Scar Treatment: Cryotherapy for Hypertrophic Scars

Scars, cryotherapy

1.
Last year, after a boil on my back healed, I noticed that the scar from the boil was inexplicably raised and itchy.
I visited a hospital for a consultation, and the doctor suspected it was a sebaceous cyst, so I underwent an outpatient procedure to have the tissue examined.
However, a few days after the stitches were removed, I noticed that the surgical scar had again become raised.
Initially, I thought it wouldn't itch, so I left it alone.
Recently, the scar suddenly became very itchy, and it was painful to touch, so I returned to the hospital to see the doctor who removed the stitches.
The doctor suggested it might be keloid or hypertrophic scarring, and recommended that I undergo cryotherapy, which would require 2 to 3 sessions.
After the first treatment, I vividly remember the pain from the cryotherapy.
I would like to know if the second cryotherapy session, scheduled for four weeks later, will be more painful than the first session.
2.
Is cryotherapy effective for keloids and hypertrophic scars?
3.
Will the scar disappear after the treatment? I am very afraid of pain.

Bao, 10~19 year old female. Ask Date: 2022/08/04

Dr. Wu Yuxin reply Dermatology

1.
The pain is generally similar.
2.
Cryotherapy is effective.
3.
It will improve, but it cannot completely disappear.

Reply Date: 2022/08/04

More Info

Cryotherapy, or cryosurgery, is a treatment method that uses extreme cold to destroy abnormal tissues, including hypertrophic scars and keloids. Understanding how this treatment works and its implications can help you make informed decisions about your scar management.

1. Pain During Cryotherapy Sessions: The pain experienced during cryotherapy can vary from session to session. The first treatment often serves as a baseline for what to expect. Some patients report that subsequent treatments can be less painful as they become accustomed to the sensation, while others may find that the pain remains consistent or even increases due to heightened sensitivity in the treated area. The pain is typically described as a burning or stinging sensation as the tissue freezes, followed by a throbbing pain as the area warms up. If you are particularly sensitive to pain, it may be beneficial to discuss pain management options with your healthcare provider before your next session. They may suggest topical anesthetics or other pain relief methods to help minimize discomfort.

2. Effectiveness of Cryotherapy for Keloids and Hypertrophic Scars: Cryotherapy has been shown to be effective in treating keloids and hypertrophic scars. The extreme cold causes cellular destruction and can lead to a reduction in the size and appearance of the scar. Studies indicate that cryotherapy can flatten hypertrophic scars and keloids, particularly when combined with other treatments such as corticosteroid injections. However, the effectiveness can vary based on individual factors, including the scar's age, size, and location, as well as the patient's skin type and healing response. It is essential to have realistic expectations; while many patients see improvement, complete disappearance of the scar is not guaranteed.

3. Post-Treatment Expectations: After cryotherapy, it is common for the treated area to appear red, swollen, and possibly blistered. Over time, the scar may flatten and become less noticeable. However, complete resolution of the scar is not always achievable. The healing process can take several weeks to months, and multiple sessions may be necessary to achieve the desired results. It is crucial to follow your healthcare provider's post-treatment care instructions to promote healing and minimize complications.
4. Managing Pain and Anxiety: If you have a significant fear of pain, communicate this with your healthcare provider. They can provide strategies to help manage your anxiety and discomfort during the procedure. Techniques such as deep breathing, visualization, or even sedation options may be available to help you feel more comfortable.

In summary, cryotherapy can be an effective treatment for hypertrophic scars and keloids, but individual experiences with pain and treatment outcomes can vary. It is essential to maintain open communication with your healthcare provider about your concerns and expectations. They can tailor your treatment plan to best suit your needs, ensuring that you receive the most effective care while managing your pain and anxiety effectively.

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