Ice Burns

Ice burns are a type of thermal burn that you can get from intense cold. Thermal burns happen because of extreme temperatures. And while most thermal burns happen because of things that are hot, extreme cold causes similar damage.

But ice isn’t the only cold thing that can burn you. That’s why experts group ice burns as a type of cold burn. Another example of a cold burn is frostbite.

Cold burns can be especially dangerous because you may not feel the damage happening. Heat burns immediately activate your sense of pain. But cold-related burns may not. It’s often impossible to tell the difference between something that just feels cold and something cold enough to harm you. Even though cold burns usually aren’t deadly, they can still cause serious injuries.

Symptoms of ice burns

Experts use a three-type system for cold injuries, including cold and ice burns. The types and their symptoms include:

Frostnip (superficial cold burn)

• Pale skin
• Peeling
• Tingling or aching that turns into numbness

Superficial frostbite (partial-thickness cold burn)

• Pale or grayed skin
• Blisters
• Numbness

Deep frostbite (full-thickness cold burn)

• Darkened or blackened skin
• Complete loss of feeling
• Stiffness and loss of muscle control

Ice burn causes

Cold and ice burns can happen in many ways. Some examples include:

• Ice and cold packs held directly against your skin for too long
• Refrigerants from home and automobile air conditioning systems
• Gases that are supercooled to a liquid form (hydrogen, helium, nitrogen and oxygen)
• Dry ice (frozen CO2 gas) used in shipping, science and industry settings and more
• Aerosol cans (the propellant gas in them can cause cold burns) when used improperly, especially when inhaled
• Exposure to cold weather conditions

How cold burns become severe

There are a few main factors that determine how cold burns become severe:

• The temperature of what burned you (the colder it is, the worse the burn is likely to be)
• Contact time (longer contact times usually mean worse burns)
• Insulators (they can lessen temperature effects and buy you more time before damage happens)

A cold pack or plastic bag filled with regular ice cubes directly on your skin may take minutes to cause a cold burn. Meanwhile, things that are extremely cold — like liquid gases or dry ice — can cause deep, severe cold burns in seconds.

Complications of ice burns

Cold burns cause cell damage and disrupt blood flow in the affected area. Most complications affect the area that had the burn.

The complications can include:

• Amputations
• Chronic pain
• Cold intolerance
• Compartment syndrome
• Complex regional pain syndrome
• Infections
• Joint stiffness
• Muscle atrophy
• Tingling

Ice and cold burns that are large and deep enough can also make you go into shock. If that happens, you need shock first aid right away.

How doctors diagnose ice burns

Healthcare providers can diagnose ice burns and similar cold injuries with a physical exam. They’ll look at the injury closely and ask questions about how it happened.

Providers may also run tests to determine how severe your burn is and the treatments you might need. One example is magnetic resonance angiography. It can show any problems with blood circulation from the burn.

Other tests might be possible, depending on your circumstances. Your healthcare provider can tell you more about tests that might help you.

How are ice burns treated?

The treatment for ice burns and other cold injuries depends on:

• Size, location and severity of the burn
• How long ago the burn happened
• What caused the burn
• Your health history

You can self-treat minor ice and cold burns that only cause frostnip. Burn ointments or aloe vera can soothe the injured area. You can also cover it with a clean bandage to protect your skin (if needed).

First aid for ice and cold burns starts with slowly rewarming affected body parts. To do that, you should:

• Loosen any clothing needed so it can’t affect circulation.
• Immerse the body part in lukewarm water. If you can’t immerse it, you can pour warm water over it.
• If the affected body part is frozen to something, pour lukewarm water on it until you can pull it away. Once it’s free, immerse the body part in lukewarm water if you can. Otherwise, just pour more lukewarm water over it.
• Cover with bandages (but be careful not to wrap them too tightly) if needed.

DO NOT:

• Use hot water.
• Use any kind of direct heat, like a space heater, hair dryer, hot towel, etc.
• Rub or massage the affected body part.

It’s important to only use warm water. Rewarming has to happen slowly. If it happens too fast, it can do even more damage to the burned tissue. And you should only start rewarming if there’s no risk of the affected body part refreezing. Warming and then refreezing can do even more damage.

Frostnip is reversible. Superficial and deep frostbite aren’t. That’s why frostnip only needs the above first aid.

More severe ice and cold burns need professional medical care. That can include treatments like:

• Additional rewarming treatment
• Debriding (cleaning the burn and removing any dead or dying tissue)
• Bandaging or covering the burn
• Skin grafts
• Medicines like pain relievers, antibiotics for infections or anti-inflammatory medicines like corticosteroids
• IV fluids
• tPA (a clot-breaking medicine often used to treat strokes) to try to restore circulation, or IV blood thinners like heparin or iloprost (Aurlumyn^®)
• Surgery, especially to treat emergency complications like compartment syndrome, or to amputate (as a last resort)

Other treatments might be possible, depending on your situation. Your healthcare provider can give you more information specific to your case.

When should I seek care for an ice burn?

You can self-treat frostnip, but partial-thickness and full-thickness ice and cold burns always need medical attention. In general, get professional medical care if:

• The burned area feels hard to the touch, looks or feels waxy, or looks and stays much darker than unburned areas
• The burned area hurts very badly, or it doesn’t regain feeling at all after several minutes
• Blisters form on or around the burned area
• Your skin freezes to something and tears when you pull away (this always needs professional medical care)

You should also get emergency medical care when:

• You have cold or ice burns on your face
• You inhale any amount of supercooled gases
• You show any symptoms of shock after a cold or ice burn

When in doubt, it’s a good idea to err on the side of caution. If you’re unsure how deep a cold burn goes, get medical care.

What can I expect if I have an ice burn?

The outlook for cold and ice burns varies. Minor ice and cold burns usually heal easily and quickly. But deeper and larger cold burns need immediate care. In general, the outlook is better when you get care right away for cold burns. And even without major complications, many people with cold or ice burns will have lingering effects for weeks, months or more.

Because the outlook varies so widely, it’s best to ask your healthcare provider what you can and should expect. They can tailor the information to your case and tell you what you can do to help your recovery.

Can ice burns be prevented?

Yes, ice and cold burns are usually preventable. The main ways to prevent them all revolve around protecting yourself from potential sources. Some things you can do include:

• Wrap cold and ice packs: Never put an ice or cold pack directly on your skin. Wrap it in a towel or another type of cloth. That keeps the cold from harming you.
• Dress warmly: Frostbite is preventable by wearing the right clothing.
• Gear up: If you might be handling something cold enough to burn you, protective gear is a must. Insulated gloves, boots and other items can spare you from a burn.
• Know your limits: Being handy around the home or a talented DIY mechanic is nothing to scoff at. But the DIY approach may not be safe when it comes to HVAC and car air conditioning systems. Leave those jobs to professionals with the training and gear to do the job safely.
• Secure aerosols: Don’t make aerosol cans easy to get to. Keeping aerosol cans secure can prevent cold injuries. And make sure to read the instructions on or with the can to avoid harm from inhaling what’s inside.