Cysts can also be treated by the twenty-second application of liquid nitrogen, a second application being given two minutes later. The whole of the cyst must be Treated. This therapy works by producing cold damage io the fibrotic  cyst wall, resulting in chemotaxis of polymorphs whose proteases - hopefully - will subsequently destroy the wall and allow healing. In a comparative study  this author's department confirmed the findings of Graham, who demonstrated that liquid r.itrogen is, in some patients, preferable to intralesional triamcinolone.

  Unfortunately some cysts respond badly to either or roth  intralesional  steroids and  liquid  nitrogen. An inadequately resolved and fibrotic cyst may be a very serious problem to the patient and excision, by a plastic surgeon, may prove valuable.