Liquid nitrogen in cryotherapy for face
In recent years, in the practice of dermatologists and cosmetologists, increasing use is liquid nitrogen.
In the Moscow scientific research Institute of cosmetology of the Ministry of health of the RSFSR liquid nitrogen is used since 1960 to treat vulgaris, plantar and flat warts, papillomas, senile keratoses, hypertrophic scars, acne vulgaris, rosacea, as well as to treat some forms of alopecia.
Liquid nitrogen is a clear liquid, without color and smell, with a boiling point of -195.8 °C at atmospheric pressure, not flammable, does not explode. The evaporation of 1 litre of liquid nitrogen produces about 700 liters of gas.
Storage of liquid nitrogen using special tanks Dewar vessels with a volume from 6 to 40 liters. For medical institutions it is better to use vessels Korosten chemical engineering plant SK-6 (capacity 6 l) and SK-16 (capacity 16 litres). They are convenient for transportation, they are liquid nitrogen can be stored up to 35 days (for SC-16).
To work in the medical cosmetic office you can use the normal (food) thermos with a capacity of 0.5-2 liters (recommended thermos flask stainless steel). From the Dewar to the thermos liquid nitrogen is poured through a funnel or using a special overflow device (like a siphon).
Liquid nitrogen has a high therapeutic activity, method of its application is simple, convenient and gives xgood cosmetic results.
The therapeutic effect of liquid nitrogen is its low temperature. Depending on methods of application, its effect on tissue may be different.
In some cases, the freezing is, it causes destruction and death of tissue, in others a narrowing of the blood vessels with subsequent extension is not only active, but also reserve capillaries, which greatly enhances the blood flow to the site of application (M. A. Levine).
Destruction and death of tissue is observed under the influence of liquid nitrogen to deep freeze the removed tumors. In these cases, longer exposure (30 seconds) with a tight fixation of applicator over the item to be deleted under slight pressure. In cases where it is necessary to create a vascular response, to provide more than a superficial effect on the skin, liquid nitrogen is applied briefly (10-15 seconds) in the form of cryo.
The technique of cryotherapy with liquid nitrogen.
Liquid nitrogen freezing is carried out with an applicator, which is a wooden stick with a length of 25-30 cm At its end tightly fixed swab of cotton wool. Note that the dimensions of the swab should be slightly larger than the deleted item.
In addition to applicator sticks with cotton swab can be used cryoapplicator, which is a tube-tank for liquid nitrogen with a removable metal tips of various configurations (including, with attachments for cryomassage).
The skin and the lesion before treatment, treated with 70° alcohol.
Technique of cryotherapy of warts vulgaris with moderate hyperkeratosis is to process each element separately. Applicator with a cotton swab dipped in a thermos of liquid nitrogen, and then with a quick movement, applied perpendicular to the wart with a little pressure.
The exposure time of freezing depends from the size and location of warts (10-30 seconds).
As the evaporation of liquid nitrogen with a cotton swab (average 20 seconds), it should be wetted again and re-applied to freeze the wart. You must follow the exact line of the applicator and freeze element, its uniform, especially deep freezing. Be sure to freeze and narrow ring in 1-1.5 mm of healthy skin around the wart.
As freezing with liquid nitrogen wart begins to fade, becomes white and dense, on the periphery it appears the white halo, indicating the necessity of ending the freeze. Subjectively, this moment marked a slight burning sensation, tingling, pain. The severity of these effects is determined by the number and localization of the warts and also their size. The pain is usually short (a few minutes) that allows the use of liquid nitrogen in pediatric practice.
After 40-60 seconds after freezing appears hyperemia and edema of the wart, and after a few hours (6-24 hours) is formed epidermally bubble with serous or hemorrhagic content. Bubble usually lasts 5-7 days. Gradually the contents of the bubble decreases and in its place formed a dense crust, which after 10-12 days rejected, leaving a subtle pink stain. If you have large bubbles that impede the work, they should be open at the base with scissors, treating an alcoholic solution of 1-2% brilliant green, liquid Castellani and impose aseptic bandage for 3-5 days.
In case of accidental failure of the bladder or crusts need to aseptically handle the wound surface and apply a bandage with a 5% sintomitsinovoy emulsion or oil with bactericidal adhesive.
In the treatment of periungual and plantar warts require a longer exposure with a high pressure (30-60 seconds). One session is usually not enough, the freezing is repeated 3-5 times at intervals of 3-5 days.
In the presence of sharply expressedennogo hyperkeratosis, application of liquid nitrogen must be preceded by preparation, which consists in maximizing the removal giperkineticeskih (keratinized) layer that surrounds the wart. In cases of multiple warts, especially in children, primary cryotherapy is carried out fractionally in 2-3 sessions.
Treatment for common flat youthful warts liquid nitrogen is used in the form of cryo - dushirovanie the skin. Applicator with a cotton swab parallel to the surface of the skin and rapid rotational movements at low pressure moved over the treated area to a light blanching of the skin. The procedure is repeated 3-4 times with short intervals (1-2 minutes). More pronounced, bulging warts freeze additionally each (applicator at the same time placed perpendicular to the skin).
Refresher sessions are held for the disappearance of the reaction (hyperemia) induced by the preceding procedure. After 5-7 days the surface of the skin darkens, peeled, warts disappear. Skin care during treatment and peeling is wiping its 2% solution of salicylic alcohol.
In the treatment of all types of warts, to avoid relapse, you need to re-medical examination. In cases of recurrence of warts or insufficient effect of the treatment should be repeated cryotherapy with liquid nitrogen.
Cryotherapy with liquid nitrogen papillomas held applicator of small size, without pressure for 10-15 seconds without affecting the surrounding skin. The papilloma should acquire a pronounced density. After 1-2 days of papilloma, as a rule, darken, become thick and 7-8 days are rejected, leaving a pink stain, which later disappears without a trace.
For cryotherapy elements senile keratoses , pre-consultation and the conclusion of the oncologist. Elements senile keratosis frozen with liquid nitrogen deeply to the appearance around the element white veinsChica with a width of 1-1.5 mm. the Exposition lasts 30-40 seconds. Sometimes you need repeated exposure in 5-6
days, which if necessary can be repeated 2-3 times.
After the rejection of crusts may sometimes be subtle atrophic scar. Patients should be under the supervision of a physician during the year.
Treatment of hypertrophic scars with liquid nitrogen.
In the treatment of hypertrophic scars, the freeze should be deep enough to be accompanied by further cystic reaction. To this end, a 2-3 lubrication of liquid nitrogen in a single session. Then the procedure is repeated several times (2-4 times) in 2 weeks. After 2-3 treatments, the scars are usually flattened to the level of normal skin.
Due to the fact that scars tend to increase after cryotherapy with liquid nitrogen, it is expedient to irradiate rays of Bukki or apply electrophoresis with lipase.
In atrophic pigmented scars, traumatic pigmentation (after burns, injuries, etc.), freckles, cryotherapy with liquid nitrogen is held in the form of dushirovanie, massage until the peeling.
The treatment of acne.
Gives good results with cryotherapy with liquid nitrogen in cases of various forms of acne and oily seborrhea of the face in combination with common methods of treatment. Especially shows the use of liquid nitrogen with severe and common forms of acne (abscess, spherical, keloid acne). In this case liquid nitrogen is used in the form of dushirovanie and deep freezing of the inflammatory infiltrates.
Dushirovanie hold applicator large diameter, which at the end of a wooden stick tightly fixed cotton swab with a length of 7-10 cm (as in "cane"). The applicator is moistened with liquid nitrogen, a parallel to the surface of the treated area and continuous pipe welding rotator:tional movements, under slight pressure of the right hand is moved across the surface until the advent of the rapidly disappearing whitening of the skin. The patient feels a sense of cold and burning.
After the disappearance of the burning sensation, the procedure is repeated 2-3 times in 5-10 minutes. After 5-6 hours there is a persistent redness of the skin that lasts 24-36 hours and then the skin gradually darkens over 3-days you receive the lamellar peeling, and after 5-6 days the darkened layers of the epidermis completely rejected.
Separate large inflammatory infiltrates acne, festering atheroma and hypertrophic scars are further treated with liquid nitrogen to enhance their deep freezing.
At the centers, subject to additional application, often produced bubbles with the subsequent formation of crusts that are rejected in 8-10 days. Further treatment sessions are held 2 times a week with a little exposition, causing the weaker phenomenon of reactive inflammation of the skin. In the course of assigned 10-15 procedures. In the process the treatment of acne, oily seborrhea of the face liquid nitrogen to the patient at home prescribed skin 2% salicylic alcohol and dusting lesions peeling with talc. There are common techniques of treatment: immunotherapy, oral vitamins, sulfur drugs, antibiotics, etc.
In the treatment of rosacea cryomassage liquid nitrogen is carried out more lightly across the surface of the affected skin. Individual nodular and pustular elements freeze additionally with short-term exposure to 10-15 seconds. Sessions repeat 1-2 times a week for the course need 10-15 procedures depending on the extent of the process. Care for the skin during the treatment is to wipe it with disinfectant lotions.
The treatment of some forms of alopecia.
For oily seborrhea of the scalp with the phenomena of behavior of hair, as well as in cases rogovicnogo baldness, liquid nitrogen has a beneficial effect while using the General methods of influence on the organism as a whole (restorative treatment, vitamin therapy, etc.). Liquid nitrogen in these cases is used in massage the scalp. The applicator is a parallel to the surface of the skin and light circular movements massage the scalp down the parting. The processing time of each area for 3-5 seconds until the small settlement of skin after the cryomassage there is a persistent erythema. The procedure usually takes 10-20 minutes (cryo entire scalp).
When alopecia baldness treatment with liquid nitrogen only source of baldness intermittently for 1-2 minutes. The procedure is repeated after 2-3 days, the course requires 15-20 procedures. After a month break, the course of treatment must be repeated. All patients receive 2-3 course. It should be remembered that the low temperature of liquid nitrogen causes dryness and brittle hair, so the treatment process should carefully monitor the condition of sebum. In addition, when carrying out cryotherapy with liquid nitrogen should be ucitati and General condition of the patient. Hypertension, epilepsy, vasospasm, are contraindications for cryotherapy on the scalp, face etc.
The method of treatment with liquid nitrogen is simple, affordable and can be used in the cosmetic and dermatological institutions.The big advantage of this method is that liquid nitrogen does not cause formation of keloid scarring, less painful, has a high therapeutic efficacy.