First Aid Heat & Cold Exposure How to Avoid Ice Burn When Treating an Injury The safest way to treat an injury and avoid skin damage By Rod Brouhard, EMT-P facebook twitter linkedin Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients. Learn about our editorial process Rod Brouhard, EMT-P Medically reviewed by Medically reviewed by Michael Menna, DO on February 05, 2020 Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York. Learn about our Medical Review Board Michael Menna, DO on February 05, 2020 Print 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. Dmitry Marchenko / EyeEm / Getty Images How Ice Packs Cause Burns Water freezes at 32 degrees Fahrenheit, 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. Use the acronym CBAN, which stands for cold, burn, ache, and numb—the four sensations felt when icing. 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. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. 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 Additional Reading American Academy of Pediatrics. Care of the young athlete patient education handouts: Use of ice and heat. 2010. Laskowski-jones L, Jones LJ. Frostbite: Don't be left out in the cold. Nursing. 2018;48(2):26-33. doi:10.1097/01.NURSE.0000529802.75665.d7