Cohort Series and Systematic Literature Review: Intentional Self- and Peer- Inflicted Aerosol Skin Injuries ‘Frosties’

Dr Christopher Maguire1, Dr Bhaveshkumar Patel1,2,3, Dr Craig McBride1,2,3

1Pegg Leditschke Children’s Burns Centre, South Brisbane, Australia, 2School of Medicine, Griffith University, Brisbane, Australia, 3Centre for Children’s Burns and Trauma Research, University of Queensland, Brisbane, Australia


Background: ‘Frosties’ are deliberate cold skin burns caused by an aerosol device.

Objectives: To examine our own cohort, and those previously published, to identify the key features and inform appropriate early clinical interventions.

Results: The median age was 13 years; 70.5% female. Adequate first aid was not reported in any patient. Where recorded, the median time to presentation was six days. Where severity of injury was recorded, 13 of 37 cases (35.1%) were full thickness and ten patients received a split thickness skin graft (STSG). Two subgroups of patients were identified; cluster injuries and psychological distress.

Discussion: Cluster injuries occur as the result of a mutual ‘test of courage’. Solo injuries may point to underlying psychological distress. Frostie severity is under-appreciated and in consequence first aid and/or presentation are delayed or absent. Frosties frequently result in significant burn injuries and often require skin grafting.


Dr Christopher Maguire is currently a Senior House Officer in Paediatric Surgery at Lady Cilento Children’s Hospital. He also holds the rank of Captain in the Australian Army Medical Core, and is the sitting Chair of the Australian Medical Association of Queensland’s Council of Doctors in Training.

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