Pigmented Scars from Cryotherapy: Causes and Solutions

Pigmented scars left by cryotherapy?

Hello Dr.
Huang: I have many moles on my body, which I find unattractive, so I have always wanted to have them removed.
Previously, I did not do thorough research and was misled by a friend to go to a hospital where a doctor used liquid nitrogen for cryotherapy.
In April of this year, I visited a local hospital and consulted a dermatologist for treatment.
The treatment lasted for seven to eight sessions, with weekly follow-ups.
The doctor assured me that this method was effective and would not leave scars.
However, to my surprise, it resulted in multiple pigmented scars, which are even more unsightly.
During the treatment, I asked the doctor what was happening.
He told me it was a matter of individual constitution, reassured me not to worry, and advised me to practice sun protection and return for regular check-ups.
It wasn't until seven or eight weeks later that I realized something was wrong and sought another physician.
The second doctor informed me that the scars had already formed and there was nothing he could do about it.
He mentioned that if it were his case, he would have used electrosurgery instead of cryotherapy (and it wasn't laser treatment either).
He finally told me that this type of pigmentation would naturally fade over time and that I should not worry about it.
However, it has now been six months since the treatment, and while the scars have faded somewhat, they are still very noticeable.
Every time I see them, I feel very self-conscious.
Therefore, I have two questions for you, Dr.
Huang: 1.
Was the initial treatment method employed by the attending physician inappropriate, and do I have the right to claim medical expenses for restoring my condition? Or should I just consider myself unfortunate due to my own negligence? 2.
Can dye laser or photorejuvenation laser help resolve my concerns? What would the approximate cost be? I have more than ten small round scars, each about one centimeter in diameter.

A-Liang, 20~29 year old female. Ask Date: 2009/11/23

Dr. Huang Ruiyun reply Dermatology

Hello! Without seeing the individual, it is difficult to determine whether it is a true scar or post-inflammatory hyperpigmentation.
Generally speaking, cryotherapy with liquid nitrogen is unlikely to cause true scars; instead, it often results in hyperpigmentation, which will fade over time, although it requires patience.
On the face, it may disappear in less than six months, while on the body it could take up to a year, and on the calves, it may take even longer.
However, it is best to leave it alone and allow it to fade naturally.
Personally, I do not recommend removing moles for cosmetic reasons, as the likelihood of hyperpigmentation occurring on the body is higher and fades more slowly compared to the face.
As for electrosurgery and laser treatments, they may leave scars on the body.
Cryotherapy with liquid nitrogen is already a relatively safe method.
Many laser treatments are suitable for the face, but the healing capacity of body skin is not as good as that of the face, and it lacks inherent advantages.
I advise you to not focus too much on these spots, as it may only lead to more frustration.
Wishing you peace and good health.

Reply Date: 2009/11/23

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding the pigmented scars resulting from cryotherapy. It’s understandable to feel self-conscious about changes in your skin, especially after undergoing a procedure intended to improve your appearance. Let’s address your questions and provide some insights into the situation.

1. Assessment of the Initial Treatment:
The use of cryotherapy (liquid nitrogen) for the removal of pigmented lesions such as moles or seborrheic keratosis is a common practice. However, the outcome can vary significantly based on individual skin types, the depth of the lesions, and the technique used by the practitioner. While many patients do not experience significant scarring, others may develop post-inflammatory hyperpigmentation (PIH) or other forms of scarring, particularly if they have darker skin types or if the lesions were treated aggressively.

Regarding your question about whether the initial physician acted improperly, it’s essential to consider that medical procedures can have variable outcomes, and not all complications can be foreseen. If the physician provided appropriate information about potential risks and benefits, it may be challenging to claim malpractice. However, if you believe that the physician did not adequately inform you of the risks or did not follow standard protocols, you might consider discussing this with a legal professional who specializes in medical malpractice.

2. Options for Treatment of Pigmented Scars:
For the treatment of pigmented scars, several options are available, including:
- Laser Treatments: Both pigment lasers (such as Q-switched lasers) and fractional lasers can be effective in reducing the appearance of pigmented scars. These lasers work by targeting the pigment in the skin and promoting collagen remodeling, which can help improve skin texture and tone.
- Chemical Peels: These can help exfoliate the top layers of skin, promoting the growth of new, healthier skin and potentially reducing pigmentation.

- Microneedling: This technique involves using fine needles to create micro-injuries in the skin, which can stimulate collagen production and improve the appearance of scars over time.

- Topical Treatments: Products containing ingredients like hydroquinone, retinoids, or vitamin C can help lighten hyperpigmentation over time.

The cost of these treatments can vary significantly based on the type of procedure, the number of sessions required, and the geographic location of the clinic. For instance, laser treatments can range from $200 to $600 per session, while chemical peels may cost between $100 to $300 per session. It’s advisable to consult with a board-certified dermatologist who can assess your specific situation and recommend the most appropriate treatment plan.

In conclusion, while it’s unfortunate that you experienced these side effects from cryotherapy, there are effective treatments available to help improve the appearance of your scars. I recommend scheduling a consultation with a dermatologist who specializes in cosmetic procedures to discuss your options in detail. They can provide a tailored approach based on your skin type and the specific characteristics of your scars.

Take care, and I hope you find a solution that helps you feel more confident in your skin.

Best regards,
Doctor Q&A Teams

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