Non-freezing cold injury (NFCI)

What is NFCI?  

Non-freezing Cold Injury (NFCI) occurs when prolonged exposure to cold and often cold/wet conditions affects nerves and small blood vessels.  The fingers and toes are most commonly affected.

What are the symptoms of NFCI?

The affected area has altered sensation: they may be painful and/or more sensitive to cold. The severity of these symptoms varies depending on how long the individual was exposed and how cold the affected area became. There are also other risk factors which affect the severity of symptoms. Most cases of NFCI are mild and symptoms resolve within weeks to months. If the symptoms persist for more than 3 months, this is considered to be chronic NFCI. 

The symptoms change over time:

During the cold exposure: 

• the area feels cold to touch and is numb

During rewarming: 

• the area is painful for an unusually long period and there may be associated tingling, burning and pins and needles

After rewarming: 

• tingling, burning, or pins and needles may occur
• sensation to touch may be altered (often reduced)
• the skin might be red and swollen (this is unusual)
• in very severe cases, blisters may form

Long term/chronic: 

• the area may be painful, particularly at night.
• other common sensations are tingling, burning, and pins and needles
• there may be altered sensation to touch 
• the area may be more sensitive to cold (feels unusually uncomfortable in the cold, or becomes pale unusually quickly in the cold, or both)
• rarely, the area is sweaty even when it is not warm (hyperhidrosis)