Spray-induced frostbite in a child: a new hazard with novel aerosol propellants

A case of deep frostbite occurred in an 8.5-year-old child. The lesion was due to the improper use of a toilet air freshener and was severe enough to require a skin graft. The propellants contained in the spray were propane and butane. We measured the temperature of this aerosol during spraying (-40 degrees) in comparison with an ethyl chloride spray (-3 degrees) widely used for local skin anesthesia. This difference is mainly due to the much lower evaporation temperature of propane (-42.2 degrees) and butane (-0.6 degrees) compared with ethyl chloride (12.5 degrees). This child aimed the spray directly toward his skin, thus producing a deep frostbite. We wish to draw the attention of clinicians to this potential hazard with new propellants, since they should soon replace chlorohydrofluorocarbons throughout the world for ecologic reasons.