A Dermatologist Froze an Age Spot Yesterday. Is This Normal? (photo)

Question

A dermatologist tried freezing an age spot yesterday. I had never heard of freezing something that wasn't a keratosis or basal cell. It looks so much worse today. It's a larger area and totally "filled in" versus liighter in color and just partial. Will it improve?

Francis X. Fleming, MD · Answer

Freezing skin lesion results in an injury to the tissues and the healing process will take 4 - 6 weeks. Large lesions like this on the face may also be a lentigo maligna, which may be a precursor of melanoma. A biopsy is always a good idea for these type of lesions.

Elisabeth Dancey, BM, BCAM · Answer

This question is a few years old now but it remains relevant as these types of lesions much be checked by a dermatologist before they are treated. Spreading lesions with darker areas can be suggestive of sun spots or more sinister things that must be excluded first.
That said, cryotherapy is a reasonable treatment and this is what it looks like the next day. However eight years on we are using more sophisticated techniques such as the hyfrecator device which offers quicker results, more controlled destruction of the lesion and faster healing.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question and photo.  That looks just like I would expect the day after liquid nitrogen.  Follow your dermatologist's post-care instructions and stay out of the sun, and it will probably come out very nicely.  Liquid nitrogen is a very old and frequently used treatment for a variety of skin lesions in dermatology.  Best of luck!

Rupa Badlani, MD · Answer

Liquid nitrogen (cryotherapy) is used to treat a wide range of skin conditions, including keratoses, warts and age spots. It is one of our oldest dermatology treatments. Since this treatment doesn't target skin pigment specifically, it works by causing a superficial burn from cold. The spot will look swollen, red and will feel tender for several hours to days after treatment, but your body will heal the burn over the next 2 to 4 weeks. Expect the spot to look worse for a while, but it will heal and look better. This is a standard treatment, so there's no need to worr

William Kwan, MD, FAAD · Answer

Liquid nitrogen (or medically known as cryotherapy) is one of our oldest treatments in dermatology.  It can be used for a wide range of conditions like keratoses (as you had heard), but also warts and age spots.  Since it doesn't target pigment specifically, how it works is that is causes a superficial burn from cold.  Your body then heals the burn and it sloughs off.  It will looks swollen, red and tender for several hours to days after the treatment, and gradually heals over 2-4 weeks.  Expect it to look worse for while, but will heal and look better.  So no worries about the dermatologist since he did a standard treatment.

Michele S. Green, MD · Answer

Treating age spots can be done with lots of modalities.  I don't choose to use liquid nitrogen because there are a lot of other methods that are more elegant and clinically effective like the Yag or Fraxel laser.  Please let me know how it looks after a few weeks since you can't tell anything one day later.

Benjamin Barankin, MD, FRCPC · Answer

Freezing age spots (called lentigines or keratoses) is a common treatment method used by physicians to treat age spots. It is safe and effective, and often less costly than laser. The reaction you are describing is entirely normal, you just need to be patient for the lesion to react and lift off. There are various circumstances to choose liquid nitrogen or laser for your age spots, best to speak to your dermatologist about the best treatment option for you. During the healing time, typically 2 weeks, ensure that you are careful in the sun. Dr. Benjamin Barankin, Toronto Dermatology Centre.

Martie Gidon, MD, FRCPC, FAAD · Answer

Liquid nitrogen is one method of treating an age spot. The area will be puffy and darker for several days. Keep it moist with Vaseline and covered. It will take about 2 weeks to heal. Please protect the area from the sun to prevent repigmentation.

Stephen Weber MD, FACS · Answer

This is not at all unusual. I prefer lightening creams or laser treatments but liquid nitrogen can be highly effective. The darkening that you've seen overnight should improve with time and the pigment that was treated should also lighten with time. I hope this information is helpful.Stephen Weber MD, FACS

Rebecca Baxt, MD · Answer

Yes, cryotherapy is a common treatment for age/sun spots. Yes, it can look worse before it looks better. There are lots of ways to treat age spots and its up to you and your doctor to pick the best treatment for you. Lasers, chemical peels, creams bleaches, are all other alternatives, and there are many types of all of those to choose from also.

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