Cold Protecting Ointments and Frostbite: A Questionnaire Study of 830 Conscripts in Finland

Abstract

The use of emollients on the face is a traditional way to protect the skin against cold injuries in cold climate countries like Finland, but their preventive effect against frostbite has been questioned. The purpose of this investigation was to define the thermal insulation and occlusivity of ointments in cold by using a skin model with a sweating hot plate. The properties of four different emollients were studied in both dry and humid conditions simulating transepidermal water loss, sweating, and a combination of sweating and drying. The thermal insulation of ointments applied on a dry surface was minimal. Evaporation of water from an oil-in-water cream caused significant cooling for 40 min after its application. The diffusion of water through the applied emollients changed their thermal effects depending on their composition and on the amount of water. Low input of water increased and high input diminished slightly the thermal resistance of ointments. The minimal or even negative thermal insulation of emollients in varying conditions gives them at best only a negligible and at worst a disadvantageous physical effect against cold.

Thermal Effects of Emollients on Facial Skin in the Cold: Clinical Report

“…The results of this study indicate that the emollients tested do not delay the cooling of facial skin temperature in cold. Together with epidemiological evidence of increased risk of frostbite in connection with emollient use (1,2) and in vitro results of their lack of thermal insulation against cold even in thick application layers (11), the results in this study lead to a recommendation that the long-lived tradition to use``protective'' ointments should be discouraged when cold exposure causes an actual risk of frostbite. Moisturizing of dry winter skin with emollients Table II.…”

“…Key words: creams; ointments; frostbite; cold injury. At least one super®cial frostbite of the head occurs in 47% of men in Finland by the age of 19 years (1). Unprotected areas of the head (i.e.…”

“…In Finnish conscripts, 21% had used cold protective ointments, mostly at school age or earlier (1). In 25% of their families another member (mostly women and children) had also used emollients to prevent cold injuries (1).…”

“…However, in a large prospective epidemiological study with 913, mostly mild, frostbites of the head and 2,478 uninjured controls (2), the use of protective ointments was unexpectedly shown to be associated with a considerably increased risk of frostbite on the face and ears. In a retrospective questionnaire study (1) there was also a statistical association of the cumulative incidence of facial frostbite with the habit of using protective ointments in the cold. No reports were found in the scienti®c literature con®rming any protective characteristics of ointments against frostbite.…”

Emollients and the response of facial skin to a cold environment

“…Different hypotheses exist regarding the effect of emollients on the skin's response to cold 1–4 . The resolution of these hypotheses has practical relevance for people regularly exposed to moderately cold environments, such as skiers, mountaineers, outdoor workers, frost‐room workers, etc.…”