Kuwahara et al used cold forceps to remove a raised benign skin lesion such as a skin tag or wart. A benign lesion usually is treated to –20°C. One advantage of this method is that there is less freezing of adjacent tissue (less collateral damage).


This method can be used on potentially risky areas such as the eyelid if the operator is experienced.



(1) liquid nitrogen source

(2) stable container for dispensed volume of liquid nitrogen

(3) freezing tool

(4) grasping tool (to help manipulate the skin lesion so easier to grasp)

(5) personal protective equipment (fingers from cold, eyes from liquid nitrogen)


The container into which the liquid nitrogen is dispensed should be stable and not likely to tip over.


The freezing tool can be as simple as a pair of tweezers. Use of a hemostat adds an element of crushing trauma to the base of the lesion. The more metal available the greater the cryo-capacity with a reduction in the need to re-apply.


The applicator end of the freezing tool is placed in liquid nitrogen. Once properly chilled the tool will develop a frost over its surface.


The freezing tool has both tips compressed against the base of the lesion for about 15 seconds. The lesion may develop a frost. A second application is often given.


A lesion that has been effectively treated should fall off in about 1 week. A war may require a second treatment session.


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