Freckles are small, flat spots ranging from red to light brown, typically appearing on sun-exposed areas like the face, arms, and chest. They are collections of the skin’s natural pigment, melanin, produced by melanocytes, usually due to ultraviolet (UV) radiation exposure. While freckles are harmless, some individuals seek cosmetic options to lighten or remove them. Cryotherapy, a non-invasive dermatological technique, is a common method for treating these and other benign skin lesions.
How Cryotherapy Targets Pigment
Cryotherapy uses a controlled application of extreme cold, typically liquid nitrogen, to induce targeted cellular destruction. Liquid nitrogen, with a temperature near -196°C, rapidly drops the temperature of the targeted freckle tissue. This intense cooling causes the water inside and outside the cells to freeze and form ice crystals.
The expanding ice crystals rupture cell walls and disrupt internal structures. This physical damage, combined with osmotic injury, leads to the necrosis of the treated cells. Melanocytes, the pigment-producing cells concentrated within the freckle, are notably more susceptible to cold injury than the surrounding skin cells.
Because melanocytes are highly sensitive, a brief application of the cryogen effectively destroys the pigmented cells while minimizing damage to deeper tissue. Once destroyed, the body’s natural healing response sheds the damaged, frozen layer of skin. This process replaces the hyperpigmented tissue with new, unpigmented skin cells.
The Specific Steps of the Procedure
The cryotherapy session begins with a consultation where the dermatologist confirms the nature of the spots and ensures they are appropriate for freezing. The treatment area is then cleansed. Proper skin preparation is important to ensure the cryogen makes direct contact with the pigmented lesion.
The clinician applies liquid nitrogen directly to each freckle using either a specialized spray device or a cotton-tipped applicator. The spray delivers a controlled mist, while the swab offers precise contact for smaller spots. For freckles, the freeze duration is short, often just three to four seconds per spot, because melanocytes require less time to be effectively treated.
During application, patients immediately feel intense cold, progressing quickly to a stinging or mild burning sensation. The freckle instantly turns white, developing a “frosting” appearance that confirms the tissue has reached the required sub-zero temperature. Once the freeze time is complete, the spot is allowed to thaw naturally, and the sensation subsides quickly.
Healing and Post-Procedure Expectations
Following the procedure, the treated freckle typically shows an immediate reaction involving redness and mild swelling, similar to a minor burn. Within hours, a blister commonly forms over the treated area. This blister may contain clear fluid or blood, and it should be left intact to protect the underlying healing skin.
After a few days, the blister will dry out and flatten, leading to the formation of a dark crust or scab. It is important to avoid picking, scratching, or forcefully removing this scab, as doing so can interfere with the healing process and increase the risk of scarring. Gentle cleansing with a non-scented soap and the application of a protective ointment like petroleum jelly can help keep the area moist and promote optimal healing.
The scab will naturally detach and fall off within a realistic timeframe of one to two weeks, revealing a patch of new, lighter skin underneath. After this period, strict sun protection is necessary, involving the daily use of a broad-spectrum sunscreen with an SPF of at least 30 on the treated area. Sun avoidance is paramount to prevent the inflammation from triggering a rebound hyperpigmentation, where the skin produces excess pigment in response to the injury.
While the goal is complete removal, patients should be aware of potential long-term outcomes. A temporary or permanent lighter area, known as hypopigmentation, can occur where the melanocytes were destroyed. This color mismatch is generally less noticeable on fair skin but is a distinct possibility for those with darker complexions. Some freckles may require a second treatment session if the initial freeze was too superficial to fully clear the pigment.