Intralesional cryosurgery treats a scar from the inside out. Rather than freezing the surface, a fine probe is placed into the scar tissue and liquid nitrogen is passed through it, freezing the scar from within while the healthy skin around it is largely spared.
Over the following weeks the treated scar shrinks, flattens and becomes less noticeable.
First in Ireland
Dr Buckley is the first doctor in Ireland to offer intralesional cryosurgery for keloids and hypertrophic scars. He is a member of the International Society of Cryosurgery and the American College of Cryosurgery, and has travelled internationally both learning and teaching the technique.
Why freeze from the inside
Surface freezing has to work through the full thickness of a raised scar, which means a great deal of cold has to pass through the skin on top. Treating from within concentrates the freeze where the scar tissue actually is. In practice that means:
- It works on stubborn keloids and hypertrophic scars that have not responded to other treatments
- It is minimally invasive, with no cutting and no stitches
- Sessions are short, usually no more than 30 minutes
- Cosmetic results improve steadily over the months that follow
Most patients see visible improvement within a few weeks. Larger scars may need more than one session.
What happens during treatment
- Consultation. Dr Buckley examines the scar and goes through your medical history.
- Local anaesthetic. The scar is numbed.
- The freeze. A small cryoprobe is inserted into the scar and liquid nitrogen is used to freeze it internally.
- Healing. The area swells and scabs, then gradually flattens over roughly four to eight weeks, depending on the size and site of the scar.
- Review. Further sessions are arranged if they are needed.
Most people are able to return to work or school the following day.
What recovery actually looks like
This is the part worth reading twice, because it surprises people who have not been told what to expect.
The first few weeks
The scar swells, blisters and weeps for the first few weeks. At around four to six weeks it goes black, dries out and falls off. This is the treatment working, not a complication. Full aftercare instructions are on the patient information page.
You can see exactly how this progresses in the week-by-week ear keloid sequence on our results page.
Who it suits
Intralesional cryosurgery tends to be the treatment of choice for medium (1–2cm) and large (over 2cm) keloids and hypertrophic scars. Keloids larger than 3cm may not be suitable, and may need to be referred elsewhere, including abroad. It is also worth considering if you have:
- Raised, thick or painful scars
- Keloids that have returned after other treatments
- A preference for avoiding more invasive procedures
Smaller scars under 1cm, particularly recent ones, are usually better served by intralesional steroid injections.
Side effects
The main one is loss of pigment in the treated area, which is more noticeable on darker skin. There is also pain, swelling and oozing for the first few weeks. Dr Buckley will go through all of this with you before treatment.