Aerosol burn

Last updated
aerosol frostbite of the skin
Other namesAerosol-induced frostbite
Aerosol-Induced Frostbite.jpg
Aerosol frostbite to the hand
Specialty Emergency medicine

An aerosol frostbite of the skin is an injury to the body caused by the pressurized gas within an aerosol spray cooling quickly, with the sudden drop in temperature sufficient to cause frostbite to the applied area. [1] Medical studies have noted an increase of this practice, known as "frosting", in pediatric and teenage patients. [2] [3]

Contents

Adiabatic expansion and/or evaporative cooling (with a low boiling temperature) causes the gas to rapidly cool on exit from the aerosol applier. In freeze sprays, a controlled amount of this cooling is useful. Uncontrolled cooling, however, can result in freeze burns to the skin. According to controlled laboratory experiments, the gas from a typical deodorant spray can reduce skin temperature by up to sixty degrees Celsius. [2]

The form of injury is freezing of the skin, a type of frostbite. It is highly advised for those who develop frostbite to seek medical attention. [4]

In rare cases aerosol-induced burns can be severe enough to necessitate skin grafting. [5]

Signs and symptoms

An example of postinflammatory hypopigmentation (the light white patches) about one year after a severe aerosol burn. Example of Postinflammatory hypopigmentation.jpg
An example of postinflammatory hypopigmentation (the light white patches) about one year after a severe aerosol burn.

Depending on the duration of exposure aerosol-induced frostbite can vary in depth. Most injuries of this type only affect the epidermis, the outermost layer of skin. However, if contact with the aerosol is prolonged the skin will freeze further and deeper layers of tissue will be affected, causing a more serious burn that reaches the dermis, destroys nerves, and increases the risk of infection and scarring. [6] When the skin thaws, pain and severe discomfort can occur in the affected area. [7] There may be a smell of aerosol products such as deodorant around the affected area, the injury may itch or be painful, the skin may freeze and become hardened, blisters may form on the area, and the flesh can become red and swollen.

Causes

The most common cause of aerosol burns is patients' spraying deodorants for prolonged periods of time in close proximity to their skin. This practice is more common in younger persons such as teenagers and can be referred to as "frosting" or having a "frosty". Injuries such as these are often self-inflicted, and depression should be considered as an underlying cause. [8] However, some do it for social media attention in viral video posts or after peer pressure, the "Deodorant Challenge" being analogous to the Cinnamon challenge and Tide Pod Challenge. [9] [10]

However, some do it due to influence by their peers as a way of "impressing" them, with the "Aerosol Challenge" gaining popularity alongside the "Cinnamon Challenge" and "Chubby Bunny" contests as trends in dangerous peer-pressure-induced self-harm.

Unintentional

A person can cause frostbite by accidental prolonged contact, using an aerosol on one place for too long. [11] This is often done with deodorants, but other products such as asthma inhalers are also common causes of injury. Injuries are especially common with younger children who "try it out" not knowing all the possible dermatological effects. In rarer cases aerosol burns are reported to have been caused by air fresheners and other compressed aerosol canisters exploding. [12] [13]

Intentional and Abuse

Fluorinated hydrocarbon (fluorocarbon) aerosol propellants can be abused, as with solvents. A common form is huffing as a means of intoxication. When inhaled, aerosols can cause the same frostbite as on other parts of the body. [14] The National Institute on Drug Abuse (NIDA) has published various resources on the internet warning of the effects of this abuse. [15] [16] [17]

Some aerosol burns are intentionally self-inflicted, the reasons being emotional/psychological. Household aerosol products such as air fresheners and deodorants can be a convenient, easily available means to satisfy the compulsions. [18]

Treatment

Various methods of treatment are used, depending greatly on the length of exposure and other factors. There are documented cases using both conservative and invasive treatments, including skin grafting and/or the application of nonadhesive dressing alongside topical corticosteroids to reduce inflammation. However, the use of steroids may exacerbate fungal infections if the aerosol product used is an antifungal medicine. In some patients postinflammatory hypopigmentation or hyperpigmentation may result in the months after initial injury, and ultraviolet protection such as sunscreen is essential to prevent an elevated risk of skin cancer in the damaged tissues. [5] [19] [2] The pain caused by these burns is often intense and can be prolonged, making a pain management plan important. This often includes short term prescriptions of painkillers.

In the case of self-harm induced injury the underlying mental health aspects should be treated as with all self-inflicted injuries.

See also

Related Research Articles

<span class="mw-page-title-main">Inhalant</span> Chemical, often household, breathed in to cause intoxication

Inhalants are a broad range of household and industrial chemicals whose volatile vapors or pressurized gases can be concentrated and breathed in via the nose or mouth to produce intoxication, in a manner not intended by the manufacturer. They are inhaled at room temperature through volatilization or from a pressurized container, and do not include drugs that are sniffed after burning or heating. For example, amyl nitrite (poppers), nitrous oxide and toluene – a solvent widely used in contact cement, permanent markers, and certain types of glue – are considered inhalants, but smoking tobacco, cannabis, and crack are not, even though these drugs are inhaled as smoke or vapor.

<span class="mw-page-title-main">Recreational drug use</span> Use of drugs with the primary intention to alter the state of consciousness

Recreational drug use indicates the use of one or more psychoactive drugs to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions and emotions of the user. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Generally, recreational drugs are divided into three categories: depressants, stimulants, and hallucinogens.

<span class="mw-page-title-main">Burn</span> Injury to flesh or skin, often caused by excessive heat

A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation. Most burns are due to heat from hot liquids, solids, or fire. Burns occur mainly in the home or the workplace. In the home, risks are associated with domestic kitchens, including stoves, flames, and hot liquids. In the workplace, risks are associated with fire and chemical and electric burns. Alcoholism and smoking are other risk factors. Burns can also occur as a result of self-harm or violence between people (assault).

<span class="mw-page-title-main">Deodorant</span> Substance applied to the body to prevent or mask body odour

A deodorant is a substance applied to the body to prevent or mask body odor due to bacterial breakdown of perspiration or vaginal secretions, for example in the armpits, groin, or feet. A subclass of deodorants, called antiperspirants, prevents sweating itself, typically by blocking sweat glands. Antiperspirants are used on a wider range of body parts, at any place where sweat would be inconvenient or unsafe, since unwanted sweating can interfere with comfort, vision, and grip. Other types of deodorant allow sweating but prevent bacterial action on sweat, since human sweat only has a noticeable smell when it is decomposed by bacteria.

<span class="mw-page-title-main">Frostbite</span> Effect of low temperature on skin and other tissues

Frostbite is a skin injury that occurs when exposed to extreme low temperatures, causing the freezing of the skin or other tissues, commonly affecting the fingers, toes, nose, ears, cheeks and chin areas. Most often, frostbite occurs in the hands and feet. The initial symptoms are typically a feeling of cold and tingling or numbing. This may be followed by clumsiness with a white or bluish color to the skin. Swelling or blistering may occur following treatment. Complications may include hypothermia or compartment syndrome.

<span class="mw-page-title-main">Injury</span> Physiological wound caused by an external source

An injury is any physiological damage to living tissue caused by immediate physical stress. An injury can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or overexertion. Injuries can occur in any part of the body, and different symptoms are associated with different injuries.

<span class="mw-page-title-main">Aerosol spray dispenser</span> Dispensing system of an aerosol mist

Aerosol spray is a type of dispensing system which creates an aerosol mist of liquid particles. It comprises a can or bottle that contains a payload, and a propellant under pressure. When the container's valve is opened, the payload is forced out of a small opening and emerges as an aerosol or mist.

<span class="mw-page-title-main">Nebulizer</span> Drug delivery device

In medicine, a nebulizer or nebuliser is a drug delivery device used to administer medication in the form of a mist inhaled into the lungs. Nebulizers are commonly used for the treatment of asthma, cystic fibrosis, COPD and other respiratory diseases or disorders. They use oxygen, compressed air or ultrasonic power to break up solutions and suspensions into small aerosol droplets that are inhaled from the mouthpiece of the device. An aerosol is a mixture of gas and solid or liquid particles.

<span class="mw-page-title-main">Air freshener</span> Product used to mask odors

Air fresheners are consumer products that typically emit fragrance and are used in homes or commercial interiors such as restrooms, foyers, hallways, vestibules and other smaller indoor areas, as well as larger areas such as hotel lobbies, auto dealerships, medical facilities, public arenas and other large interior spaces. Car fresheners are used in automobiles. As a source of odors, specific deodorizing blocks are made for toilets and urinals.

Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy may be used to treat a variety of tissue lesions. The most prominent use of the term refers to the surgical treatment, specifically known as cryosurgery or cryoablation. Cryosurgery is the application of extremely low temperatures to destroy abnormal or diseased tissue and is used most commonly to treat skin conditions.

<span class="mw-page-title-main">Tear gas</span> Non-lethal chemical weapon

Tear gas, also known as a lachrymator agent or lachrymator, sometimes colloquially known as "mace" after the early commercial aerosol, is a chemical weapon that stimulates the nerves of the lacrimal gland in the eye to produce tears. In addition, it can cause severe eye and respiratory pain, skin irritation, bleeding, and blindness. Common lachrymators both currently and formerly used as tear gas include pepper spray, PAVA spray (nonivamide), CS gas, CR gas, CN gas, bromoacetone, xylyl bromide and Mace.

1,1,1,2-Tetrafluoroethane (also known as norflurane (INN), R-134a, Freon 134a, Forane 134a, Genetron 134a, Green Gas, Florasol 134a, Suva 134a, or HFC-134a) is a hydrofluorocarbon (HFC) and haloalkane refrigerant with thermodynamic properties similar to R-12 (dichlorodifluoromethane) but with insignificant ozone depletion potential and a lower 100-year global warming potential (1,430, compared to R-12's GWP of 10,900). It has the formula CF3CH2F and a boiling point of −26.3 °C (−15.34 °F) at atmospheric pressure. R-134a cylinders are colored light blue. A phaseout and transition to HFO-1234yf and other refrigerants, with GWPs similar to CO2, began in 2012 within the automotive market.

Axe or Lynx is a brand of male grooming products owned by the British company Unilever and marketed toward the younger male demographic. It is marketed as Lynx in the United Kingdom, Ireland, Malta, Australia, New Zealand and China.

<span class="mw-page-title-main">Gas duster</span> Product used for cleaning or dusting sensitive devices that cannot be cleaned using water

A gas duster, also known as canned air or compressed air, is a product used for cleaning or dusting electronic equipment and other sensitive devices that cannot be cleaned using water.

A topical anesthetic is a local anesthetic that is used to numb the surface of a body part. They can be used to numb any area of the skin as well as the front of the eyeball, the inside of the nose, ear or throat, the anus and the genital area. Topical anesthetics are available in creams, ointments, aerosols, sprays, lotions, and jellies. Examples include benzocaine, butamben, dibucaine, lidocaine, oxybuprocaine, pramoxine, proxymetacaine (proparacaine), and tetracaine.

Artificial skin is a collagen scaffold that induces regeneration of skin in mammals such as humans. The term was used in the late 1970s and early 1980s to describe a new treatment for massive burns. It was later discovered that treatment of deep skin wounds in adult animals and humans with this scaffold induces regeneration of the dermis. It has been developed commercially under the name Integra and is used in massively burned patients, during plastic surgery of the skin, and in treatment of chronic skin wounds.

<span class="mw-page-title-main">Cold injury</span> Medical condition

Cold injury is damage to the body from cold exposure, including hypothermia and several skin injuries. Cold-related skin injuries are categorized into freezing and nonfreezing cold injuries. Freezing cold injuries involve tissue damage when exposed to temperatures below freezing. Nonfreezing cold injuries involve tissue damage when exposed to temperatures often between 0-15 degrees Celsius for extended periods of time. While these injuries have disproportionally affected military members, recreational winter activities have also increased the risk and incidence within civilian populations. Additional risk factors include homelessness, inadequate or wet clothing, alcohol abuse or tobacco abuse, and pre-existing medical conditions that impair blood flow.

<span class="mw-page-title-main">Freeze spray</span> Aerosol spray for rapid cooling

Freeze spray is a type of aerosol spray product containing a liquified gas used for rapidly cooling surfaces, in medical and industrial applications. It is usually sold in hand-held spray cans. It may consist of various substances, which produce different temperatures, depending on the application.

Non-freezing cold injuries (NFCI) is a class of tissue damage caused by sustained exposure to low temperature without actual freezing. There are several forms of NFCI, and the common names may refer to the circumstances in which they commonly occur or were first described, such as trench foot, which was named after its association with trench warfare. NFCI is caused by microvascular endothelial damage, stasis and vascular occlusion and is characterised by peripheral neuropathy. NFCI generally affects the hands or feet during exposure to temperatures just above freezing, often wet, and is typically found in soldiers.

2-Hexoxyethanol or 2-(Hexyloxy)ethanol is a glycol ether that has a chemical formula of C8H18O2.

References

  1. ↑ "Brrrr! Aerosol sprays are a silly way to get frostbite - The Body Odd". Bodyodd.msnbc.msn.com. Archived from the original on 2012-05-07. Retrieved 2012-07-01.
  2. 1 2 3 May, U; Stirner, KH; Lauener, R; Ring, J; Möhrenschlager, M (2010). "Deodorant spray: A newly identified cause of cold burn". Pediatrics. 126 (3): e716–8. doi:10.1542/peds.2009-2936. PMID   20679305. S2CID   10841905. Archived from the original on 2015-06-27. Retrieved 2012-07-01.
  3. ↑ "Deodorant burns on the increase - ABC News (Australian Broadcasting Corporation)". Abc.net.au. 2007-07-10. Archived from the original on 2020-01-11. Retrieved 2012-07-01.
  4. ↑ "Login | Electrolube - the Solutions People" (PDF). Archived (PDF) from the original on 2015-04-02. Retrieved 2015-03-11.
  5. 1 2 Lacour, M; Le Coultre, C (1991). "Spray-induced frostbite in a child: A new hazard with novel aerosol propellants". Pediatric Dermatology. 8 (3): 207–9. doi:10.1111/j.1525-1470.1991.tb00860.x. PMID   1745629. S2CID   900852.
  6. ↑ "Frostbite: Complications". MayoClinic. Archived from the original on 2012-12-26. Retrieved 2012-07-05.
  7. ↑ "Frostbite: Symptoms". nlm.nih.gov. Archived from the original on 2016-07-05. Retrieved 2012-07-05.
  8. ↑ Tan, J; Anwar, M. U.; Timmons, M. J. (2008). "Self inflicted aerosol burns--a disturbing development". Journal of Burn Care & Research. 29 (5): 845–7. doi:10.1097/BCR.0b013e3181848b28. PMID   18695608. S2CID   3701270.
  9. ↑ Miller, Ryan W. (May 9, 2018). "'Deodorant challenge': Are teens really burning their arms to go viral?". USA TODAY. Archived from the original on January 11, 2021. Retrieved 2021-01-11.
  10. ↑ Knudson, Annalise (2018-04-03). "Social media challenges: 8 dangerous teen trends". silive. Archived from the original on January 11, 2021. Retrieved 2021-01-11.
  11. ↑ Kale A, Shackley F (2010). "Accidental cutaneous burns secondary to salbutamol metered dose inhaler". Case Rep Med. 2010: 1–2. doi: 10.1155/2010/201809 . PMC   3014811 . PMID   21209810.
  12. ↑ Sarwar U, Nicolaou M, Khan MS, Tiernan E (2011). "Air-freshener burns: a new paradigm in burns etiology?". Int J Prev Med. 2 (4): 291–3. PMC   3237275 . PMID   22174972.
  13. ↑ Yarbrough Dr, 3rd (1998). "Burns due to aerosol can explosions". Burns. 24 (3): 270–1. doi:10.1016/s0305-4179(97)00121-6. PMID   9677032.
  14. ↑ Kuspis, D. A.; Krenzelok, E. P. (1999). "Oral frostbite injury from intentional abuse of a fluorinated hydrocarbon". Journal of Toxicology. Clinical Toxicology. 37 (7): 873–5. doi:10.1081/clt-100102469. PMID   10630273.
  15. ↑ "Inhalants". Archived from the original on 2013-01-19. Retrieved 2012-11-01.
  16. ↑ "Inhalant Abuse is on the Rise". www.kidsgrowth.com. Archived from the original on 2016-07-01. Retrieved 2012-11-01.
  17. ↑ "Inhalant Abuse by Children". Archived from the original on 2016-11-14. Retrieved 2012-11-01.
  18. ↑ Jacobi, A.; Bender, A.; Hertl, M.; König, A. (2011). "Bullous cryothermic dermatitis artefacta induced by deodorant spray abuse". Journal of the European Academy of Dermatology and Venereology. 25 (8): 978–982. doi:10.1111/j.1468-3083.2010.03861.x. ISSN   1468-3083. PMID   21740463. S2CID   7265071.
  19. ↑ "About Cancer". 2017-08-30. Archived from the original on 2011-07-14. Retrieved 2012-10-28.
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