Ouch! One Patient’s Account of Cryosurgery
Cryosurgery is a common treatment for seborrheic keratosis
Is concern about pain a stumbling block to getting a procedure that will remove your seborrheic keratosis (SK) lesions? Having information about what to expect may help. We asked Stephanie, a 51-year-old business executive living in Philadelphia, to report on her experience with cryosurgery treatment for her SK. Here is her diary:
2 hours before cryosurgery: I dread the procedure. Since breaking my leg four years ago, I’ve had a great fear of pain. That incident caused such excruciating pain that I had a hard time existing from one moment to the next and never quite adjusted to the agony. So while it may have raised my pain threshold, it has caused far more anticipatory anxiety. I practically hyperventilate just thinking about my cryosurgery treatment for seborrheic keratosis.
5 minutes before the procedure: Anxiety skyrockets when the assistant gives me a squeeze ball to manage my pain. This confirms my worst fear. Among the multiple seborrheic keratoses on my back, the doctor identifies three that are coarse and irritated along my bra line. These three are targeted for removal. Okay, so I have to get through just three, I tell myself.
First 30 to 60 seconds of cryosurgery: Feel intense cold, like the sharp sensation when you put your bare hand in ice. But I don’t feel pain because the freeze numbs it. Instead it’s a cold shock. I grab the squeeze ball.
60 to 90 seconds into cryosurgery: Pain sets in. It’s not a deep pain but rather a severe sting. It feels like a really bad sunburn. It doesn’t let up. I remind myself that I really wanted this cryosurgery for my seborrheic keratosis. It takes about two minutes for the three lesions to be treated.
15 minutes later: On the car ride home, I still feel the stinging sensation. I can’t sit back on the seat. It reminds me of the time I had a deep tissue massage and, for a day or two, I couldn’t sit back against the couch or a soft pillow. It’s hard to distract myself from the pain. I try to think of pleasant things but feel bothered and uncomfortable. I wonder when the pain will lessen.
45 minutes later: I put on loose clothing at home. I can’t possibly wear a bra; it would be too painful. I plan to work at home tomorrow, too, so I can go braless. I try to get comfortable in my chair but still feel bogged down in my pain. It’s hard to focus. I walk the dog to keep myself moving and distracted. It helps a little.
3 hours later: I’m surprised the sting is still strong. I take an ibuprofen. It’s approaching night time, and I want to take the edge off my pain and be able to rest. I put on loose pajamas.
5 hours later: The ibuprofen helped somewhat. I try to get comfortable in bed, but two of the growths were on either side of my torso. I toss and turn all night.
24 hours later: I wake up and immediately feel the sting. I’m surprised it continues into the next day, though it comes and goes. I can move past it, finally, and get my work done. But I still can’t sit comfortably in my chair. I wear loose clothing all day. The mere thought of my bra rubbing against the crusted growths is enough to rattle my nerves.
36 hours later: I no longer feel the sting. I can sit in my chair comfortably and can think about wearing a bra again—tomorrow, just to be sure. I’m relieved. I look forward to wearing a bathing suit without having those ugly growths on my back poking out.
Dr. Diane Berson, a board-certified dermatologist, comments:
“Everybody experiences pain differently. People have different pain thresholds. I have treated patients like Stephanie, but also I have treated patients who say they consider cryosurgery to be quite easy to tolerate. You might want to try freezing just one SK at first, so you see how you react.
Cryosurgery for seborrheic keratosis can be painful because it is very cold and freezes the skin lesions. If you have concerns about pain related to cryosurgery, let your dermatologist know. There are ways to avoid or minimize the pain.
Removal of thicker SKs with cryosurgery is going to require deeper and longer freezing than thinner SKs, so it is associated with more pain than cryosurgery for thinner SKs. I prefer to treat thick SKs with a combination approach. I will inject the area with an anesthetic first. Then I will lightly freeze the SK, which helps to begin its separation from the skin. I finish off by using a tool called a curette to scrape off the SK. This approach minimizes pain and generally avoids any lasting scars or white spots.”
See “Current Options” to learn more about cryosurgery and see a video of the procedure.