What happens at a consultation
Dr Buckley will examine the scar, ask about how and when it formed, and go through your medical history. Size, age, site and skin type all change which treatments are realistic, so this is the point at which a plan gets made.
He will set out what treatment can and cannot achieve for your particular scar. If a treatment that suits you is not provided at the clinic — superficial X-ray therapy or bleomycin and 5-FU injections — he can refer you on.
Caring for your wound after cryosurgery
Cryosurgery uses very low temperatures to destroy unwanted tissue. There may be some pain or discomfort at the time of treatment and for a few hours afterwards.
Pain relief
This seldom needs more than paracetamol or ibuprofen.
- Paracetamol can be taken every 4 hours, no more than 4 doses in 24 hours
- Ibuprofen can be taken every 4 to 6 hours, no more than 3 doses in 24 hours
- Take the maximum dose appropriate for your age
- In the first 18 hours you may alternate paracetamol and ibuprofen every three hours if needed
- For more intense pain, take both at the same time
If the treated area is on an arm, use a sling. If it is on a leg, keep it 30 degrees above horizontal for 24 hours. This eases pain, reduces swelling and lowers the risk of bleeding.
Cleaning and dressing
For as long as the wound is oozing, clean it daily with diluted antiseptic or salt water — half a teaspoon of salt in a cup of boiled, cooled water. Wash gently, pat dry, and apply an antiseptic cream. Keep the wound covered with a clean dry dressing each day until it stops oozing.
Once a scab has formed and the oozing has stopped, leave the dry scab open to the air. Wait for it to fall off, which it will do within two to six weeks once the skin underneath has healed. If the scab is only loosely attached, you can gently remove it yourself a few weeks after treatment.
Swelling and blistering
The treated site and the skin around it may swell within minutes. A blister may develop within a few hours or a day or two, and it may be filled with clear or blood-stained fluid.
If the blister is large, burst it with a sterile pin and squeeze out the fluid. Leave the top of the blister on the wound — it acts as a biological dressing.
Areas frozen on the face may cause swelling of the eyelids or cheeks, and occasionally an eyelid will close with swelling. No special treatment is needed; it always settles within a few days.
Bleeding
Bleeding occasionally happens. It can usually be controlled by applying firm pressure to the wound for 5 to 10 consecutive minutes — timed on a watch, without letting go — using kitchen towel, tissue or a clean cloth. Bleeding from an arm or leg can be further controlled by elevating the limb as high as possible and applying a firm bandage.
Healing time
Healing after liquid nitrogen treatment varies from two to eight weeks, and may be longer on some parts of the body such as the legs and feet.
Signs of infection — contact the clinic
Wounds occasionally become infected. Signs are redness spreading into the surrounding untreated skin, swelling, a smelly or pus-like discharge, and pain that gets worse rather than better as the days pass. If you think the wound is infected, contact the clinic immediately — you may need an antibiotic.
If you have any worries or problems after treatment, contact one of the doctors or nurses at the Kerry Skin Clinic.
Fees
Fees are charged according to the time allocated, the investigations performed and the treatment given. Prices are subject to change, and fees are discussed with you before treatment.
The facility fee
For more complex surgical procedures, including cryosurgery for keloids and hypertrophic scars, there is a facility fee, separate from the surgeon's fee. It covers the surgical assistant, the surgical materials used, insurance, rent and rates.
Single-use instruments are used once and safely disposed of. Other surgical instruments go through a three-stage sterilising procedure in line with HSE guidelines. Suturing materials, glues, dressings and surgical assistant time are needed for most surgical procedures.
What insurance covers
The facility fee is not covered by private health insurance — VHI, Laya, Irish Life Health, Garda Medical Aid, or Level Health — nor by a medical card. You may be able to claim some or all of it back through tax relief at the end of the year.
The surgeon's fee is separate and is usually covered in full by insurers or the medical card. It includes a free follow-up visit to remove sutures where required.
For approximate prices, insurance and tax relief, see Fees.