Removing warts with liquid nitrogen: how the procedure is performed and its effectiveness

Warts appear on the face, fingers, feet, and body. The occurrence of the neoplasm is surrounded by numerous speculations. There are a lot of folk signs that explain the appearance of warts - there is wealth, good news, and much more. However, the real reason is skin infection by a virus.

Removing warts with liquid nitrogen

The development of the neoplasm occurs against the background of decreased immunity, which significantly “facilitates” the invasion of the virus, increases the risk of infection and the growth of papillomas and warts. And this means that the main reason may be hidden behind skin manifestations. The well-known expression that the skin is a mirror of the condition of the internal organs should make you wary and seek advice from a doctor.

One of the reasons for the development of neoplasms is weak immunity.

Benign formations can degenerate into malignant ones and threaten human life. A reasonable and necessary precaution is to contact a medical professional and follow their recommendations.

Therefore, if such formations appear on the skin, their color, surface character, quantity, or size change, you must be careful and contact a medical facility. Changes in the skin often indicate internal illness. In any case, the problem is best treated if detected early.

The appearance of such neoplasms is a reason to consult a doctor.

Important ! Every person, organizing his life, strives to maintain his protective forces. Natural immunity is an important factor in the health of the skin and its appendages. The stronger the body, the less chance viruses and other pathogens have. However, the appearance of warts indicates a certain “failure” of the natural mechanism.

It is important to pay attention to the immune system, which is the body’s natural defender.

Modern medicine offers reliable diagnosis and effective treatment of warts. To eliminate the tumor, you can resort to several methods. One of them is cauterization of warts with liquid nitrogen. What is the method? How painful is it? Is it possible for warts to reappear after this treatment?

You will find answers to these and other questions in the article.

Types of warts

Medical specialists distinguish several types of warts depending on their location, the age of the patients, and the properties of the virus. So, warts are distinguished:

• vulgar (translated from Latin into Russian - ordinary);
• by localization – palmar-plantar;
• juvenile – most often occur in children, adolescents, girls and boys and are characterized by a flat surface, round or irregular shape;
• genital warts with a characteristic location in the area of ​​the external genitalia, intergluteal and inguinal folds;
• Senile skin changes associated with aging.

There are several types of warts

Viral warts are one of the most widespread infectious skin pathologies. Statistics show that women and children most often seek medical help. This fact in no way indicates that this group is at risk for uncleanliness.

Important ! The most likely reason for this selectivity of the virus is the thin skin of the fairer sex and children.

Viral warts are common in women and children

Children are often exposed to microtraumas while playing and interacting with pets. The risk of skin growths in patients of a younger age group also increases the risk of imperfection of the immune system and its ongoing development. Children's skin is physiologically “thinner”, as it has three layers. In adults, the skin has five layers with different functions.

Warts occur after careless actions or as a result of infection

Age-related warts reveal themselves as darker in color. Externally, they look like a brown or gray-black, round or oval formation on the skin, which rises several millimeters above it.

Important ! The reason is a slowdown in the physiological regeneration of the skin, disturbances in the secretion of the sebaceous glands.

Darker colored warts are considered age related.

Genital warts look like papillary growths of pink color and elastic consistency. They are characterized by ulceration of the surface and the presence of an unpleasant odor.

According to experts, the characteristic localization of warts indicates neglect of personal hygiene rules. This version is confirmed by the data that in 60% of cases the pathogen - HPV infection - is transmitted sexually through contact with an infected person.

The main reason for the problem is neglect of personal hygiene

To confirm the diagnosis, HPV tests are performed and, if the result is positive, complex treatment is prescribed. It includes agents for local use, as well as systemic action: antiviral drugs, immunomodulators.

It is believed that flat or juvenile warts have the most favorable course. They owe their name to their appearance: small, multiple nodules, similar in color to healthy skin. They are called juvenile because such formations are more often found in children and adolescents of both sexes. The most typical locations are arms, legs, face.

Important ! Such skin manifestations should not be ignored, especially when they spread over large areas of the body.

We need to deal with this problem as quickly as possible

The most common type is wart vulgaris. Despite the fact that when translated into Russian they are referred to as “simple” or “ordinary”, the causative agent is also HPV.

Infection occurs through injury to the skin. Once in favorable conditions, the pathogen actively reproduces. After a few months, a wart appears.

Vulgar warts of a round shape can most often be seen in people

Important ! Simple warts are round in shape. They rise above the skin level. The size can range from 2 to 5 mm or more (on average no more than 1 cm).

This variety has the appearance of growths, that is, the rashes are multiple in nature. The appearance of one wart entails the appearance of a daughter wart located next to the first. A characteristic phenomenon is “kissing” warts - the elements are located opposite each other and are constantly in contact. A common example is warts located on two adjacent fingers.

Warts can grow and increase in number and size

The spread of the process on the skin is a sign of virus multiplication. Timely diagnosis and elimination of the cause in one of the following ways is important for maintaining the health of the skin and the body as a whole.

Treatment methods help eliminate all known types of warts. The liquid nitrogen cryodestruction technique is simple and effective. It provides a deep effect on the local area of ​​the skin by freezing the damaged area.

Liquid nitrogen freezes the wart, making it easier to get rid of

GUIDE TO CRYOSURGERY for general practitioners

What principles should cryosurgeons follow? What benign formations are subject to cryosurgery? What are the main side effects of cryosurgery procedures? What is the best way to organize a cryosurgery department in general practice?

It is well known that cryosurgery is easily adaptable to the capabilities of general practice, and the number of general practitioners offering cryosurgery procedures to their patients continues to grow. This trend may have been initially supported by additional payments to general practitioners for performing minimal surgical procedures, but today the effectiveness of dermatological cryosurgery in primary care and the availability of liquid nitrogen play a major role.

The doctor must have a clear understanding of the basic principles of cryosurgery. Inadequate treatment of even benign skin lesions often leads to complications, and an unjustified choice of treatment for malignant tumors can have very serious consequences.

Table 1. Surface tissue temperatures achieved using various cryogens

Cryogen and operator.

A number of cooling agents have been used in clinical practice in the past. In table 1 shows the types of modern cryogens along with the corresponding decrease in surface temperature during their action.

For the treatment of benign superficial skin formations, a temperature of -200C is sufficient; malignant neoplasms require more severe regimes - up to -500C.

Liquid nitrogen, whose boiling point is –1960C, has the highest “deadly” subzero temperature for tissue destruction. Dry ice and nitric oxide provide adequate subzero temperatures for benign growths or superficial areas of sun-damaged skin such as solar keratoses, but are not as good as liquid nitrogen for destroying malignant skin growths.

Due to its availability, liquid nitrogen is often used in cutaneous cryosurgery. There are different freezing regimes recommended for different skin lesions.

Cryosurgery using dry ice and nitric oxide requires a longer exposure time than with liquid nitrogen, which should be kept in mind by clinicians transitioning from dry ice and nitric oxide to liquid nitrogen; to avoid side effects and complications.

It is also important that the operator is “experienced” in the treatment of benign tumors before moving on to the treatment of precancerous and cancerous tumors.

If there is no certainty about the origin of the tumor or a preliminary biopsy has not been performed, the cryosurgical method cannot be used.

The supply of liquid nitrogen can be arranged from several sources. Most suppliers of equipment for cryosurgery include in the contract the supply of flasks with liquid nitrogen of various volumes to the customer.

The pharmacy department of the local main hospital is usually happy to provide liquid nitrogen. In this situation, it is best to organize a group of patients in a permanent department, so that liquid nitrogen is delivered, say, once a month in a special transport container with a protective container.

The author has his own 50-liter Devar flask, which is replenished by the supplier every six weeks.

Cryofreezing.

Regardless of the equipment and method used, a white ice field forms on the surface of the skin during cryofreezing. Subsequently, deeper tissues are involved in the freezing process (Fig. 2).

Histologically, cryofreezing causes ischemia and necrosis through direct cell injury, thrombosis, and microvascular failure. The faster the cooling, the lower the temperature achieved, and the slower the thawing, the more cells die.

The extent of tissue damage is related in part to the duration of freezing, but other factors are also important. Different cells, tissues and organisms have different intrinsic sensitivity to cold (Table 2). Melanocytes and basal cells die easily, while fibroblasts, collagen, nerve tissue and blood vessels are relatively immune to cold injury.

This fact constitutes one of the main cosmetic advantages of cryosurgery: negligible effect on connective tissue and relatively little damage to blood vessels and nerves under normal therapeutic regimens.

Vascularization of the underlying tissue also influences the rate or extent of cold injury. I also note that bacteria quickly die from freezing, but viruses do not.

Equipment and method.

The simplest way to deliver liquid nitrogen to the treatment site is to apply nitrogen using a cotton-wool swab, which is dipped into an open flask with nitrogen and pressed against the formation being treated until a white ice border appears around the swab (Fig. 1).

Table 2. Relative sensitivity to cold damage

For larger lesions, repeated dipping and pressing of the swab may be necessary. In this case, to prevent cross-contamination between patients, it is necessary to stock up on small individual metal containers filled from a common flask.

Liquid nitrogen applied in this way makes it possible to achieve a temperature of the cooled surface not exceeding –200C. The technique is suitable for the treatment of benign superficial skin formations. These include superficial viral warts (the insulating properties of keratin in thick formations preclude cryosurgery), thin seborrheic warts, or very thin areas of solar keratosis (Figure 3). If there is the slightest doubt about the diagnosis, solar keratosis is subjected to a curettage biopsy.

The most effective method of using liquid nitrogen involves applying it to the formation using a spray. Today, cryosurgeons have several hand-held cryosurgical units at their disposal.

Cryoguns such as the CRY-AC (Figure 4) come with a 300- or 500-milliliter general liquid nitrogen flask. Its trigger effect allows you to precisely control the process and minimize the size of the resulting ice field. The set includes a variety of spray tips and probes, as well as angled and sliding extenders, allowing for more flexible application at different angles.

The freezing spot spray technique involves placing the tip of the liquid nitrogen spray at a height of about 1 cm above the center of the formation or surface being treated (see Fig. 5). With the start of processing, a circular “ice field” is formed.

If ice forms in the desired area, continue processing to maintain the size of the field for a time appropriate to the nature of the formation being treated (from 5 to 30 seconds). The time of freezing should be noted in the medical history, for example, a single 20-second exposure to the spray can be abbreviated as follows: Liq. N2 20s. one FTC (freeze-thaw cycle).

When treating benign lesions larger than 2 cm in diameter or irregular in shape, the freezing spot can be modified by applying a “pattern” or spiral to ensure sufficient freezing of the entire lesion.

I don't use the cryoprobe often, but there are times when it works best:

• formations that require particularly precise and careful treatment, such as small seborrheic warts near the eye or on the eyelid;
• labial mucoid cysts, usually located on the mucous lining of the lips;
• some types of warts (see below).

When treating small or irregularly shaped lesions (especially malignant lesions such as cutaneous carcinoids that require a full freeze-thaw cycle) and surrounding areas or structures that require protective measures (such as the eyes), I prefer to use the guide as a protective field.

First, the edge of the lesion is outlined with a marker, covering at least 3 mm of healthy skin. A piece of guide with a hole of suitable size and shape is applied so that it surrounds the treated area. When treated with liquid nitrogen, the guide freezes to the outlined margins, protecting the normal surrounding tissue from cold damage.

Thick, raised warts are relatively resistant to cryotherapy. The best results are achieved by first cutting off most of the keratin and then applying liquid nitrogen through an ear specula with an opening slightly larger than the size of the wart until an icy spot forms (Figure 6). The method allows you to achieve a good depth of limited freezing without cold damage to surrounding tissues.

All cryooperators should adhere to the following rules:

• be sure of the diagnosis, in doubtful cases, do a biopsy before freezing;
• do not treat children under 6 years of age;
• Explain the detailed procedure to the patient and provide him with an information booklet;
• treat deep or malignant tumors under local anesthesia;
• note freezing times, cycles and techniques - this allows you to establish a connection between freezing time, technique and result, and will help other doctors observing the patient to choose further methods of treatment.

Diagnostics.

It is useful to always keep the following in mind.

The patient must first be examined by a general practitioner who makes the diagnosis. If there is the slightest doubt about the correctness of the diagnosis, the cryosurgical method is not used. All malignant or suspicious lesions are biopsied prior to the cryosurgery procedure.

The medical record must include an explanatory histopathological report. And one last thing. If you have doubts about the correctness of the patient’s treatment method, honestly tell him about them and refer him to the appropriate specialist.

• Benign formations subject to cryosurgery

Cryosurgery is a fast and effective method for treating common benign tumors. If necessary, side effects and complications can be minimized by leaving the benign tumor untreated. Then, taking into account the reaction to the first procedure, a decision is made regarding further treatment.

Warts.

Most warts can be treated at home using astringents. If the patient agrees to cryosurgical treatment, some common and flat warts can be easily removed with liquid nitrogen using a cotton wool swab or spot freezing spray.

The first time, liquid nitrogen is applied once and for no more than 5 seconds, since some patients have increased sensitivity to it (Fig. 7). Subsequent treatment is determined by the response to the first exposure.

The best results are achieved with repeated treatments at intervals of three to four weeks. When treating periungual warts, shorter repeated freezing sessions should be used to avoid causing severe pain to the patient and to avoid excessive damage to the nail matrix.

Warts around finger joints, nerves and tendons also need to be treated very carefully. For finger-shaped warts, especially on the face, I prefer to scrape them out under local anesthesia using a small ophthalmic curette and then lightly work the base with a fine heat cautery.

Viruses are relatively immune to liquid nitrogen (Table 2), and it is the destruction of the wart tissue that leads to the desired result. However, liquid nitrogen appears to stimulate an immune response to any existing warts, increasing treatment effectiveness and resistance to infection. Keratin does not pass liquid nitrogen well, so large warts must first be cut off with a scalpel. Thick, raised, circumscribed warts are better treated with the help of an ear funnel.

It is necessary to weigh the pros and cons before prescribing cryosurgical treatment for plantar warts. I initially treat most mosaic plantar warts with repeated 5% formaldehyde soaks and trimming of the rough tissue. This procedure is painless, and with good understanding with the patient and clear instructions, it usually gives a good result. Thick localized warts can also be treated with liquid nitrogen, after first cutting off the surface layer of keratin and using a probe slightly smaller in diameter than the formation itself. The use of special jelly ensures good contact with the probe throughout the entire freezing cycle. Freezing must continue long enough to form an ice rim around the probe. This method provides good, local, deep freezing with minimal damage to surrounding tissue, which reduces the likelihood of postoperative complications.

Seborrheic warts (keratoses).

Seborrheic warts multiply with age and normally do not require treatment. Indications for treatment include persistent irritation, disfiguring appearance (especially on the face), or disturbing pigmentation changes and occasional bleeding.

Such formations are easily removed with a relatively short-term single cryospray (4-8 seconds), and the spray should not extend beyond the formation by more than 1-2 mm. However, for thicker keratotic lesions or at the slightest suspicion of malignancy, especially highly pigmented lesions, curettage biopsy and thermocautery under local anesthesia are necessary (Fig. 8).

Purulent granulomas.

Post-traumatic or wound granulomas respond well to cryosurgical treatment. A 20-30 second freeze may be required here. If there is any doubt about the diagnosis, a biopsy is performed before or immediately during freezing.

I believe the proper treatment for a true ingrown toenail is to remove it. Cryotherapy helps reduce inflammatory granulations before the decisive stage of surgery.

Labial mucoid cysts.

To remove these benign formations, a single 10-20 second freezing with a cryoprobe of a suitable size is sufficient. If contact with the underlying mucosa occurs at the beginning of freezing, it is sufficient to slightly change the direction of application to reduce the risk of unnecessary cold damage to deep tissues.

Soft warts, body nevi and vascular formations.

The simplest way to treat soft warts and pedunculated papillomas is to cut them off and lightly treat them with a thermal cautery or simply cauterize them under local anesthesia or without it, depending on the patient’s wishes and the size of the formation.

Benign, elevated “body” nevi with many years of experience can be treated with cryosurgical treatment using a spray or probe. However, excellent cosmetic results with minimal complications are achieved by simply cutting off the lesion with a scalpel just above the surface of the skin and gently cauterizing it under local anesthesia. This allows for histological examination if there is the slightest doubt about the benignity of the nevus.

On the contrary, “spider” nevi respond better to “cold” cauterization using a special hot needle, which is included in the equipment of most electrocautery departments. The technique allows for coagulation of the main feeding subcutaneous vessels, which leads to involution and emptying of small tributaries without subsequent changes in pigmentation, which can develop when a cryoprobe is exposed to the entire nevus.

Hemangiomas are effectively treated by cryosurgery using a cryoprobe or auriscope. If the origin of the hemangioma is in doubt, a biopsy is performed.

With the right patient selection, equipment and skills, cryosurgery using liquid nitrogen represents a promising option for the treatment of some precancerous skin lesions, including Bowen's disease, and skin cancers such as basal cell carcinoma.

However, the purpose of this article is to discuss the safe use of cryosurgery in the treatment of benign skin lesions. Physicians wishing to improve their skills in cryosurgery should first consult more specialized literature (see list below for further reading) and gain practical experience under the supervision of a cryosurgeon.

• Side effects, complications and limitations of cryosurgery

During the freezing and thawing phase, patients always experience pain, and they should be warned about this before the cryoprocedure (see section “Tip List A: Wart Cryosurgery”). When treating extensive lesions and malignancies using more aggressive freezing regimens, local anesthesia is required.

In sensitive patients, blistering may occur even with short-term freezing using cotton wool swabs. Therefore, you should not delay the first procedure when treating benign formations, and you need to note the time to use it in subsequent procedures as a starting point.

The bladder may be filled with bloody contents (Fig. 7). Such a bubble looks scary, but it is easy to treat: it is opened with a sterile needle and a dry bandage is applied. Recovery occurs within one to two weeks.

After a cryosurgery procedure, it is not uncommon to develop edema or tissue swelling, especially in loose tissue of the eyelids and lips and when using the harsh freezing regimens required to treat malignancies. It is important to warn the patient about the possibility of developing edema (see section “Tip List B: after a cryosurgical procedure”). To alleviate the condition, an ointment containing steroids is used.

Changes in pigmentation after a cryosurgical procedure vary in severity. Often, even after treatment of benign neoplasms, post-inflammatory hyperpigmentation develops. It usually disappears gradually. Long-term cryogenic regimes can lead to subsequent hypopigmentation.

In cases of pigmented or tanned skin, it is worth considering alternative treatment methods to cryosurgery.

Hypertrophic scars rarely form during cryotherapy at therapeutic doses. The initially forming scab or subsequent keloid scar is usually characteristic of long-term cryogenic regimes. When using less than short-term regimens, hair follicles often die, so it is better not to use this method for treating the scalp or beard area. Damage to cartilage is caused only by the most severe freezing regimes.

• Organization of the cryosurgery department

To organize a service at a high professional level, you need to consider the following.

• Adequate training for doctors and nurses
• Acceptable source of liquid nitrogen
• Correct installation of cryosurgical equipment, local anesthetics, dressings, etc.
• If a biopsy is required, biopsy kits, local anesthetics, sutures, dressings and a histopathology kit are required
• The doctor and nurse must have time to work in the clinic.

Cryosurgery training

Cryosurgery is a fairly simple and effective technique that is increasingly used in pediatrics and nursing services, as well as by general practitioners.

Appropriate training must be completed so that the operator reaches a high level of competence before performing cryosurgery.

Training is carried out in different ways

• Many postgraduate training centers offer basic surgical courses for general practitioners. These typically include cryosurgery sessions under the supervision of a dermatologist or general practitioner with relevant experience and are often supported by cryosurgery equipment suppliers. General practitioners who can work in departments of medical centers or even lead nursing departments are also invited to these courses.
• Most consultant dermatologists welcome the desire of general practitioners to use cryosurgery to treat warts and benign growths and support their training in the future if the opportunity arises
• General practitioners trained in cryosurgical techniques may want to train nurses to treat warts. Any growth should initially be examined and assessed by a general practitioner. If a department is organized under the leadership of a nurse, it is important that she has sufficient experience and competence

List of tips A: cryosurgery of warts

• Your wart(s) have been treated with liquid nitrogen. Freezing destroyed the wart tissue. A feeling of stabbing pain appeared during treatment and may persist for some time, but, as a rule, the pain goes away after a few minutes. If the pain returns later, aspirin or paracetamol will give you relief.
• A blister may form over the treated area within one to two days. This is normal, cover it with adhesive tape. If you have any cause for concern, tell your GP
• After four weeks, you should visit the wart treatment department again to ensure that the treatment was adequate.

List of tips B: after a cryosurgery procedure

• After treatment with liquid nitrogen, the treated area will swell greatly and become wet. These phenomena can be significantly reduced if gauze with an ointment containing an antibiotic and a steroid drug is applied to the surgical area. The gauze is held in place with adhesive tape. The doctor will make the appropriate appointments
• After 10–14 days, a hard, dry, black, tight-fitting crust will form at the site of exposure. You will have to wait a week, or maybe a month, before it falls off and in its place there will be a pink scar that will definitely turn pale
• After the procedure there should not be much pain, but if necessary, you can take paracetamol. Rarely, severe pain or swelling indicates infection. In this case, the doctor will prescribe you a course of antibiotics. The nurse will show you how to change the bandage and clean the wound
• For any problem related to cryosurgery, please seek advice from the medical center

Signs

So, in order to “see” a wart, you need to know its characteristic signs:

• as a rule, such a formation does not hurt;
• size can vary from several mm to 1 cm;
• the formation may be single or part of a growth (the latter include vulgar warts or genital warts);
• looks like a growth, rises above the skin;

  
  The wart usually rises somewhat above the skin

• surface without skin pattern;
• depending on the age of the person, it can be smooth or rough, flaky;
• to the touch is defined as dense, hard;
• the color in young patients does not differ from healthy skin, in older patients it may have a dark color;
• most often localized on the hands, for example, due to frequent skin trauma.

Warts often appear in the area of ​​the hands

Independent use of pharmaceutical products for cryotherapy

Liquid nitrogen in special containers is purchased by medical institutions and industrial enterprises. This drug is not sold in small containers in regular pharmacies.

For cryotherapy at home, there are liquid nitrogen substitutes on sale that have a similar effect - CryoPharma and WARTNER Cryo. In both drugs, the active ingredients are:

• dimethyl ether;
• liquefied propane gas.

Cryopharma and Wartner cryo burn out plantar and common warts.

These drugs should not be used on the delicate, thin skin of the armpits or genitals.

Use of refrigerants at home may cause scars on the face and neck.

Step-by-step instructions for using Wartner Cryo

1. The skin is steamed for half an hour in warm water and dried with a towel.
2. The wart is treated with a nail file to cut off the stratum corneum.
3. The blue part of the applicator is slightly squeezed until a hole appears, and put on the rod of the nozzle (holder).
4. The holder is inserted into the can and pressed firmly (at least 3 seconds) until a hiss appears.
5. The applicator, saturated with reagents, is removed from the can.
6. Wait 20 seconds. During this time, the refrigerant temperature continues to decrease. After this time, the applicator is ready for use.
7. The applicator is applied to the wart and held for 40 seconds (with light pressure) to cauterize the growth with low temperature. At this time, a slight tingling sensation may be felt on the skin.
8. The procedure can be repeated three times, once every 14 days.

Precautionary measures

Home procedures should be carried out carefully

All precautions are indicated in the instructions for the can.

• Wartner Cryo and Cryopharm products should not be used by pregnant women or nursing mothers; they are not used in children under four years of age.
• The product is not intended to remove formations of unknown origin and moles.
• The can cannot be stored near heating devices.
• The cylinder should not be exposed to sunlight.
• The storage temperature of the cylinder should not exceed plus 25 degrees.
• The product should not be used by children.
• The same applicator cannot be reused.

Cryotherapy is treatment (cauterization) with liquid nitrogen. This procedure made a real revolution in medicine and cosmetology, becoming an alternative to surgical intervention and drug treatment - the human body’s natural desire for self-renewal and self-rejuvenation

Cryotherapy is cold treatment, the effect of ultra-low temperatures (-100-160 C) on body tissues. The liquid nitrogen treatment procedure has a mild stimulating therapeutic effect and produces pronounced immunomodulatory, anti-inflammatory and analgesic effects.

“Cryotherapy treatment” (eg cryosauna) is accompanied by the release of endorphins, the “hormones of happiness”, therefore it is a very pleasant and safe procedure, in demand by both women and men.

Cryotherapy with liquid nitrogen causes a spasm of blood vessels and then their persistent dilation, due to which the metabolic process is accelerated and blood circulation is improved, regeneration is significantly enhanced.

Wart removal

Wart removal procedures:

• the use of a surgical laser ensures safety, moderate pain, and effectiveness;
• cryodestruction – deep cauterization with liquid nitrogen;
• electrocoagulation - under the influence of high-frequency current, the wart is cut off and the vessels are coagulated to avoid bleeding;
• classic method of excision of a tumor with a scalpel.

There are different ways to remove warts

Important ! Even in the recent past, the main method was the use of surgery with skin dissection and a long period of rehabilitation. Potential complications included infection and the formation of rough scars. At the current stage of development of medical cosmetology, advanced technologies are used that combine safety and reliability.

Nitrogen storage and transportation

Nitrogen is released in accordance with GOST 9293 in gaseous and liquid forms. For welding and plasma cutting, gaseous grades 1 (99.6% N2) and grade 2 (99.0% N2) are used.

It is stored and transported in a compressed state in steel cylinders in accordance with GOST 949.

The cylinders are painted black with the inscription “NITROGEN” in yellow letters on the top cylindrical part.

In what cases is it necessary to consult a dermatologist?

You should think about removing warts in the following cases:

• “unsuccessful” localization of the wart, in which there is a constant risk of injury – neck, armpit area, groin, eyelids, fingers, sole;
• discomfort from an aesthetic point of view;
• bleeding from a wart due to injury or without it;
• complaints of itching, tingling, pain in the area of ​​formation;
• an increase in the size, number, shape, surface, color of warts.

In certain cases it is better to go to a dermatologist

Properties and characteristics

The substance is standard nitrogen N2, which has been converted into a liquid state. In accordance with the chemical characteristics of this gas, it becomes a liquid if it is cooled to a temperature of -196 ° C or 77.35 K. In production, it is also necessary to pump up high pressure - 101.3 kPa.

The main properties of the product include:

• Nitrogen has no odor or color. It is important to check the container in which it is stored and transported. Leaks are very difficult to notice and much easier to prevent.
• The substance is capable of gradually changing its boiling point. This occurs due to the fact that when nitrogen enters the air, it begins to gradually draw oxygen out of it. This also poses a danger to humans - in such conditions suffocation can occur.
• Nitrogen can freeze. To do this, its temperature is reduced to -210 ° C (63 K). At the same time, the formation of surface vacuum is added to the list of requirements. In industry, for this purpose, sealed containers and vacuum deposits are used, which can pump the required pressure inside.
• The density level of the substance in the liquid state is 808 kg/m3. In this case, the indicator changes along with the change in pressure.

The use of liquid nitrogen is explained by its ability to cool other objects or substances, as well as create an optimal conservation environment. Properties are in demand in many industrial fields.

The production process for obtaining N2 in liquid form is quite complex and requires the use of a large amount of special equipment. The most commonly used method is to liquefy atmospheric air. The substance enters the distillation column, where separation occurs.

Liquefaction of nitrogen, which is in a gaseous state, is also practiced. In this case, two methods of air separation are used - membrane or sorption.

The finished product is pumped into specially prepared and pre-tested containers and sent to customers. It can be used directly in production, without additional preparation.

Description of the method

Cryodestruction is carried out in two ways. With hardware, a special instrument is used - a cryoprobe or a technical medical cryoapplicator, through which liquid nitrogen is supplied.

In the manual method, cryodestruction is carried out using cotton wool on a wooden stick. This method is used most often in medical clinics and offices.

Manual cryodestruction is extremely popular today

Important ! The manipulation can be carried out under local anesthesia if the wart is large in size, found in an area of ​​sensitive skin, in pediatric patients.

Liquid nitrogen is applied to the affected area by applying pressure with a cotton swab for 10-40 seconds. If necessary, re-cauterization is performed.

You need to cauterize the wart with liquid nitrogen for 10-40 seconds

After cryodestruction, the skin becomes pale and dense. Then redness, swelling appears, and a bubble with yellowish or reddish-yellow contents forms in the cauterized area.

The latter dissolves on its own within a week, leaving behind a crust. After two weeks, the crust peels off painlessly, forming a pale pink spot on the skin.

After the procedure, a crust remains on the skin

When treating flat warts, the skin shading technique is used. With quick, gentle movements, the doctor moves over the affected area, using low pressure. A slight discoloration appears in the treatment area.

Important ! The manipulation is repeated 3-4 times with breaks of several minutes. After 5-7 days, the skin darkens, begins to peel off, and the formation disappears.

Cauterization of warts located on the sole

Warts on the sole may not appear for a long time. But as the tumor grows into deeper layers, complaints of discomfort and pain when walking appear. A common location is the sole in the heel area, the pads of the toes. Children often suffer from warts on the soles.

When performing cryodestruction in the area of ​​the sole, exposure to ammonia lasts longer, the pressure on the wart is greater, and therefore the pain is more pronounced.

Using ammonia causes more pain during the procedure

It is also necessary to take into account that in this case repeated treatments are required according to the scheme of 2-3 sessions every 2-4 days. In unfavorable cases, treatment may take up to 4-6 months. The healing and rehabilitation period may take several weeks, as pain and swelling make it difficult to step on the painful area of ​​the foot.

Cost of services in salons

Moscow

Saint Petersburg

Krasnodar

Rostov-on-Don

Nizhny Novgorod

Voronezh

Volgograd

Ekaterinburg

Yaroslavl

Tver

Healing period

After the bubble appears, do not allow the wound to become wet or injure. For faster healing, you can apply medicinal solutions as recommended by your doctor. They help dry the wound surface. Once the tissue has been exfoliated, treatment can be stopped.

It is necessary to apply solutions during the healing of warts

It is important to maintain personal hygiene without damaging the wound. To do this, it is enough to protect it from external influences with a gauze cloth, and secure it on top with an adhesive plaster or bandage. Do not apply the adhesive plaster directly to the wound.

A small blister heals on its own - there is no need to puncture it or try to quickly shrink it. It must be taken into account that under the contents of the bladder there is an active process of wound healing.

Important ! If it is interrupted, the skin will lose its protection and begin to crack; it will take longer to recover.

You have to wait for the bubble to burst

After 5-6 days, the bubble opens on its own, possibly during sleep or active movements of the hands.

If there are no signs of inflammation, no healing agents need to be applied. It takes another 5-7 days for a crust to form, under which safe skin restoration will continue.

The crust is the first sign of the beginning of skin restoration

When treating small warts, the cauterization time is no more than two to three seconds. No blisters form on the skin. This does not mean that there was no therapeutic effect.

All other signs of exposure to liquid nitrogen remain - pain, redness, swelling.

Important ! A single cauterization of small formations with nitrogen leads to a cure. Larger warts must be treated repeatedly.

The number of procedures depends on the size of the wart

When treating foot warts, it is necessary to keep the body clean. Washing your feet prevents contamination of the wound. If you have questions about care after cauterization, it is better to consult a doctor. Individual characteristics should be taken into account in each individual case.

It is necessary to take into account the individual characteristics of the patient

Preventing the spread of warts includes maintaining good personal hygiene. Infection with the virus occurs through contact and household contact: through towels, sponges, and other personal hygiene items.

Important ! After cryodestruction, socks, indoor and outdoor shoes should be changed or disinfected. This will help avoid re-infection.

After the procedure, you need to change shoes and socks or disinfect them

Removal of neoplasms with liquid nitrogen

Removing tumors with liquid nitrogen is a time-tested, effective treatment method. Many patients often perceive tumors as cosmetic problems on the skin, rather than as a disease, and turn to a doctor late for help. Benign epithelial skin tumors differ in size, color, number, location, but they are more often of a viral nature or associated with self-medication. So, many patients bandage skin tumors with female or horse hair, trim them with nail scissors, etc. This does not solve the problem, but creates an environment for a secondary infection to occur. Injured tumors grow faster, disturb the owner, become wet, bleed, become crusty, and are painful. It is much easier to see a doctor without self-medication

Advantages and disadvantages of the method

Positive aspects of cryodestruction with liquid nitrogen:

• relatively affordable prices;
• short duration of the procedure;
• there is no need to pre-prepare the patient;
• the freezing effect acts as a prevention of the spread of infection;
• minimal possibility of scar formation after manipulation.

The procedure has its advantages

The disadvantages of the method include the following:

• during application, the patient may experience tingling and burning;
• During healing, slight itching may occur;
• the need for anesthesia during manipulation in particularly sensitive areas in children;
• pain persists for up to two days, analgesics may be required;
• when the process spreads deeply, repeated cauterization is required.

Cryodestruction has its disadvantages

Before cryodestruction, the tumor must be examined. It is necessary to exclude malignant degeneration of the wart. Diagnostic tests are performed if necessary.

Potential complications after cryodestruction:

• overreaction;
• complaints of severe pain during and after manipulation;
• swelling in the wound area;
• necrosis of tissue around the wart.

Possible serious complications

Benefits of freezing

Before you decide to remove warts, you need to understand the benefits of liquid nitrogen. As the doctors and patients who decided to undergo this procedure say, it is tolerated quite easily. Moreover, in some cases, when removing formations, anesthesia is not even used. You should decide whether to use local anesthesia together with your doctor at your appointment.

Experts say that thanks to the use of ultra-low temperatures, the risk of spreading, and even more so introducing, infection is minimized. The result of the procedure is visible immediately, and scars practically do not remain in the place of former warts, for the removal of which liquid nitrogen was used. The cost of the procedure, according to most patients, is low. Everyone can afford it.

The advantages also include high efficiency. Only in particularly difficult cases are several sessions performed. For example, this is necessary if you have plantar warts. All of them have a multilayer structure and are located deep in the skin layers, so to completely remove them the procedure is repeated several times.

Features of the procedure from the patients' point of view

Each person handles treatment differently. Despite the fact that people react individually, most note the following features.

Pain is described as ranging from mild to severe. This is often due to age - adults tolerate pain more calmly than children and adolescents. Despite the different pain thresholds, most patients note that the discomfort goes away within 2-3 days.

Each person can feel discomfort differently

Patients consider wound healing through the formation of a bubble to be an unpleasant experience. There is a need to be careful during water procedures and beware of additional injury to the treated area.

Positive reviews evaluate cryodestruction as a technically simple and effective method. Patients understand the sometimes necessary need for re-treatment. Some believe that timely prescribed immunomodulators and vitamin preparations contributed to better wound healing.

Important ! Patients note that after healing, there are no rough scars or scars left on the skin.

The skin becomes cleaner and no traces of procedures are visible on it

A large role is given to the doctor and his professional qualities, including the ability to explain the features of the procedure and answer questions. The attentiveness of the medical staff calms the patient, gives him confidence, and helps him recover faster.

Thus, if skin tumors appear in one area of ​​the body, and especially if they cause discomfort, you should consult a dermatologist. The doctor will conduct an examination, make a diagnosis based on it and suggest the necessary treatment.

If you experience any discomfort, you should see a doctor

Application of nitrogen

The liquid form of this chemical element has found its application in several directions at once, for example, it is actively used in removing papillomas and warts, performing a number of surgical procedures, and for creating spectacular film stunts in world cinema. We can talk about the use of nitrogen for hours, so below are the most relevant and popular areas:

• cryotherapy;
• firefighting;
• freezing of organic and inorganic materials;
• cell cryopreservation;
• cryogenic cutting;
• cooling of various machinery and equipment.

In industry

Before ordering such a unique product, it is important to determine the storage conditions. Enclosed spaces are strictly prohibited as storage; strong ventilation must be present. Liquid nitrogen should be stored cold in containers that should only occupy a vertical position. For domestic purposes, it is appropriate to liquefy the substance in an ordinary Chinese thermos.

The use of nitrogen in industry is important when working with equipment that gradually heats up under load. The liquid form of this microelement promotes natural cooling of equipment. Nitrogen can be used in other areas of production. This:

• creation of an inert environment for containers for the upcoming transportation of natural gas;
• production of nitrogen fertilizers, ammonia synthesis;
• processing of ferrous metals;
• fire fighting in coal mines;
• decrease in pressure at oil wells.

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In cosmetology

The use of this chemical element in modern cosmetology is appropriate due to its high boiling point. It is used to refill medical equipment, the main focus of which is cryotherapy. In the absence of contraindications, it has enormous benefits for the health and aesthetic appeal of the skin. In cosmetology, the substance is necessary for the quick and painless removal of papillomas and warts. Its properties and characteristics can be used in the following areas:

• elimination of acne and pink pimples;
• increasing the pain threshold for better tolerance of cosmetic procedures;
• elimination of swelling after aesthetic and surgical procedures;
• improved wound healing;
• elimination of acute skin inflammations;
• prevention of rapid aging of the dermis;
• cryoapplications;
• cryomassage;
• successful fight against signs of cellulite.

In medicine

It is difficult to get a bottle with such an element of the periodic table in a pharmacy; it is also not always possible to order liquid via the Internet. Use is recommended only in a hospital setting under strict medical supervision. In addition to dermatology, the element is also used for other areas, for example, it is part of an analgesic complex and improves recovery in the postoperative period. The use of nitrogen in medicine includes other, no less relevant areas:

• treatment of oily skin, facial cleansing from symptoms of acne, acne;
• ensuring a sustainable analgesic effect;
• normalization of systemic circulation;
• elimination of ulcers, erosions of mucous membranes;
• treatment of seriously ill patients in the field of surgery.

How much does it cost to cauterize warts with nitrogen?

The price tag for a wart removal service is determined depending on the pricing policy of the medical organization, the qualifications of the doctor, the region, the number of tumors, their location, and the type of wart.

Clinics in central Russia offer cryodestruction of one element for 380 rubles. The intervention is carried out only after a preliminary consultation with an oncologist, which is provided for 700 rubles.

The inspection fee is not too high

The price justifies the result

Interesting ! Clinics usually offer discounts when several items are removed.

As already mentioned, the qualifications of a medical specialist are crucial. The practical experience and skills of the doctor ensure rapid healing, the expected aesthetic effect and the absence of complications.

Once the diagnosis is established, contraindications are excluded. When removing warts using the cryodestruction method, these can be:

• individual nitrogen intolerance;
• trauma, skin irritation, elements of a rash around the wart;
• acute viral or bacterial infections;
• signs of an inflammatory process: high temperature, chills, changes in general condition;
• history of convulsive syndrome;
• exacerbation of chronic diseases that occur with complications from breathing and circulation;
• arterial hypertension;
• pregnancy period.

Contraindications should be taken into account by the doctor

Advantages and disadvantages

Modern methods of wart removal

Many of us prefer to skip the clinic visit. Stops fear of pain. Information about possible complications adds to doubts. At the heart of the difficulty is the lack of objective information.

The pharmacy chain offers a selection of products for cauterizing warts at home. Among them are compositions containing celandine juice or extract, solutions based on alkalis and acids. Each of them has indications, contraindications, and features of use.

In pharmacies you can find everything you need for home cauterization of warts.

The “Super Clean” cosmetic product is based on alkali, which has a local exfoliating effect. It is important to follow the recommendations - pre-steam the object and lubricate the skin around the wart with a rich cream to prevent burns to healthy skin. A 3 ml product costs about 45 – 50 rubles.

Cosmetic product "Superclean"

"Verrukacid" is a phenol-based cauterizing agent that coagulates proteins in tissues. A 2 g dark glass bottle with an applicator costs 190 – 207 rubles.

"Verrukacid"

The drug "CryoPharma" freezes the wart in one application. Available in the form of an aerosol can containing a mixture of dimethyl ether and propane. “CryoPharma spray” with a volume of 35 ml produced in Holland costs 876 rubles.

"CryoPharma"

"Solcoderm" is a solution with local necrotizing action. The recommendations contain a special note about carrying out the first treatment under the supervision of a dermatologist. A package with one 2 ml ampoule costs about 900 – 1000 rubles.

"Solcoderm"

These products are designed for use independently according to the attached instructions.

Important ! To make a decision, it is also necessary to exclude contraindications and take into account side effects. And you should start with a diagnosis, which can only be established by a medical specialist. Thus, carrying out manipulation at home is fraught with potential problems.

It is better to check with a doctor before the procedure

Pharmacy drugs

Nowadays, in pharmacy chains you can find drugs for cryodestruction (Cryopharma, Wartner Cryo). These products contain various refrigerants (ethers and gases) in liquefied form. They are produced in the form of aerosols for the cauterization procedure at home. Is it possible to use such products yourself?

Doctors do not recommend self-medicating papillomatosis. Before removing warts using pharmaceutical products for cryodestruction, you should consult a specialist and carefully study the instructions for these products.

A patient who does not have special skills can very easily make mistakes when using products with refrigerants. The consequences of this can be scarring on the skin, destruction of nerve endings and loss of sensitivity. Such complications require long-term treatment. Therefore, it is better to entrust the cryodestruction procedure to a specialist and carry it out in a clinical setting.

Patient reviews

Semyon, Krasnodar

“My school friend works as a doctor. On his advice, I decided to remove the wart on my ring finger so that there would be no more of them. In addition, it was unpleasant for me purely from an aesthetic point of view. Despite the warning that it would hurt, I didn't expect it to hurt this much. It feels no less than a burn. The pain is acute and does not go away immediately, but seems to get stronger. The next day a bubble appeared, with redness and swelling all around. I tried not to injure myself. After 5 days, the bubble opened, the wound began to dry out, and after about 7-8 days the crust fell off. A pale pink spot remains at the site of the wart. It’s good that I deleted it, but I don’t want to repeat anything.”

People are happy with the chance to get rid of warts, although they note that some discomfort was felt during the procedure

Alexandra, Samara

“I went to a cosmetic clinic to remove a wart on my neck. Only 10 pieces. After the consultation, the doctor explained that all warts can be treated in one session. The procedure turned out to be quite tolerable. The doctor cauterized the warts with a cotton swab dipped in liquid nitrogen. It was unpleasant, but I didn’t feel any acute pain. After the session at home, I saw that the skin was red, but there were no blisters. After a few days, the redness disappeared, and the papillomas began to darken and fall off. After a week and a half, everything healed, there were no papillomas left.”

Precautionary measures

Cryotherapy is absolutely safe. When carried out correctly, recovery time takes no more than a day and is not accompanied by restrictions. This distinguishes the method from other hardware cleanings.

It is important that the cosmetologist knows the technique of performing this procedure (they undergo special training for this). Distributing the substance too quickly does not have the desired effect, and the slightest delay can lead to frostbite.

To maintain the result and prevent the appearance of pigmentation, you must:

• use sunscreen;
• choose a soft foam for washing;
• take care of skin hydration.

Side effects

Negative consequences are possible if the procedure protocol is not followed, which is due to the lack of experience of the cosmetologist. If the specialist is sufficiently qualified, complications will not arise.

In rare cases, the following are observed:

• mild redness;
• mild swelling;
• allergy to cold;
• peeling of the skin;
• change in skin color;
• damage to the tissues of the lips or conjunctiva of the eyes.

Contraindications:

• exacerbation of herpes;
• epilepsy;
• heart and vascular diseases;
• open form of tuberculosis;
• the presence of wounds, abrasions, burns on the face;
• individual intolerance to cold.

Photos before and after

Photos before and after wart removal with liquid nitrogen No. 1

Photos before and after wart removal with liquid nitrogen No. 2

Photos before and after wart removal with liquid nitrogen No. 3

Consequences and recovery period

Almost immediately after the end of the procedure, swelling occurs at the site of the former wart. It appears approximately a minute after the cessation of exposure. Over time, after a few hours, it gives way to a blister. In most cases, it goes away in 5, maximum 7 days. But if the blister is damaged, the recovery period may be delayed. If you accidentally open it, then this area must be treated with an antiseptic solution and covered with a bactericidal bandage. This will prevent infection.

After the blister is reduced, a dense crust forms from the tissue. It disappears on its own after about two weeks, but sometimes, as people’s reviews indicate, the process takes up to six weeks. At the site of the former wart, which you used liquid nitrogen to remove, only a pink spot remains. For complete restoration of the epidermis, you have to wait from 3 months to a year.