Edema usually disappears in less than five days if the patient is kept at
(6) Shedding of the superficial layers of skin may begin within five to ten
days after injury and may continue as long as a month.
(7) In very severe cases, deep aching pain, paresthesia (burning, prickling--
a morbid sensation), cyanosis (blueness of the skin from imperfectly oxygenated blood),
hyperhidrosis (excessive perspiration), and coldness of the injured part may appear two
or three weeks after the injury has occurred and persist for many months. In milder
cases, symptoms may persist for several hours, causing intense discomfort but
gradually disappearing without serious consequences.
b. Second Degree--Hyperemia and Vesicle Formation.
Hyperemia, edema, and burning pain occur soon after rewarming.
The skin becomes deep red, with mottled cyanosis and feels hot and dry
to the touch.
Swelling begins within two or three hours.
(4) There may be a sensation of tingling and burning which gradually
becomes more intense; light touch and position sense are frequently absent.
(5) In severe cases, blisters and huge blebs (large, soft sacs) may appear
within six to twelve hours. The large, clear appearance of these blebs appearing early
and extending nearly to the tips of involved fingers or toes is generally felt to be a
valuable sign identifying the injury as second degree.
(6) Pain, usually a deep, aching sensation in association with intense
(7) Edema is usually not marked and disappears within three to five days
after rewarming if the patient is not ambulatory.
(8) The vesicles (small sacs or cysts) appear in the germinative layer of skin
and frequently occur on the great toe and heel or the back of one or more fingers.
These vesicles dry, forming black scabs within 10 to 24 days after rewarming.
(9) There may be slight limitation of motion in the injured part of the body,
fingers or toes for example.
(10) Throbbing or aching pain is usually noted 10 to 20 days after injury.