Cryotherapy treatment is used to remove skin lesions by freezing them. Liquid nitrogen is the most common type of cryotherapy and the one we use at Ashtead Hospital.
Cryotherapy is used to remove actinic keratosis (an area of sun-damaged skin found predominantly on sun-exposed parts of the body), viral warts, seborrhoeic keratoses, Bowen’s disease and other benign lesions. It’s also effective in treating malignant lesions.
It’s performed as an outpatient procedure where liquid nitrogen is applied to your skin for a few seconds using a cryoprobe, cotton-tipped applicator or cryospray. Depending on the nature of the lesion, more than one treatment may be necessary, for example, in resistant viral warts.
Excision of skin lesions (punch biopsy and curettage)
The excision of a skin lesion (lump or bump) is a form of minor surgery. You may have a skin lesion removed if it’s causing you significant problems or if it could be cancerous. Most skin lesions are harmless and you can choose to have them removed at Ashtead Hospital if they’re aesthetically bothering you. This service is not available on the NHS.
There are several ways to remove skin lesions. Here at Ashtead Hospital we most commonly perform a punch biopsy and curettage of skin lesions. The type of procedure you’re offered will depend on the type of skin lesion you have and where it is on your body.
- Punch biopsy
A punch biopsy is performed under local anaesthetic and involves using a special circular blade to punch a small hole in your skin and remove a cylindrical section of the skin lesion to send to the laboratory for further testing.
- Curettage of a skin lesion
This involves using a curette to scoop away the lesion. It’s used on predominantly epidermal superficial skin lesions. The curettage procedure can be combined with cautery (heat treatment) or cryotherapy (freezing).
Steroid cream (topical corticosteroids)
Topical corticosteroids, also known as topical steroids, are a useful and common treatment for many dermatological conditions including: psoriasis, eczema and dermatitis. They contain corticosteroids which are hormones that can reduce inflammation and irritation.
There are many topical steroids available, including creams, gels, lotions, mousses and ointments, that differ in potency and formulation.
It’s important that you follow the advice of your dermatologist when using topical corticosteroids. Typically, they only need to be used once or twice a day for a few days or weeks at a time and should only be applied directly to the affected areas of skin.
Acne treatment with Isotretinoin (Roaccutane)
Acne can diminish quality of life and decrease self-confidence. Severe acne can also be very painful. Isotretinoin is a prescription medicine for severe acne. It comes in pill form and involves taking one or two pills a day as your dermatologist prescribes. One course of treatment generally takes about four to five months.
Isotretinoin is very effective. It’s the only acne treatment that attacks all four causes of acne: excess oil production, clogged pores in the skin, too much of the bacteria P. acnes and, inflammation. It has anti-inflammatory properties, shrinks the sebaceous glands and inhibits the growth of acne bacteria as it reduces the moisture of the affected skin.
Isotretinoin is a strong drug and is only prescribed by a specialist doctor or dermatologist.
Mycology – fungal toes/hands
Mycology is the study of fungi that causes human disease. An accurate diagnosis of the disease-causing fungi is required to prescribe the appropriate antifungal treatment. To identify the fungal infection, tissue samples are taken from a patient’s nail, skin and hair and sent for microscopic examination and culture (which may take several weeks).
The tissue sample can be done by:
- cleaning the skin with alcohol and scraping scale from the edge of a rash
- taking hair samples with the hair root in tact
- scraping skin from under the nail, for example an infected toe nail
- a biopsy
- using tape to strip the skin and then transferring the sample on to a glass slide for testing
Dermatological infections that may be diagnosed by mycology include: athlete’s foot, ringworm, tinea capitis (scalp hair loss), candidiasis (yeast infection that causes red itchy rash), pityriasis versicolor (scaly and discoloured skin) and onychomycosis (finger and toe nail infection).