Ice packs are used sometimes to treat muscle strains or sprains in different parts of the body. These packs if incorrectly used, can cause skin burns which may vary from mild such as first degree burns or more severe such as second and third degree burns. Cold burns are caused by the prolonged contact with icy objects or snow, as well as the exposure to windy conditions. The burn is cause by a drop in the temperature of the skin in contact with the ice pack, this drop in temperature causes the water contained in the cells to freeze forming sharp ice crystals and damaging the surrounding cell structure. In addition the blood vessels located close to the skin start to constrict and when the skin and the underlying tissues are exposed to prolonged cold or extreme cold, the flow of blood to the affected areas will be greatly reduced leading to damage to these areas. (See also Frostbite)
One of the most common ways this can occur is through the application of the ice pack directly on the skin of the injured area. There are certain factors that may increase the incidence of cold induced burn injuries, these may include:
- People who use medications that decrease the blood flow to the skin such as beta-blockers.
- People with peripheral vascular disease which decrease the blood flow to the affected tissue.
- People with peripheral neuropathy which decreases the ability to feel injuries.
- Smoking and diabetes.
- High velocity wind which increases the rate of heat loss from the skin.
- People who are not well dressed for extremely cold temperature.
Clinical features of cold induced burn injuries including ice packs are:
- Each individual may experience symptoms differently; the signs and symptoms depend on the severity.
- Pins and needles sensation followed by tingling and numbness.
- Redness and pain in the affected skin area.
- Firm or waxy skin which is white and completely numb (a sign that tissues have started to freeze).
- Skin blisters.
- Very severe frost bite may cause gangrene (blackened, dead tissue) and damage to the deep structures such as muscles and nerves.
Treatment of ice pack burn:
You may notice having an ice pack burn if you start developing the signs and symptoms of cold induced injury such as developing blisters, feel burning, numb, itchiness and/or pain sensation in the affected area. The color of the affected skin may turn yellowish-gray. The affected area need to be re-warmed to stop the burn from becoming severe.
- Warming process should be GRADUAL to avoid burning yourself and causing more damage to the skin. Soak the burned skin in warm water. The National Institute of Health suggests the temperature of water to be between 104 and 108 degree Fahrenheit for 20 minutes (never use hot water). You can use warm compresses or wrap yourself in blankets. Avoid massaging or moving the damaged area as this can cause the subcutaneous ice crystals in the tissue to move and cause more damage and avoid using direct dry heat to warm the affected area such as radiator or hair dryer as these areas are numb and can burn easily.
- You may need to use pain killers, local antibiotic ointment and/or dressing depending on the condition of the wound.
You should seek medical attention if the burned area:
- Doesn’t begin to burn and/or tingle.
- Remain numb with the skin white, cold and hard when you touch it.
- Doesn’t regain a pinkish complexion.
As these may be a signs of more severe damage of the blood vessels, nerves and muscles underneath the affected skin that may lead to gangrene.
How to avoid ice pack burns:
- Use the correct size and style of ice pack on the affected area, more than one ice pack may be needed in large areas.
- Put a barrier between your skin and the ice pack. You can use a thin folded hand towel or several layers of paper towels as a barrier. Using thick towels may keep the ice from affecting the area decreasing its benefit.
- Small children and elderly people can suffer skin burns and damage quicker than adults because of their fragile skin therefore it’s safer to use frozen vegetables as a source of cold as these vegetables will melt and become soft well before they can cause damage to the skin.
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.