Cold therapy, particularly using liquid nitrogen (LN), has demonstrated remarkable versatility in dermatology beyond its traditional role in destroying skin lesions. In addition to its efficacy in this regard, LN has found application as an alternative form of anesthesia for various procedures, exemplified by its use in botulinum toxin infiltration on palms and soles (cryoanesthesia). This highlights LN’s multifaceted utility within dermatological practices. For instance, it serves as a topical analgesic for superficial procedures like shaving biopsies, offering simplicity, rapidity, and the distinct advantage of obviating the need for local anesthesia infiltration. Consequently, shave biopsies conducted with LN present minimal concern regarding tissue alterations in biopsies examinations as LN induces no microscopic artifacts in the specimen. Such multifunctional capabilities underscore the significance of LN as a valuable tool in dermatological practice, extending beyond lesion destruction to enhance patient comfort and procedural efficiency.