How to Avoid Ice Burn When Treating an Injury

The safest way to treat an injury and avoid skin damage

a woman icing her knee

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When you have an injury, experts often recommend using ice to help with pain, inflammation, and swelling. However, too much cold therapy can also cause an ice burn. It's possible to get frostbite from an ice pack if you leave it on your injury for too long or put it directly on your skin.

How Ice Packs Cause Burns

Water freezes at 32 degrees, but the ice that comes out of the freezer is likely to be much colder than that. Putting ice or any kind of chemical cold pack—homemade or otherwise—directly on the skin can lead to frostbite in minutes.

Ice crystals form in the skin cells and blood flow slows, depriving the tissues of oxygen. As it progresses, the ice burn causes permanent damage to your skin and underlying tissues. In severe cases, it can lead to amputation.

Avoiding Ice Burns

When you use an ice pack, pay attention to how your skin feels. The first stage of ice burn is known as frostnip, which causes your skin to get red or pale with a tingling and prickly sensation. It’s a sign that you should remove the ice pack and warm the area so that you don't damage your skin.

You can also remember the acronym CBAN, which stands for cold, burn, ache, and numb—the four sensations you’ll feel when icing your injury. First, you’ll notice the cold, and soon after a burning feeling. After a few minutes, you may notice that the area feels achy before the skin finally feels numb. As soon as you feel any numbness, remove the ice to avoid causing ice burn.

Make sure you watch the clock. The time between the initial cold sensation and numbness can be anywhere from 10 to 20 minutes, so don’t leave an ice pack on the injury for more than that. A good rule of thumb is 20 minutes on followed by 20 minutes off. Never fall asleep with an ice pack, or you may leave it on far too long.

Don’t put ice or ice packs directly on the skin. A plastic bag isn’t enough to protect your skin from ice burn. You should always wrap the ice in a towel or other thin cloth. 

When You Shouldn't Use Ice

Don’t use ice on your skin if it already feels numb. When your skin is numb or tingly, you may not be able to tell when the ice is causing damage. Also, don’t use an ice pack on an area that’s already injured with a blister or burn. When the skin is already compromised, you're more likely to cause further tissue damage with an ice burn. 

Certain medical conditions (e.g., vascular disease and diabetes) may make your tissues more likely to be damaged with ice burn. If you have questions about your risk for frostbite, speak to your physician about whether it’s safe for you to ice your injury.

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  1. Millet JD, Brown RK, Levi B, et al. Frostbite: Spectrum of Imaging Findings and Guidelines for Management. Radiographics. 2016;36(7):2154-2169. doi:10.1148/rg.2016160045

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