Everything you need to know about ice burns

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The symptoms of an ice burn can include:

• red, white, dark, or gray skin
• pain
• blisters
• numbness
• tingling
• itchiness
• hard or waxy skin

When a person experiences an ice burn, several things happen to the tissue:

• the water in the skin cells begins to freeze
• the frozen water forms ice crystals, which damage the skin cells
• the blood vessels constrict, reducing blood flow and delivery of oxygen to the area
• blood clots may form, further restricting blood flow and oxygen
• bleeding can occur if the cold temperature affects blood-clotting proteins

Exposure to extreme cold causes the blood vessels to narrow, diverting blood to the vital organs to protect them.

A reduced volume of blood will reach the parts of the body furthest from the central organs, which is why the hands, feet, fingers, and toes are particularly prone to injuries from the cold.

Causes of ice burns include:

• exposure to freezing temperatures for extended periods
• exposure to wind and high altitudes
• direct contact with a freezing object, such as an ice pack, for a prolonged period

Other factors that can increase a person’s likelihood of getting an ice burn include:

• homelessness
• participating in winter sports
• smoking
• taking medications that restrict blood flow, such as beta-blockers
• conditions that impair circulation, such as diabetes or peripheral vascular disease
• peripheral neuropathy or other conditions that reduce a person’s ability to detect injuries
• Raynaud’s phenomenon

Younger children and older people have a higher risk of cold injury, as they are unable to regulate their body temperature as efficiently and tend to lose heat more quickly.

People under the influence of alcohol or drugs may not be as alert to the cold and may not immediately notice the discomfort of cold exposure that can lead to ice burns.

To prevent ice burns, people should wear appropriate clothing for cold temperatures or high-velocity winds.

Also, when using an ice pack, people should ensure that it does not directly touch the skin. Placing a cloth or towel in between the ice pack and the skin can help to prevent ice burns.

Ice burns can cause scarring. The likelihood of scarring depends on many factors, including the area of the ice burn and how many layers of tissue are affected.

The skin consists of several layers. These include an outer layer, known as the epidermis, and a lower layer, called the dermis. Beneath these layers are tissues that include muscles, tendons, and other connective tissue.

If a burn only penetrates the epidermis, it may not cause significant scarring. However, injuries that affect the dermis or the tissues beneath it are more complex wounds that can leave scars.

There is little difference between ice burn and frostbite. The term ice burn refers to burns that result from contact with ice or ice packs.

Frostbite occurs when the exposure of parts of the body to extremely cold temperatures freezes the skin and the tissue beneath it.

Frostbite that penetrates the deeper layers of the skin and damages tissue and bone can cause permanent damage.

Upon getting an ice burn, a person should immediately be taking the following actions:

• getting out of the cold or removing the item causing the injury
• removing wet clothing
• avoiding touching or rubbing the area to prevent further damage
• removing debris from any injured skin
• warming the skin by soaking it in 99–102°F (37–39°C) water
• applying blankets or warm compresses
• repeating the soaking process every 20 minutes if necessary

Once the area is warm again, a person should try:

• using gauze to protect the skin from dirt and germs
• increasing fluid intake for hydration
• taking an over-the-counter (OTC) pain reliever if necessary
• applying a soothing ointment, such as aloe vera, to unbroken skin
• seeking medical advice regarding the necessity of a tetanus shot

It is vital to warm up the skin gradually rather than using very hot water or air, as extreme heat could make the injury worse.

People can usually treat superficial ice burns at home using first aid. These burns often heal without the need for further medical attention.

If a person experiences a more severe ice burn, they should see a doctor and may require hospital treatment.

The signs and symptoms of a severe ice burn include:

• skin turning and remaining white, dark, or gray
• skin feeling numb
• skin that feels cold or hard after warming
• the affected body part being less able to function
• blood-filled blisters
• injury-related ice burn

These signs may indicate damage to the tissue underneath the skin. Tissue damage may require more intensive medical or surgical treatment.

Any signs of infection will also require medical treatment. A person should see a doctor if they experience the following symptoms:

• changes to the color of the burn
• pus or green discharge leaking from the burn site
• fever
• increased pain
• the affected body part being less able to perform its function

If the affected area remains white, dark, or gray rather than pink or red and does not start tingling or burning as it warms up, this could signify more extensive damage that requires medical attention.

Anyone concerned about an ice burn should speak to a doctor for a proper evaluation.