Please discuss with Ruth:

Contra-indications: Medications

Tricyclic Medications: Amitriptyline/Nortriptyline - cryotherapy might not work

Anticoagulants -warfarin - heparin - clopidogrel - Apixaban (daily aspirin is fine)

NSAIDs: Regular ibuprofen - Naproxen - Celecoxib

Immunosuppressants: Prednisolone - Azathioprine

Other Contra-indications:

Clotting deficiencies

Raynaud’s Disease (not Phenomenon) where fingers go dark red

Diabetes (discuss with Ruth)

Pregnancy

Skin Type Fitzpatrick 4-5-6 : increased pigmentation risk

Prone to hyperpigmentation

Prone to Keloid Scarring

Hepatitis/HIV/ HTLV3/ Compromised Auto-Immune System

Transmissible spongiform encephalopathy (CJV/vCJD)

On kidney dialysis

Scleroderma - autoimmune condition that can cause hard, thickened areas of skin.

Necrotic Conditions

Cancers

Cryotherapy is a relatively low-risk treatment and side effects and complications are usually minimal. Some side effects may occur as a result of the treatment. These include:

• Headaches are not uncommon when freezing on the forehead, scalp and temples and can last for 2 hours.

• Pigment changes. Both hypopigmentation (lightening of the skin) and hyperpigmentation (darkening of the skin). Both generally last a few months, but can be longer lasting.

• Nerve damage. Though rare, damage to nerves is possible, particularly in areas where they lie closer to the surface of the skin, such as the fingers, the wrist, and the area behind the ears. Reports suggest this will disappear within several months.

• A blister may appear in the treated area and can last anything from a few hours to a few days, dependent on the area to be treated. Do not pop.

• Shards of frozen ice. The innovation of Cryotherapy is the direct application of Nitrous Oxide under high pressure (55 bar). This high pressure jet may cause minor shards of frozen ice in the air blown away in a circle of approximately 30cm. They will thaw the moment they would eventually touch healthy skin.

• Treatments on sites with coarse terminal hair. Hair follicles are easily damaged by Cryosurgery and permanent alopecia is not uncommon.

Cryotherapy treatments are safe and effective, with excellent results. However, aftercare for the areas treated is also important for you to achieve the best possible outcome.

There are few things, which can affect the outcome. Generally, the treatment will go smoothly and there will be no problems.

EXPECTATIONS

Treatment is usually painless, or with slight discomfort, initially immediately after the treatment has been applied you may get any of the following which will have been explained to you when you signed the consent form.

• Redness due to the initial inflammation, this is normal and is part of the healing process. The area may also be slightly raised.

• You may get a small dry scab, do not pick or pull the scab. Allow it to come away by itself

• Itching may occur, usually within a few minutes of treatment. It usually lasts only a few minutes but may last up to 1⁄2 an hour. It is due to release of histamine, and is totally normal in treatment of this kind

• Blisters may form with any treatment to the skin and can happen to anyone. Any blisters which do form, may last just a few hours or a few days dependent on the location that has been treated. Blistering may occur after treatment of any type of lesion. Any blistering will not affect the outcome of the treatment.

If blistering does occur, it is regarded as a normal occurrence -

*DO NOT* pop the blister; it will go down on its own.

• Should it burst, use a non-alcoholic wipe to clean the area, and apply a smear of antiseptic cream. It may also be covered with a dressing/plaster.

FOLLOWING TREATMENT WITH CRYOTHERAPY

DO NOT:

• Scratch or pick the treated area this will cause the area to take longer to heal and may cause damage to the skin

• Use scrubs on the area, as this will damage the surface of the skin

GENERAL HEALING EXPECTATIONS

• Most healing is straightforward and occurs without problem

• Most healing will take place in 4 to 6 weeks, however it may sometimes take longer than this, as all skin varies, and can take longer to regenerate

• Any treatments that take longer than 6 weeks to heal may need to be reviewed by your GP or clinic nurse.

• If your immune system is compromised, you may still have treatment, BUT healing may take longer, and you may require further treatment.

• If the area treated is tanned, the treatment will remove the tanning and the skin will need to repigment to the tanned colour. The small dry crusting that forms should come away after 4 weeks, if not please wait until it has done so before contacting the clinic/salon.

• During the healing time you may shower/wash as normal and use your usual cosmetics, including makeup, deodorants and moisturising creams.

SKIN TAGS;

• These will turn darker from the base and will dry up and fall off as the skin heals beneath them over 1 to 6 weeks.

• Larger tags may need a second treatment

• If the tag becomes sore or rubs against clothing it may be covered with a dressing or plaster

IMPORTANT INFORMATION

It is important that you use sun block (factor 50) following treatment.

You may continue to wash, bathe and shower as normal. Pat the area dry afterwards, do not rub dry. You may continue to use cosmetics and deodorants and perfume as normal.

If the treated area is weeping 2 weeks after treatment contact Ruth advice.