Acrochordons, commonly known as skin tags, are small, benign growths of the skin, often found in areas where skin creases or rubs together, such as the neck, armpits, or groin. While harmless, many people choose to have them removed for cosmetic reasons or to prevent irritation. Cryotherapy, a method using extreme cold, is a common and effective technique for removal. This process involves a predictable healing sequence, and understanding this timeline helps manage expectations about when the treated skin tag will detach.
Understanding the Immediate Effects of Freezing
Cryotherapy employs a cryogen, typically liquid nitrogen, to subject the skin tag tissue to sub-zero temperatures, which causes cellular destruction. This rapid cooling and subsequent thawing process creates ice crystals, leading to cellular necrosis. The extreme cold also damages the tiny blood vessels supplying the skin tag, inducing localized ischemia, which further ensures the tissue cannot survive.
Immediately following the procedure, the treated area will often turn pale or white due to the rapid freezing. Within hours, the site commonly develops redness and mild swelling as a localized inflammatory response begins. A blister frequently forms within the first 24 to 48 hours, which can be clear or sometimes hemorrhagic (blood-filled) due to damaged capillaries. This blistering is how the unwanted tissue is separated from the healthy skin below.
The Expected Timeline for Shedding
Detachment is a gradual process following the tissue death induced by freezing. The first sign of successful treatment is the darkening of the skin tag (deep purple, brown, or black) within a few days, indicating the tissue has died and is drying out.
As the underlying skin begins to heal, the dead tissue shrivels and forms a hard, protective scab. For most small to medium-sized skin tags, detachment occurs within 7 to 14 days after the procedure. The skin tag falls off when the natural healing process separates the scab from the healthy, newly formed skin beneath it.
Larger or thicker skin tags, or those located on areas with reduced circulation (like the lower legs), require a longer healing period. For these more substantial lesions, the complete shedding process can take up to three or four weeks. If the skin tag has not fallen off after three weeks, a second treatment session may be necessary, and a follow-up consultation is recommended.
Essential Post-Treatment Care
Proper care minimizes the risk of infection and promotes optimal healing. The area should be gently washed once daily with mild soap and water to keep it clean. Applying a protective barrier, such as petroleum jelly, helps keep the wound site moist and protected until the scab naturally falls off.
If a blister forms, do not puncture it, as the skin acts as a sterile dressing protecting the underlying tissue. The blister will typically flatten and dry out on its own, eventually forming the scab. If the blister breaks spontaneously, apply a sterile dressing or bandage to protect the open skin from friction and contaminants.
Over-the-counter analgesics, such as acetaminophen or ibuprofen, can be used to manage mild discomfort in the first day or two. Avoid picking, scratching, or forcefully removing the scab or skin tag prematurely. Doing so can disrupt the healing process, increase the risk of scarring, and potentially introduce infection.
Recognizing Signs of Complications
While cryotherapy is generally safe, monitor the treated site for signs of abnormal healing. Some degree of temporary redness, swelling, and tenderness is expected in the initial days after freezing. However, signs of a secondary wound infection warrant immediate medical attention.
Signs of infection include increasing and spreading redness beyond the treatment zone, excessive warmth, or thick, yellowish discharge or pus. Persistent or worsening pain unrelieved by medication, or the development of a fever, are also concerning.
Be aware of potential long-term cosmetic side effects, such as changes in skin color at the site. Hypopigmentation (lightening of the skin) or hyperpigmentation (darkening of the skin) can occur because the cells responsible for skin color are sensitive to cold temperatures. While these changes are often temporary, sun protection is recommended while the area is healing to minimize the risk of prolonged discoloration.