A woman has a pained expression as a lightning bolt zaps over her face.

Cryosurgery – How Can Such a Quick Procedure Cause Such Intense Pain?

I had my six-month skin check the other day. At my last six-month checkup, my dermatologist and I were both celebrating that there was nothing that needed to be biopsied or treated. I knew this time may be a different story though, because I had a couple of places on my face of actinic keratosis. I didn’t have anything that I thought might need to be biopsied, though, so I was still hopeful it might be a fairly easy appointment.

I was thinking cryosurgery isn't so bad

And it was, relatively speaking. My dermatologist agreed that nothing needed to be biopsied. She said she did want to “freeze” me though, meaning there were some areas she wanted to treat by cryosurgery. My doctor uses a spraying device to apply the liquid nitrogen, although some doctors may apply it with a cotton swab. She first sprayed four areas on my chest, which only stung for a couple of seconds. Nothing too terrible. She then directed a quick shot at my leg, and I couldn’t even feel that one. Next, she sprayed an area on my shoulder. Again, not too painful. She then surprised me and sprayed an area on my left side. “But that area doesn’t even see the light of day!” I protested, and her response was “No, but it used to.”

Darn that sun damage from when I was younger. I’m now in my mid-50’s and am still paying the price for the damage I did to my skin many years ago.

But cryosurgery on the face is painful

My dermatologist saved the worst for last. I had three areas on my face that she wanted to treat. The first was on my left cheek, and she blasted it four times. She reminded me to breathe during it because I have a tendency to hold my breath while she does it. I told her I couldn’t breathe because I didn’t want to inhale the liquid nitrogen or all of my insides would be frozen. We both got tickled over that. While I was busy cracking up at myself, she zapped an area just over my upper lip. And holy moly, did that hurt. My eyes immediately started to water. (Side note, I learned long ago to wear only waterproof mascara to the dermatologist. I’d had too many visits that caused watering eyes and streaky mascara).

The area above the lip was the worst

While I was trying to recover from the shock of that pain, she zapped another area on the other side of my upper lip. Full-on eyes watering now. The pain was Intense, with a capital I. The sting from the other areas was already wearing off, but not the areas above my lip. Within a couple of minutes, I felt like my lip was swollen. I was sure I had a fat lip. I looked in a mirror, and it wasn’t swollen but it sure was still throbbing. It throbbed my entire drive home, and for the next hour. My doctor didn’t even spray those areas four times like she did my cheek, but wow was that pain noticeable.

The only procedure that's brought on watery eyes

I have a pretty high pain tolerance. I have had numerous excisional surgeries to remove skin cancer, and I had my first Mohs surgery this year, to treat an area of infiltrating basal cell carcinoma on my face. It would seem that those would be more painful, but for some reason, the shock of the liquid nitrogen on tender areas of skin is what brings on the watery eyes.

Post-cryosurgery thoughts

My areas typically start scabbing over a couple of days after treatment, and about a week or so after treatment the scabs fall off. It really is an easy treatment, especially if you don’t have to get a tender area treated. Despite the pain that it can bring (which is thankfully almost always short-lived) cryosurgery has been an effective treatment for me, so even though it’s not my favorite treatment, I’ll keep getting it – as long as I’m wearing my waterproof mascara.

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