What should you know about cryosurgery for actinic keratosis?

Actinic keratosis is a rough, scaly area caused by long-term sun damage, often on exposed skin such as the face, scalp, ears, forearms, or backs of the hands. During cryosurgery, a clinician applies extreme cold to the chosen lesion. The area may sting or burn briefly, then become red, swollen, blistered, crusted, or tender while it heals.

A treated spot may need time to settle, and colour change or a small scar can occur. Not every rough patch is actinic keratosis. A thick, painful, rapidly changing, bleeding, or non-healing lesion needs careful review because [Squamous Cell Carcinoma](/conditions/squamous-cell-carcinoma/) can resemble sun-damaged skin.

Tell the clinician about previous skin cancers, poor wound healing, immune problems, allergies, and medicines that affect bleeding or healing. Ask whether one lesion or a wider field needs treatment. Alternatives for selected cases include [Photodynamic Therapy](/treatments/laser-and-energy/photodynamic-therapy/), [Imiquimod Treatment](/treatments/medical-dermatology/imiquimod-therapy/), or [Topical 5-Fluorouracil](/treatments/medical-dermatology/topical-5-fluorouracil/).

Keep the site clean, do not pick the crust, and use the dressing recommended by the clinic. Protect treated and surrounding skin from sunlight as advised. Arrange follow-up if the lesion persists, returns, or cannot be distinguished from a healing mark.

Report spreading redness, increasing warmth, pus, fever, worsening pain, or swelling that is not improving. Seek urgent help for severe allergic symptoms or rapidly worsening illness. Arrange prompt review for a lesion that grows, bleeds, becomes painful, forms a thick horn-like scale, or remains open; it may need [Skin Cancer Screening](/treatments/diagnostics-and-testing/skin-cancer-screening/).

How confident are you in the diagnosis, and is a biopsy needed? What healing changes should I expect? How should I care for the site and protect it from sun? What will we do if the spot remains? Should I have broader skin checks or [Follow-Up After Cancer Treatment](/treatments/survivorship-and-rehabilitation/post-treatment-surveillance/)?