and take longer to heal.

We recommend covering the blister with a Band-Aid or other simple dressing for a few days.

Avoid antiseptics, powders or other unadvised products on the blister. Your clinician may specifically recommend a wound-care hydrogel such as Epicyn; this is different from applying an ordinary scar cream. Use it as directed for your wound.

Inflammation

Sometimes after a large or raised lesion is treated (e.g. a skin tag), the lesion itself and the surrounding skin becomes swollen, red and tender to touch. This is not necessarily a sign of infection; it can be a normal response as your immune system reacts to the damage caused by cryotherapy. This inflammation usually improves in 1–2 days without treatment but you should contact the clinic if you have a fever or if pain doesn’t respond to paracetamol or other over-the-counter pain killers.

What can I put on the skin as it heals?

If the surface of the skin remains intact, you can treat it the way you would normally, using sunscreens, moisturiser and other skin care products as usual.

If the treated area forms a blister, sore or scar, you should wait until the surface is healed or dry and crusted before washing with anything other than plain water. In general, when washing your skin, we recommend a soap substitute such as Cetaphil, Aveeno or Dermaveen wash.

Silicone gel, applied two or three times daily, helps to seal open wounds and can reduce the risk of infection or scarring. Apply after gentle cleaning, or use under a dressing if the area is open. We usually recommend Epicyn or Stratamed gel for open wounds.

Open wounds or blisters should be covered with a Band-Aid or other dressing to protect them from sunlight while they are healing. If you can’t cover wounds with a dressing, use a silicone gel. You can apply sunscreen over the top.

Sun protection

Healing skin is more sensitive to UV exposure and more prone to pigmentation changes. Keep the treated area covered or protected from direct sunlight while it heals. Once the skin surface has closed, apply SPF 50+ sunscreen to the area daily.

Activity

Avoid swimming in pools or the ocean while any blister is open or weeping. Normal activity can resume once the skin surface has healed.

LED light therapy

LED light therapy can sometimes be used after procedures such as cryotherapy or biopsy to support wound healing and reduce inflammation. Low-level light treatments may help stimulate the skin’s natural repair processes and can be useful in patients at higher risk of delayed healing or scarring.

If appropriate, your doctor may recommend LED light therapy to help support healing after the procedure.

When to have the area reviewed

Book a skin check if:

• The treated spot has not resolved after several weeks
• The lesion appears to return or change after initial healing
• The diagnosis was uncertain at the time of treatment
• New or additional spots appear nearby

Recurrence after treatment

Cryotherapy treats solar keratosis, seborrheic keratosis, superficial BCC, Bowen’s disease or other skin lesion from the top. It works best on thin, flat lesions.

Because cryotherapy sometimes leaves a scar, we may prefer to treat gently. This reduces the risk of scarring, but it means that the deeper part of the skin lesion might not have frozen completely. This can lead to recurrence of the skin lesion.

In these cases we are usually happy to re-treat the lesion, but we might recommend alternative treatment with a higher success rate, depending on the lesion to be removed.

If you develop a new or changing spot in the future, it is important to have it assessed with a skin cancer check.