A freeze burn, also known as frostnip, is an injury caused by exposure to extreme cold temperatures. It can happen when skin or other tissues freeze, causing damage to cells and blood vessels. While less severe than frostbite, freeze burns can be quite painful. In this article, we’ll explore what causes freeze burns, their symptoms, and how to treat them.
What causes a freeze burn?
Freeze burns are caused by prolonged exposure to freezing temperatures. They usually affect extremities like fingers, toes, ears, cheeks, and noses since these areas are farthest from the body’s core and have less blood circulation to keep them warm. Certain factors can increase your risk of getting a freeze burn:
- Cold temperatures below 32°F (0°C)
- Wind chill from strong winds
- Moisture on the skin from sweating or wet clothing
- Restricted blood flow from tight clothing or accessories
- Exposed skin not covered by gloves, hats, or other protective gear
- Being at higher altitudes where air is thinner
- Having certain medical conditions like Raynaud’s phenomenon that affect circulation
When skin gets extremely cold, the blood vessels constrict in an attempt to preserve body heat. This reduces blood flow, depleting cells of oxygen and nutrients. Prolonged constriction can lead to ice crystal formation and damage to cell membranes. The tissues essentially become frozen.
Signs and symptoms
The most common signs and symptoms of a freeze burn include:
- Tingling or stinging: One of the first sensations is painful prickling or stinging of exposed skin as it starts to freeze.
- Numbness: As freezing progresses, the affected area will become numb due to impaired nerve function and reduced blood flow.
- Firm/waxy skin: The skin will feel unusually firm or stiff to the touch, with a waxy or white appearance.
- Clumsiness: Fine motor skills become impaired, making it difficult to grasp objects or perform coordinated movements.
- Blisters or skin discoloration: In severe cases, blood-filled blisters or dusky, blueish-grey skin can occur as tissues begin to die.
- Pain when warming: Once temperatures rise and circulation returns, there is often throbbing, aching pain.
The face, fingers, and toes show symptoms first since they have less insulating fat. Without treatment, freeze burns can progress to frostbite, which involves actual tissue freezing and requires emergency care.
Does a freeze burn hurt?
Yes, freeze burns can be quite painful, especially when thawed. The initial sensations of cold exposure may only feel uncomfortable or chilling. However, once circulation is restored, nerves damaged by ice crystals send pain signals to the brain. This leads to throbbing, burning, and aching pain.
Depending on severity, the pain may be mild and short-lived or more intense over several days. Blistered skin is often very painful. Using the affected area normally, like grasping with frostbitten fingers, increases the discomfort. Nerve damage can lead to long-term hypersensitivity and chronic pain too.
Treating a freeze burn
Freeze burns are serious and require first aid to prevent complications. Here are some treatment tips:
- Get out of the cold: Seek shelter to allow skin to warm gradually. Don’t use direct heat like hot water or a heating pad.
- Remove wet clothes: Take off any damp garments that could accelerate freezing.
- Wrap in blankets: Gently insulate the injured area to warm it slowly without rubbing.
- Apply warm compresses: Once inside, place warm, moist towels over frostbitten areas to help circulation.
- Take OTC medication: Use an NSAID like ibuprofen to reduce swelling and relieve pain.
- Keep blisters intact: Don’t break any blisters, which act as protective coverings.
- Elevate the injury: Raise swollen extremities above heart level to improve blood flow.
- Seek medical care: See a doctor for severe or worsening burns to prevent complications.
Warming frostbitten skin is often extremely painful, so medication and managed rewarming are key. In general, freeze burns should not be massaged or rubbed during treatment. The injured area may look swollen and irritated for a few days afterwards. Blistering and peeling skin can occur. Keep the wound clean, covered, and moisturized as it heals.
Complications
Without proper first aid, freeze burns can lead to serious complications like:
- Infections: Blisters and damaged skin are prone to bacteria entering and causing infections.
- Loss of dexterity: Nerve and tissue damage can reduce mobility and function in hands, feet, or other areas.
- Hypothermia: Heat loss from extensive burns drops core body temperature dangerously low.
- Frostbite: Freeze burns may turn into actual frostbite with ice crystal formation in deeper tissues.
- Bone and joint injuries: Freezing can injure bones, joints, and cartilage as cells rupture.
- Blood clots: Damage to blood vessels can impede circulation and promote clot formation.
These complications can be minimized through prompt first aid. But if a freeze burn is severe, seek emergency care to prevent permanent effects like amputation or loss of function.
Recovery and long-term outlook
Most freeze burns heal fully within a week or two, like a mild to moderate sunburn. However, recovery depends on factors like:
- Depth of tissue damage
- Body part affected
- Extent of blistering
- Any complications or infections
- How quickly it was treated
- Underlying medical conditions
With quick rewarming and care, superficial freeze burns generally heal without issues. The skin may peel, resembling a sunburn. Deeper burns cause more extensive blistering and damage, extending recovery time. It can take months for full sensation and function to return depending on which nerves and tissues were impacted.
In rare cases, severe injuries may even require amputation if circulation cannot be restored. With proper treatment, though, most people make a full recovery. However, burn sites often remain hypersensitive to cold temperatures going forward.
Preventing freeze burns
It’s best to take precautions to avoid freeze burns in extremely cold conditions:
- Wear layered clothing for insulation, especially on extremities.
- Use mittens instead of gloves to keep fingers warmer.
- Wear a hat, hood, scarf, and face cover to protect the head and neck.
- Choose wind-resistant outer garments to reduce wind chill.
- Apply protective balms or patches to exposed skin.
- Stay dry – change out of wet clothes and gloves regularly.
- Listen to weather advisories and avoid prolonged cold exposure.
- Learn to spot early signs of frostnip and seek warmth immediately.
- Avoid consuming alcohol before cold weather activity.
- Be aware of medications or conditions impacting circulation.
Dressing appropriately and limiting time spent in freezing temperatures can help prevent painful freeze burn injuries.
Key points about freeze burns
- Freeze burns result from skin or tissues becoming frozen from extreme cold exposure.
- They usually affect exposed areas like the face, fingers, and toes farthest from the body’s core.
- Symptoms include numbness, firm/waxy skin, blisters, and pain upon rewarming.
- Freeze burns can damage the skin, blood vessels, nerves, bones, and joints.
- Treatment involves gradual rewarming and medications for pain relief.
- Most heal fully within a few weeks, but severe cases may cause lasting effects.
- Proper preparation and attire when out in the freezing cold can help prevent injuries.
The bottom line
Freeze burns are a painful condition caused by prolonged cold exposure. Unlike frostbite which involves tissue freezing, freeze burns only damage surface skin and areas just below the skin. However, they can still be quite uncomfortable and lead to complications if not properly treated. First aid steps like hydrating blisters, taking NSAIDs, and slowly rewarming are key to managing symptoms and promoting healing. While recovery is usually complete within two weeks, severe burns may have lasting impacts. With appropriate precautions and preparation though, most freeze burns can be avoided when spending time outdoors in the extreme cold.