Procedure

Cryotherapy (Liquid Nitrogen)

Liquid nitrogen is sprayed or dabbed onto a spot to freeze and destroy it. It is a standard treatment for warts, precancerous sun spots and some harmless growths. It commonly leaves a pale mark that does not fully come back.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
16:9 hero for Cryotherapy (Liquid Nitrogen). Never cropped: the tone strip and the corner logo depend on the full frame.

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Freezing is genuinely quick, cheap and effective, and it regularly leaves a permanent pale mark.

What I find myself repeating: the pale spot is not a rare complication. Pigment cells die at milder cold than a wart does, so a freeze hard enough to work often takes the color out of that patch of skin, and on deeper skin tones that shows far more.

The line I do not cross is freezing a spot nobody has identified, because a melanoma destroyed without a diagnosis can look gone while it is still growing underneath.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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Also calledCryosurgery, cryodestruction, freezing, liquid nitrogen treatment, having something frozen off
DowntimeNone from the appointment itself. The treated spot blisters and crusts, and takes 1 to 3 weeks to heal, longer on the legs and feet
SessionsOften one for a sun spot or a harmless growth. Warts usually need repeat freezes every 2 to 4 weeks, frequently several
Typical costIn the US, usually billed as a medical treatment and covered by insurance for warts and precancerous spots. Freezing a harmless growth for appearance is generally cosmetic and paid out of pocket
Results timelineA blister within a day, a crust that separates over 1 to 3 weeks. Warts take weeks to months of repeat treatment
PainA sharp burning sting for 10 to 30 seconds during the freeze, then aching for up to a few hours. Fingers, toes and soles hurt most
Skin tone safetyA permanent pale mark is a common outcome and is much more visible on deeper skin tones. This belongs in the conversation before treatment, not after

What It Is

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Liquid nitrogen is a liquefied gas at about -196C, or -320F. It is sprayed or dabbed on with a spray gun, a cotton-tipped applicator or a metal probe, freezing the tissue within seconds. The frozen cells die, the body lifts them off as a blister and a crust, and new skin heals underneath. It treats viral warts, actinic keratoses (rough scaly precancerous sun spots), seborrheic keratoses (harmless raised growths that look stuck on), molluscum and skin tags. Because it destroys the tissue, nothing goes to a laboratory, so it only suits a spot already identified confidently by eye. Anything pigmented, new, changing or uncertain should be examined and sampled instead.

How It Works

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Freezing forms ice crystals in and around the cells, tearing their membranes. As the tissue thaws, the vessels feeding it clot and the frozen tissue dies over the next few hours. The skin separates between its top layer and the one beneath, so a blister forms with the growth on its roof, and a light freeze rarely scars. Depth depends on how long the freeze lasts, how wide a margin is taken, and whether it is repeated. A few seconds treats a thin sun spot; a thick wart on the sole needs longer and is usually frozen twice in one visit. With warts, the inflammation also helps the immune system notice the virus, part of why they sometimes clear beyond the area treated. The catch is the same mechanism — pigment cells die at milder cold than the growth, so almost any effective freeze takes color with it.

Skin is about two millimetres thick on the face. How deep a treatment reaches decides what it can change, and whether it treats all of the skin or scattered columns of it decides how long you take to heal.

How it works
Compare
Skin basics
EPIDERMISDERMISFAT0.05 mm — pigment0.5 mm — texture + pores1.0 mm — collagen1.5 mm — deep dermisPEELNEEDLINGNON-ABLATIVE LASERABLATIVE LASERREACHES THE UPPER DERMIS

This reaches just past the epidermis into the top of the dermis, around half a millimetre down. That is where fine texture, pores and the shallowest scarring sit. Deep enough to remodel a little, shallow enough that healing is measured in days.

A peel or a scrub takes the skin off evenly from the surface down. Everything above the line goes and nothing below it is touched, which is why peels suit surface pigment and rough texture, and why the whole face flakes for a few days after.

Needles make hundreds of separate channels and leave the skin between them untouched. That untouched skin is what heals the rest, so recovery is quick — but a needle only injures the skin to start repair. It removes nothing.

The light passes through the surface and heats a column underneath it. The surface stays whole, so you leave red rather than raw — and it takes a course of sessions rather than one.

The laser removes columns of skin outright: the white gaps here are tissue that is gone, and new skin grows in from the sides. The strongest of the four, and the longest to heal.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

What It Treats

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Sun Spots (Solar Lentigines)
Sun Spots (Solar Lentigines)
Strong evidence
A few seconds of liquid nitrogen on each spot, done in the room, no anesthetic needed. The spot darkens, crusts and lifts off over one to two weeks. It suits a small number of spots rather than a whole hand, and its known cost is a permanent pale mark where too many pigment cells were destroyed, which is a bigger risk on medium and deeper skin tones.
Warts
Warts
Strong evidence
Liquid nitrogen freezes the infected skin and the injury also draws immune attention to the spot. It needs repeating every two to four weeks, usually three or four times, and a wart regrowing from the edge between sessions is normal rather than failure. Over several months its results are broadly similar to salicylic acid used properly. It stings, it blisters, and on deeper skin tones it can leave a lasting pale or dark mark.
Actinic Keratosis
Actinic Keratosis
Strong evidence
Freezing with liquid nitrogen is the quickest option for a handful of separate patches, done in a few seconds each with no prescription. It stings sharply, then blisters or crusts and heals over one to three weeks. Its limit is that it only treats what can be seen, so new patches keep arriving from the damaged skin around them. It often leaves a permanently pale mark, which is more noticeable on deeper skin tones — worth asking about before you start.
Seborrheic Keratosis
Strong evidence
A few seconds of liquid nitrogen makes flatter growths blister and lift off over a week or two, and it is the quickest way to treat several at once. It destroys the growth, so nothing can be examined afterward, which is why it is not used on anything with a question attached. It is used cautiously on the face and on deeper skin tones, because the pigment cells are sensitive to cold and it can leave a pale spot.
Plantar Warts
Plantar Warts
Moderate evidence
Freezing in clinic, repeated every two to three weeks. Over several months the results are broadly similar to salicylic acid used properly, so it is one reasonable option rather than the top of a ladder. On the sole it is more painful than elsewhere, walking is sore for a day or two, and it works far better if the callus is pared first.
Molluscum Contagiosum
Molluscum Contagiosum
Moderate evidence
Each bump is frozen for a few seconds, and it usually takes several visits a few weeks apart. It works, and it is quick. It also stings sharply at the time, which most young children will not sit through twice, and it leaves dark or pale marks more readily than the other options — a real consideration on deeper skin tones, where those marks can last longer than the infection would have.
Skin Tags
Skin Tags
Moderate evidence
A few seconds of liquid nitrogen freezes the tag so it drops off over a week or so, and it is quick when there are many. It is less predictable with pigment, because the pigment-producing cells are sensitive to cold, so it is used more cautiously on deeper skin tones and near the eyes. It destroys the tag, so nothing can be examined afterward.

Not the Best For

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Keloids
Keloids
Limited evidence
Freezing can soften and flatten smaller keloids, and is sometimes used just before an injection to make the scar easier to inject. The problem is that freezing destroys pigment cells and often leaves a permanent white patch. On deeper skin tones, where most keloids occur, many dermatologists use it cautiously or not at all.
Squamous Cell Carcinoma
Squamous Cell Carcinoma
Limited evidence
A quick freeze in clinic, used for actinic keratoses and occasionally for a small patch of carcinoma in situ. It is a treatment for the step before this cancer, not for the cancer itself. Freezing an invasive tumor leaves cells behind at depth and hides what is happening under a healing crust.
Basal Cell Carcinoma
Basal Cell Carcinoma
Limited evidence
Freezing is quick and occasionally used for small superficial tumors when other options do not suit. Nothing is checked under a microscope, so an incompletely treated tumor can carry on growing under a healed surface. It also leaves a permanent pale patch, which is much more noticeable on deeper skin tones.
Milia
Weak evidence
Freezing is sometimes offered for milia. It is less precise than extraction, more uncomfortable, and on deeper skin tones it carries a real risk of leaving a pale or dark mark where the bump was. There is little reason to choose it over opening the sac and lifting the contents out.
Moles
Never use
Freezing is excellent for several other skin growths and is the wrong tool for a mole. It destroys the tissue, so nothing can be examined, and it commonly leaves the deeper pigment cells behind along with a pale mark. Lasering or burning a mole off has the same two problems. If a mole is worth removing, it is worth removing in a way that can be checked.

Pros and Cons

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Pros
  • Fast and simple No cuts, no stitches, seconds.
  • Effective for what it treats First-line for precancerous sun spots.
  • Usually covered Warts and sun spots are medical, not cosmetic.
  • Little disruption Normal activity the same day.
Cons
  • Pale marks are common A lighter patch, often permanent.
  • It hurts more than people expect A sharp sting, hours of ache, days of blister.
  • Warts often need repeats Several over months; some never clear.
  • Nothing goes to the laboratory Sample an uncertain spot first.
  • Some sites are a poor choice Lower legs heal slowly; finger sides overlie nerves.

How to Prepare

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A few days beforeOn the day
Thick warts
A few days before
Soaking and filing the wart with a pumice stone or emery board helps the freeze reach the wart, not the callus on top. The clinic often pares it down too.
Wart acid and clothes
On the day
No wart acid that morning. Wear something that leaves the area easy to reach, and expect a dressing when you leave.
Ask your provider
If more than one spot is planned, ask to start with one and see how the skin heals.

What Happens

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ArrivingThe treatmentLeaving
Arriving
The spot is examined first — the most important part of the visit. Anything pigmented, new, changing or uncertain is examined closely, often with a dermatoscope, and sampled if in doubt, not frozen. Thick warts and callus are pared with a blade, painlessly. Numbing is usually none, though local anesthetic is used for a large area, a thick sole wart, or children. Your provider will ask about these things.
The treatment
Liquid nitrogen is sprayed or dabbed on until a white frozen halo covers the spot and a small margin. A sun spot takes seconds; a wart takes longer and is usually thawed and frozen again the same visit. It burns and stings, peaking as the skin thaws, then aches for a few hours. Fingertips, toes, soles and ears are sorest. Brief and unpleasant, not severe.
Leaving
Red, swollen and tender, sometimes blistering within the hour. Face and eyelid swelling looks more dramatic than the spot's size suggests. A dressing goes on and you go back to normal activity.

Recovery

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Days 1 to 3Days 4 to 14Weeks 2 to 8
Days 1 to 3
A clear or blood-filled blister is expected, not a sign anything went wrong. Leave the roof intact. If it is large and painfully tense, the clinic can drain it cleanly. Acetaminophen or ibuprofen handles the ache.
Days 4 to 14
The blister dries into a dark crust with the growth on top, and lifts off on its own over one to two weeks. Feet and lower legs take longer. Picking it off early is the main cause of a scar.
Weeks 2 to 8
New skin is pink and delicate. It often darkens first, especially on deeper skin tones, then settles paler than the skin around it. After a hard freeze the pale mark is permanent.

Aftercare

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From the next dayUntil the crust liftsSeveral months
Washing
From the next day
Wash gently with soap and water and pat dry. Keeping it dry and untouched slows healing.
Dressing
Until the crust lifts
Petroleum jelly and a bandage until the crust separates — faster healing and less marking than letting it dry out and split.
Sun
Several months
SPF 30 or higher on the healing spot. Sun makes a dark mark more likely and slower to fade.
Blisters
Leave them alone. If one is large, tense and painful, ask the clinic to drain it.
Crusts
Let them fall off. Pulling one off is the most common cause of a scar.
Exercise
Fine, though a frozen sole is sore to walk on for a few days.

Risks

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Pain, swelling, a blister and a crust are expected. The risks worth naming are the ones that last.

A pale mark that is not filling back in
Pigment loss at the site is common, and after a hard freeze permanent. Say so — it changes what should be used on any remaining spots.
A dark mark
Post-inflammatory hyperpigmentation, a brown mark left after inflammation. More common on deeper skin tones and after sun, and treating it early shortens it.
Numbness or tingling
Nerves close to the surface, particularly at the sides of the fingers and toes and near the ear, can be injured. Recovery usually takes months, sometimes far longer.
A raised or thickened scar
More likely on the chest, shoulders, upper back and jawline, and in anyone who has had a keloid.
Hair loss in the treated patch
Follicles are cold-sensitive, so freezing the eyebrow, beard or scalp can leave a bald patch that does not regrow.
Still not healed after 4 weeks
Especially on the lower leg, where circulation is poorer and a frozen spot can turn into a slow ulcer.
The growth is back or never went
Common with warts and expected. A sun spot that returns should be sampled, not frozen a third time.

In Deeper Skin Tones

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Cryotherapy works the same way on every skin tone. What changes is how visible the mark it leaves is, and that should change how the decision gets made.

Pigment-making cells sit at the base of the top layer of skin and are more sensitive to cold than the cells around them. They die well short of the temperature needed to destroy a wart or a sun spot, so almost any freeze strong enough to work takes pigment with it. The result is a pale patch — hypopigmentation — at the treated site. It is a common outcome, not a rare accident, and after a firm freeze much of it is permanent.

The site often darkens first for several weeks, then lightens. That two-stage pattern misleads people — early reassurance that the dark mark is fading is followed months later by a pale one. The patch is usually wider than the original spot, since the freeze spreads sideways. Against deeper skin a pale ring where a harmless bump used to be can be more noticeable than the bump ever was.

So the first question is whether the spot needs treating at all. Seborrheic keratoses, skin tags and most benign growths are harmless, and freezing them is a cosmetic choice you can decline. Where treatment is needed, ask for a shorter freeze with a tighter margin, have one spot done as a test before another twenty, and ask what the mark should look like at six months.

Dermatosis papulosa nigra is a specific example. These are the small dark raised bumps on the cheeks and temples, common in people with deeper skin tones. Freezing them leaves pale dots that stand out more than the bumps did, so most dermatologists use fine electrodesiccation, a light snip, or a laser suited to deeper skin tones, testing a small area first.

Alternatives carry less pigment risk. For warts — salicylic acid at home over weeks, cantharidin in the office, injected immunotherapy, or waiting, since a great many warts clear on their own. For precancerous sun spots — 5-fluorouracil or imiquimod cream treats a whole sun-damaged area rather than spot by spot, with weeks of redness and crusting but usually no pale marks. They take longer, and that trade is often right somewhere visible.

Keloid and thickened scars are also more common in deeper skin tones, and freezing the chest, shoulders, upper back or jawline can trigger one, so say up front if you have ever had one. If you have vitiligo, freezing can set off a new patch of pigment loss at the site.

None of this means avoiding cryotherapy. Precancerous spots and stubborn warts are worth treating and freezing works. It means the pale mark should be a decision you made with information in front of you, not something you find in the mirror two months later.

If You Stop

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Stopping partway through causes no rebound or flare, and it does not change the marks already left. What it changes is the underlying problem. A partly treated wart usually regrows and stays contagious, so it can spread on your own skin and to other people — though many warts clear on their own, particularly in children, and choosing to wait is a legitimate decision rather than a failure. Untreated actinic keratoses are different. A small proportion turn into squamous cell skin cancer over years, so stopping treatment means keeping up with skin checks rather than forgetting about them. If you stop because the freezing hurt too much or because of the marks, say so — there are other treatments for both problems.

Combining Treatments

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Same day
Salicylic acid for warts
At home between visits, it beats either alone.
Same day
Soaking and filing
Softening and filing the wart first is part of the plan.
Same day
5-FU or imiquimod cream
Often combined with freezing for sun spots.
Same day
Sunscreen
Daily use is part of treating sun damage, not an extra.
Same day
Ordinary skincare
Continues as normal on untreated skin.
Wait 2–4 weeks
Another freeze
Space repeat freezes 2 to 4 weeks apart so skin heals.
Don’t combine
Broken or treated skin
Not skin just peeled, lasered, waxed or resurfaced, or an active rash.
Until healed
Cosmetic treatments
Wait until the crust has separated and the pink settled.
Wait several months
Laser on a pale mark
The final color takes that long to declare itself.

Insurance Coverage

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In the US, freezing warts and precancerous sun spots is billed as medical treatment, so you pay your copay or whatever the deductible has not covered. Removing harmless growths like seborrheic keratoses or skin tags for looks is cosmetic and not covered.

Ask Your Doctor

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If you are pregnant or breastfeeding
Ask the doctor managing your pregnancy or breastfeeding first, even for a small spot.
If you have a deeper skin tone
The pale mark is the main issue and often permanent. Ask for a shorter freeze, a test spot first, and what the site will look like at six months.
If you have Raynaud's or cold hives
Cold can set these off, as it can in cryoglobulinemia. Fingers and toes are generally not frozen in Raynaud's.
If you have poor circulation in your legs
Diabetes in the legs and feet counts. A frozen spot on the lower leg heals slowly and can become a long-lasting sore. That changes whether to do it at all.
If you take a blood thinner
The blister may fill with blood — alarming rather than dangerous, but easier if you expect it.
If you have ever had a keloid scar
Freezing the chest, shoulders, upper back or jawline can trigger one.
If you have vitiligo
Freezing can start a new patch of pigment loss at the site.
If you get cold sores near the area
Freezing near the lips can trigger an outbreak; antiviral medicine can be started first.
If the area has hair you want to keep
Freezing the eyebrow, beard or scalp can leave a permanent bald patch.
If your immune system is suppressed
Warts are harder to clear and need more treatments. Discuss a plan, not an appointment.
If the spot is somewhere visible
Ask what the mark will look like, and whether something that leaves less of one fits better.

At-Home Versions

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Salicylic acid wart treatments, 17% liquid or 40% plaster
Good alternative
The best-supported home option for warts on the hands and feet. Soak, file the surface, apply daily, and expect weeks to months. Cheap, and it leaves no pale mark.
Over-the-counter freeze sprays for warts
Okay alternative
A propellant gas that is cold but far warmer than liquid nitrogen and much harder to aim. Reasonable for a small wart on a hand, often not enough for a thick or plantar one. It can still blister and still leave a pale mark. Never on the face, and never on a mole or any spot that has not been looked at.
Duct tape over a wart
Okay alternative
Trials are mixed and it is harmless to try alongside salicylic acid. It is not a reason to skip treatment that works.
Freezing pens, mole removal pens and cauterizing pens sold online
Bad alternative
Do not. They destroy a spot without anyone knowing what it was, scar readily, and treating the surface of a skin cancer can hide something that is still growing underneath. Nothing pigmented should ever be treated at home.
Anything applied to a spot on the face, genitals or around the eyes
Bad alternative
Do not. These sites need a diagnosis first and treatment chosen to fit them.

How It Compares

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Salicylic acid for warts
The same
Daily treatment at home over weeks to months, with soaking and filing. Slower and needs persistence, but it does not bleach the skin and costs very little. It works better still alongside freezing.
Cantharidin for warts and molluscum
Better
Painless when applied in the office, then blisters hours later. Useful in children who cannot tolerate freezing, and less likely to leave a pale mark.
Injected immunotherapy for stubborn warts
Different job
An antigen is injected into a wart every few weeks, and warts elsewhere on the body sometimes clear too. Can cause a flu-like day afterwards. Reserved for warts that have not responded.
5-fluorouracil or imiquimod cream
Different job
For precancerous spots. Treats a whole sun-damaged area rather than the visible spots one at a time, which usually means fewer new ones later. The trade is weeks of visible redness, crusting and discomfort instead of one appointment.
Curettage and electrodesiccation
Better
The growth is scraped off and the base sealed with heat. Comparable marking risk, more precise control of the edges, and it can provide tissue for the laboratory if there is any doubt.
Shave or excision biopsy
Different job
The only option that removes the spot and tells you what it was. This is the right choice, not freezing, for anything pigmented, changing or uncertain.

Finding a Provider

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Cryotherapy is done by dermatologists, family doctors, nurse practitioners, physician assistants and, for feet, podiatrists. It is a medical treatment, not a spa one — no esthetician, salon or mobile mole-removal service should be freezing anything. Ask what they think the spot is, whether it should be sampled instead, how long they plan to freeze, what mark to expect, and the plan if it does not clear. Red flags: freezing a pigmented spot without examining it closely, offering to freeze moles, treating a long list of spots in one visit without discussing the marks, refusing a test spot on deeper skin tones, and cosmetic mole removal outside a medical setting.

Myths

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  • "You can have a mole frozen off." You cannot, and no one should offer to. Freezing destroys the tissue without anyone knowing what it was, and if the spot was a melanoma the surface can heal over while it keeps growing underneath. Any mole that needs removing is cut out and sent to a laboratory. That applies even to a pigmented spot someone is sure is harmless — that confidence is what a biopsy exists to check.
  • "The freeze kits from the drugstore are the same thing." They are not. Home kits use a propellant gas that is cold but nowhere near liquid nitrogen, and cannot be aimed precisely. They work on some small hand warts and often fail on thick or plantar ones. They can still blister and leave a pale mark, and never belong on the face or on anything pigmented.
  • "If it blistered, something went wrong." A blister is the expected result — the skin separates at a natural plane and lifts the growth off with it. A blood-filled blister is normal too and looks worse than it is.
  • "The white mark will fade eventually." Some usually does, over months. A meaningful proportion does not, and a hard freeze leaves a permanent pale patch.
  • "One freeze cures a wart." Frequently not. A wart is a virus in the skin, and freezing the visible lump does not always reach all of it. Several treatments over months is normal, and some warts need a different approach.
  • "It is a quick fix for a skin tag at home." Freezing something on your own body without knowing what it is, with a device you cannot aim, on skin you cannot see properly, is where the avoidable harm on this page comes from. A skin tag is a two-minute job in a clinic.

Questions Patients Ask

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Does freezing leave a white mark?

Often. Pigment cells die at milder cold than the growth, so most effective freezes take some color out. Some returns over months; a good part does not. The mark is usually a little wider than the spot and stands out far more on deeper skin tones — worth discussing before you agree.

Can a mole be frozen off?

No. Freezing destroys the tissue without a diagnosis, so a skin cancer can heal over at the surface while it keeps growing underneath. Anything pigmented, new or changing gets examined and sampled, and moles that need removing are cut out and sent to a laboratory. Same for at-home freezing and mole removal pens.

How much does it hurt?

A sharp burning sting for ten to thirty seconds during the freeze and the thaw, then an ache for a few hours. Fingers, toes, soles and ears are worst. Brief and genuinely unpleasant rather than severe, and ordinary painkillers are enough.

Is the blister normal, and should I pop it?

Normal, and it is how the treatment works — the skin separates and lifts the growth off with the blister roof. Leave it alone and cover it. If it is large, tense and painful, the clinic can drain it, which beats tearing the roof off yourself.

How many treatments will my wart need?

Usually several, every two to four weeks. Many clear over three to six treatments, some need more, and some never respond. Salicylic acid at home in between improves the odds. If nothing has changed after three or four sessions, ask about a different approach.

Are the drugstore freeze kits the same as what a doctor uses?

No. They use a propellant gas much warmer than liquid nitrogen and harder to aim, so they are weaker on thick and plantar warts. They can still blister and leave a pale mark. Not for the face, and never on a mole or an unexamined spot.

References

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