Individuals who use a cold therapy machine may fail to realize when their body is getting too cold, and they can easily miss the first symptoms of skin necrosis: skin discoloration, swelling, and pain. Over time, symptoms of skin necrosis (dead tissue) grow progressively worse until blisters form, the skin blackens, and it peels away from their body.

Symptoms of Skin Necrosis

The symptoms of skin necrosis vary depending on the depth of the injury. Skin necrosis can involve only the uppermost layers of skin (epidermis), deeper layers (dermis), subcutaneous tissue, and even structures under the skin (nerves, muscles, ligaments, etc.). Skin damage can occur in as little as 40 minutes of using a cold therapy machine.

Unfortunately, the earliest symptoms of skin necrosis often go unnoticed by people using a cold therapy machine. The problem is that many people falsely believe that the machines are safe to use for hours at a time, because they do not realize that skin necrosis can occur at above-freezing temperatures.

Although the first symptoms of skin necrosis are obvious (redness, swelling, and pain), patients using a cold therapy machine may be numb or fail to distinguish a new injury from a pre-existing injury.

Symptoms of skin necrosis include:

  • Partial thickness skin necrosis: Mild necrosis only involving the epidermis. Symptoms include red discoloration of the skin, rash, fluid accumulation, swelling, and transient feelings of burning or tingling. The skin may appear mottled blue, gray, or red. It may also feel hot and dry to the touch.
  • Deep partial thickness skin necrosis: This is characterized by blister formation within 24 hours after the injury. The blisters are filled with a clear fluid. The patient may feel burning, tickling, tingling, pricking, or numbness. Although the patient will have no long-term nerve damage, they may have increased cold sensitivity.
  • Full thickness skin necrosis: Necrosis extends into the subcutaneous tissue and may involve nerves. Blisters filled with blood will form (hemorrhagic blisters) and the skin will turn dark red, deep purple, and finally black. The skin may begin peeling and detaching from the body.

List of Skin Necrosis Symptoms

  • Pain
  • Nerve damage
  • Loss of sensation in the affected area
  • Feeling tickling, tingling, burning, pricking, or numbness
  • Skin discoloration:
    • When skin is cold: white, pale, or grayish-yellow skin
    • When skin is warmed: red, purple, or black skin
  • Swelling
  • Skin is hard, waxy, or dry
  • Blistering (may be clear fluid or blood-filled blisters, hemorrhagic blistering)
  • Skin death, detachment, decomposition, infection (gangrene)
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