Medical expert of the article
New publications
Tissue damage without freezing
Last reviewed: 07.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Acute or chronic injuries without freezing can occur due to hypothermia.
Cold cramp. The mildest degree of cold injury. The injured area becomes numb, swollen, and red. Treatment involves gradual warming, which is accompanied by pain and itching. In rare cases, moderate hypersensitivity to hypothermia persists for months or years.
Trench foot. Prolonged exposure to cold and damp conditions can lead to trench foot. Peripheral nerves and blood vessels are usually affected; in severe cases, muscles and skin may be damaged.
Initially, the foot is pale, edematous, the skin is sticky, cold, stiff; skin maceration is possible, especially if patients walk a lot. Warming is accompanied by hyperemia, pain and often hypersensitivity to light touch, symptoms persist for 6-10 weeks. The skin may ulcerate with the formation of a black scab. The development of autonomic dysfunction with increased or decreased sweating, vasomotor changes and local hypersensitivity to changes in ambient temperature is characteristic. Muscle atrophy, sensory disturbances up to anesthesia may also develop and become chronic.
Trench foot can be prevented by avoiding tight shoes, keeping feet and boots dry, and changing socks frequently. Direct treatment involves warming the feet in water at 40-42°C, followed by applying a sterile bandage. Chronic neuropathies are difficult to treat; amitriptyline can be tried.
Chilblains (first-degree frostbite). Localized areas of erythema, swelling, and itching occur due to repeated exposure to dry cold; the mechanism is not fully understood. Blisters or ulcers may develop on the skin. Chilblains usually affect the skin of the fingertips and the anterior tibial region, and resolve on their own. Relapses are rare.
The term "chilblains" is often used to describe vascular disease, more common in young women with a history of Raynaud's phenomenon. Endothelial and neuronal damage results in vascular hypersensitivity to cold and sympathetic instability. In refractory chilblains, nifedipine 20 mg 3 times daily may be effective. Sympatholytics may also be effective.
[