[Cryosurgical treatment of hypertrophic scars and keloids]

The treatment of hypertrophic scars and keloids is a problem that has not yet been satisfactorily solved. We report here the results obtained with cryosurgery by the contact freezing method in 45 patients with 56 evaluated lesions. During the period of the investigation, cryosurgical treatment was completed in 23 patients with 28 lesions: in 53.6% we recorded an excellent result (ER), in 32.1% a good result, and in 14.7% a poor result. None of the lesions was totally resistant. Lesions that had been present for under 1 year (ER = 77.8%) and hypertrophic scars (ER = 72.2%) responded better than older lesions (ER = 41.2%) and keloids (ER = 20.0%), respectively. Optimal results were obtained after 4 +/- 2 sessions. Evaluation of the cryosurgical treatment in all patients revealed that the flattening of the lesions was increased after each session. Hypertrophic scars and lesions less than 4 cm2 in area responded more quickly than keloids and larger lesions, respectively. Pretreatment had a negative influence on the results of cryosurgery. No relapses were observed. The treatment was generally well tolerated, slight pain during freezing (52.1%) and hypo-/hyperpigmentation (22.9%) being the most frequent side-effects. Cryosurgery is simple to learn, and the technique is recommended for the treatment of hypertrophic scars and keloids.