Cold panniculitis occurs when skin is in direct contact with freezing temperatures.
The skin is injured as fat cells freeze and rupture, resulting in firm, red, persistent patches of skin in the area in contact with the cold. The overlying skin may appear a bit taught and shiny. In contrast to a baby with a skin infection — which is hot, red, and spreads quickly — the infant appears otherwise well and may not be in any discomfort at all.
Cold panniculitis does not cause a fever, so a rash that appears alongside fever always warrants a trip to the pediatrician’s office. Frozen teething objects are one cause of cold panniculitis and are the reason we recommend cooling teethers in the refrigerator and not the freezer. There is no specific treatment for mild cold panniculitis, and it may take several weeks or longer for it to resolve completely.