Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report

Nitrous oxide has a wide range of medical applications, such as being used as an analgesic in general anesthesia, dental procedures, childbirth and sedation. Lately, it has also been employed as an inhalant recreational drug to induce brief euphoria. Recent studies indicate a worldwide rise in the i...

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Main Authors: Sebastian Holm, Reza Tabrisi, Johann Zdolsek
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:European Burn Journal
Subjects:
Online Access:https://www.mdpi.com/2673-1991/6/1/14
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author Sebastian Holm
Reza Tabrisi
Johann Zdolsek
author_facet Sebastian Holm
Reza Tabrisi
Johann Zdolsek
author_sort Sebastian Holm
collection DOAJ
description Nitrous oxide has a wide range of medical applications, such as being used as an analgesic in general anesthesia, dental procedures, childbirth and sedation. Lately, it has also been employed as an inhalant recreational drug to induce brief euphoria. Recent studies indicate a worldwide rise in the incidence of skin frostbites associated with nitrous oxide use. A scoping review was conducted to synthesize and summarize the existing literature published in English regarding frostbite injuries associated with the recreational use of nitrous oxide. The literature search was carried out in July 2024 using databases such as Embase, Web of Science and PubMed<sup>®</sup>. From an initial pool of 83 publications, 8 studies were ultimately selected for full-text review as they met our inclusion criteria for analysis. Additionally, we provide a representative clinical case involving a 21-year-old male who experienced frostbite following skin exposure to nitrous oxide. Most publications on nitrous oxide induced frostbites are from recent years, primarily between 2022 and 2024, with the first case documented in 1996. These injuries are mostly observed in young adults, with a female dominance, and are typically localized to the inner thighs. According to the existing literature, the predominant treatment approach is conservative management, with excision and split-thickness skin grafting (STSG) in the second place. This study represents the first literature review summarizing frostbite injuries to the skin from nitrous oxide misuse. There is a need for enhanced preventive measures to raise public awareness and reduce the incidence of frostbite injuries associated with the recreational use of nitrous oxide.
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spelling doaj-art-d8cae6dc2a544e5ca0dc1b2170cd42b42025-08-20T03:43:30ZengMDPI AGEuropean Burn Journal2673-19912025-03-01611410.3390/ebj6010014Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case ReportSebastian Holm0Reza Tabrisi1Johann Zdolsek2Department of Plastic and Reconstructive Surgery, Örebro University Hospital, Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, SwedenDepartment of Plastic and Reconstructive Surgery, Örebro University Hospital, Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, SwedenDepartment of Plastic and Reconstructive Surgery, Örebro University Hospital, Faculty of Medicine and Health, Örebro University, SE 70182 Örebro, SwedenNitrous oxide has a wide range of medical applications, such as being used as an analgesic in general anesthesia, dental procedures, childbirth and sedation. Lately, it has also been employed as an inhalant recreational drug to induce brief euphoria. Recent studies indicate a worldwide rise in the incidence of skin frostbites associated with nitrous oxide use. A scoping review was conducted to synthesize and summarize the existing literature published in English regarding frostbite injuries associated with the recreational use of nitrous oxide. The literature search was carried out in July 2024 using databases such as Embase, Web of Science and PubMed<sup>®</sup>. From an initial pool of 83 publications, 8 studies were ultimately selected for full-text review as they met our inclusion criteria for analysis. Additionally, we provide a representative clinical case involving a 21-year-old male who experienced frostbite following skin exposure to nitrous oxide. Most publications on nitrous oxide induced frostbites are from recent years, primarily between 2022 and 2024, with the first case documented in 1996. These injuries are mostly observed in young adults, with a female dominance, and are typically localized to the inner thighs. According to the existing literature, the predominant treatment approach is conservative management, with excision and split-thickness skin grafting (STSG) in the second place. This study represents the first literature review summarizing frostbite injuries to the skin from nitrous oxide misuse. There is a need for enhanced preventive measures to raise public awareness and reduce the incidence of frostbite injuries associated with the recreational use of nitrous oxide.https://www.mdpi.com/2673-1991/6/1/14frostbitesfrostbite injuriesnitrous oxidelaughing gas
spellingShingle Sebastian Holm
Reza Tabrisi
Johann Zdolsek
Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
European Burn Journal
frostbites
frostbite injuries
nitrous oxide
laughing gas
title Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
title_full Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
title_fullStr Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
title_full_unstemmed Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
title_short Recreational Use of Nitrous Oxide as a Source of Frostbite Injuries to the Skin: A Review of the Literature and a Case Report
title_sort recreational use of nitrous oxide as a source of frostbite injuries to the skin a review of the literature and a case report
topic frostbites
frostbite injuries
nitrous oxide
laughing gas
url https://www.mdpi.com/2673-1991/6/1/14
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