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What are Ice Burns & How is it Treated? | Symptoms, Causes, Risk Factors of Ice Burns

What are Ice Burns?

Most people often use ice to reduce pain, bring down swelling and inflammation caused by an injury. You usually never associate ice with causing damage to your skin and ice burns. However, if you end up leaving that same ice pack on your injury for a longer period of time, or if you place it directly on the skin, you can get a frostbite or an ice burn. An ice burn occurs when ice or any other cold things come in contact with the skin, causing damage. Ice burns don’t happen in short-term exposures. However, after long exposure to below-freezing or freezing temperatures, you may get an ice burn.(1, 2, 3)

Symptoms of an Ice Burn

You get an ice burn when the water in your skin cells freezes. This causes the water to form sharp ice crystals, which cause damage to the structure of your skin cells. At the same time, blood vessels located close to the skin’s surface become constricted which reduces the blood flow and delivery of oxygen to the affected parts. This can cause more damage to the skin. In some cases, prolonged exposure can cause blood clots to form, which further limits the flow of blood and oxygen. If the cold temperature affects the blood clotting proteins in the body, it can cause bleeding from the injury site.(4, 5)

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Some of the common symptoms of an ice burn include:

  • Red, dark, white, or grayish skin
  • Pain
  • Numbness
  • Blisters
  • Itching
  • Tingling sensation
  • Hard or waxy skin

An ice burn usually looks like other burns, very similar to how sunburns look. You are likely to see a change in the color of the skin in the affected area, and it may appear bright red, white, or even a yellowish-gray color.

Causes and Risk Factors of Ice Burns

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When the body is exposed to extreme cold, it causes the blood vessels to narrow, which diverts the blood flow to your vital organs in order to keep them safe. This also means that a reduced amount of blood will be available for the other parts of the body, especially the ones that are furthest away from the vital organs. This is why your hands, feet, toes, and fingers are usually more susceptible to suffering injuries from the cold or frostbite.

An ice burn happens when the skin directly touches ice or anything else that has been very cold for an extended period of time. Ice or ice packs are one of the most common causes of ice burns if you touch them directly to your bare skin. Prolonged contact with high altitudes, high-velocity winds, cold weather, or snow can also cause ice burns.(6, 7, 8)

Some of the other factors that increase the chances of getting an ice burn are as follows:

  • Smoking
  • Homelessness
  • Playing winter sports
  • Conditions that disrupt blood circulation, such as peripheral vascular disease or diabetes
  • Taking medicines that restrict your blood flow, such as beta blockers
  • Raynaud’s phenomenon(9)
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Peripheral neuropathy or other similar conditions that lowers a person’s ability to detect injuries.

Older people and young children are at a significantly higher risk of getting a cold injury since they are unable to regulate their body temperature, have fragile skin, and are also prone to losing heat more quickly. People under the influence of drugs or alcohol are also not able to feel the cold as effectively as they would had they not been under the influence of these substances. As a result of this, they are unlikely to immediately take note of the discomfort caused by the cold exposure, which can lead to ice burns over a period of time.(10, 11, 12)

How is Ice Burn Treated?

If you think you might have gotten an ice burn, you need to remove the source of the cold at the earliest and take steps to start to gradually warm your skin back up. If you experience any of the following symptoms, you need to seek medical assistance immediately:

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  • Your skin looks white or pale and feels cold and rock-hard when you touch it.
  • Your skin is numb, and you don’t feel any tingling or burning sensation as you warm up.
  • Your skin looks pale and does not return to its normal complexion even after warming up.

These are symptoms that indicate severe tissue damage that needs immediate treatment. You may also need medical help if you have developed blisters over a large area of your skin. Your doctor will need to look at the affected area to come up with an appropriate treatment plan.

Ice burns are typically treated by getting rid of the source of cold and warming up your skin slowly to bring it back to its normal body temperature. Here are some steps to take to warm up your skin:

  • Soak the affected part in warm water for 15 to 20 minutes. The water should not be more than 42.2 degrees Celsius or 108 degrees Fahrenheit.
  • Keep repeating the soaking process, making sure to take 15-minute breaks in between each soak.
  • Apply blankets or warm compresses along with warm water soaks.

However, you have to be careful not to apply too much of heat as this may make the burn worse.

In case you develop an open wound or blisters, you have to clean the area and bandage the wound to keep it free from germs or dirt. Make sure to use gauze that does not stick to your skin and does not leave any lint behind. Applying a soothing ointment to the burnt area can also provide relief.

To relieve pain, you can take an over-the-counter painkiller, and once the skin starts to heal, you can consider applying topical gels like aloe vera to help reduce any discomfort or itching.

If you notice any signs of severe tissue damage due to the ice burn, you must seek medical attention immediately. The biggest indicator of this is if your skin remains hard or cold after you try to warm it up gently. In such conditions, your doctor is likely to prescribe medications, remove the damaged tissue, or move on to other treatment options if there is an infection.(13, 14, 15)

If you develop symptoms of an infection, don’t delay showing the affected area to a doctor. Signs of an infection include:

  • Changes to the color of the burn on the skin
  • Greenish discharge
  • Pus discharge
  • Fever

If you develop an infection, your doctor is likely to prescribe antibiotics.(16)

Conclusion

Depending on the severity of your ice burn, it may take a few days to even a few weeks to heal. You may even develop a scar afterward. In some rare cases, doctors may have to surgically remove the damaged tissues, though, in most cases of ice burns, you are likely to recover completely. The best thing to do to help the healing process is to keep the burnt area covered, away from cold, and away from direct sunlight.

Of course, it is best to prevent ice burns, to begin with, by keeping a layer of clothing between the skin and the source of cold. Even when using an ice pack, do not apply it directly to your skin. It is better to wrap it in a towel first. In fact, using a bag of frozen vegetables rather than an ice pack will reduce the chances of getting ice burns.

Remember to dress warmly in cold weather and keep your skin protected from high-velocity winds.

References:

  1. Chakraborty, M. (2022) Ice burn: Causes, symptoms, and treatment, STYLECRAZE. StyleCraze. Available at: https://www.stylecraze.com/articles/ice-burn/ (Accessed: October 9, 2022).
  2. Team, F.H. (2020) Should you put ice on a burn (or not)?, Cleveland Clinic. Cleveland Clinic. Available at: https://health.clevelandclinic.org/should-you-put-ice-on-a-burn-or-not/ (Accessed: October 9, 2022).
  3. What is A cold burn? (no date) Dispotech. Available at: https://www.dispotech.com/en/blog/what-is-a-cold-burn (Accessed: October 9, 2022).
  4. Li, A.K., Ehrlich, H.P., Trelstad, R.L., Koroly, M.J., Schattenkerk, M.E. and Malt, R.A., 1980. Differences in healing of skin wounds caused by burn and freeze injuries. Annals of surgery, 191(2), p.244.
  5. Mohr, W.J., Jenabzadeh, K. and Ahrenholz, D.H., 2009. Cold injury. Hand clinics, 25(4), pp.481-496.
  6. Mäkinen, T.M., Jokelainen, J., Näyhä, S., Laatikainen, T., Jousilahti, P. and Hassi, J., 2009. Occurrence of frostbite in the general population–work-related and individual factors. Scandinavian journal of work, environment & health, pp.384-393.
  7. Giesbrecht, G.G. and Wilkerson, J.A., 2006. Hypothermia, Frostbite and other cold injuries: prevention, survival, rescue, and treatment. The Mountaineers Books.
  8. Khan, S.L., Parikh, R., Mooncai, T., Sandhu, S., Jawa, R. and Farber, H.W., 2019. Barriers to frostbite treatment at an academic medical center. The American journal of emergency medicine, 37(8), pp.1601-e3.
  9. Luks, A.M., Grissom, C.K., Jean, D. and Swenson, E.R., 2009. Can people with Raynaud’s phenomenon travel to high altitude?. Wilderness & Environmental Medicine, 20(2), pp.129-138.
  10. Roche-Nagle, G., Murphy, D., Collins, A. and Sheehan, S., 2008. Frostbite: management options. European Journal of emergency medicine, 15(3), pp.173-175.
  11. Kanzenbach, T.L. and Dexter, W.W., 1999. Cold injuries: protecting your patients from the dangers of hypothermia and frostbite. Postgraduate medicine, 105(1), pp.72-78.
  12. Hallam, M.J., Cubison, T., Dheansa, B. and Imray, C., 2010. Managing frostbite. Bmj, 341.
  13. McIntosh, S.E., Hamonko, M., Freer, L., Grissom, C.K., Auerbach, P.S., Rodway, G.W., Cochran, A., Giesbrecht, G., McDevitt, M., Imray, C.H. and Johnson, E., 2011. Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite. Wilderness & environmental medicine, 22(2), pp.156-166.
  14. Sheridan, R.L., Goverman, J.M. and Walker, T.G., 2022. Diagnosis and Treatment of Frostbite. New England Journal of Medicine, 386(23), pp.2213-2220.
  15. Murphy, J.V., Banwell, P.E., Roberts, A.H. and McGrouther, D.A., 2000. Frostbite: pathogenesis and treatment. Journal of Trauma and Acute Care Surgery, 48(1), p.171.
  16. Persitz, J., Essa, A., Ner, E.B., Assaraf, E. and Avisar, E., 2022. Frostbite of The Extremities–Recognition, Evaluation and Treatment. Injury.
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