Ask the Experts: Extreme Cold Sensation

About "Ask the Experts"

In this advice column for Burn Support Magazine, a panel of experts draws on their personal and professional experience to offer guidance. They do their best to make it good advice, but remember that their opinions and views can never replace the diagnosis, treatment, or care of a licensed physician or mental health professional.

Dear Experts,

I have episodes when I get extremely cold and achy, almost as if I am feverish and have chills. At times, it can be so debilitating I cannot work or function. The cold is most severe in my hands, arms, and neck. This can even occur in high, humid 90-degree temps. It is extremely difficult to regulate, as I have to wear fleece and use electric blankets year-round. It seems to be especially triggered by light breezes, like sitting under a ceiling fan. My skin is actually cold. If someone holds my hand or touches my arm, they remark how cold I am to the touch.

I’m surprised, because I always hear that burn survivors are hot and have difficulty functioning in the heat. All I want to do is sit in a sauna or a hot car in the summer. Please help me understand why I experience this and what I can do to get and remain warm.

- Katheryne

Dear Katheryne,

This is an interesting phenomenon for burn survivors. Much more has been written about heat intolerance than cold intolerance. It’s thought to be related to perspiration area, cutaneous vasoconstriction, and impaired heat dissipation. This can last for years after injury and can be permanent. This is not necessarily burn size dependent.

Whether you suffer from heat intolerance or cold intolerance, your experience dictates how you live your life. The modifications you have already made with clothing or blankets may be permanent modifications you need to continue. Avoiding ceiling fans may also be beneficial. Studies on heat intolerance found some benefit from heat acclimation over time (actively working through the heat). For cold intolerance, it may be beneficial to work on acclimating to cooler temperatures or gentle breezes over time.

It is not necessarily a permanent intolerance but waiting for change or improvement may not be sufficient. It is also important to rule out any thyroid, cardiac or vascular abnormalities that may be unrelated to prior burn injury. Living your best life by whatever accommodations you can make to thrive and succeed is what you need to do.

Dr. Felicia Williams
Burn Surgeon