Missed derm opportunity:

No frostbite in "Cold Mountain"

The Civil War epic "Cold Mountain" recounts the romantic return of a Confederate soldier to a woman he kissed only once. Though this premise sounds far fetched, if the woman happens to be austere Aussie Nicole Kidman, then we believe! This powerful tale relies on the visual impact of skin problems, particularly wounds and scarring.


Unfortunately, a great dermatologic opportunity is missed. There are scenes in the wilderness in the dead of winter, yet shockingly there is no example of frostbite to be found. For the sake of all that's right in the world, director Anthony Minghella's gave us the uber ulcer epic "The English Patient" where the romance's Romeo had more scars than normal skin. How could dermatology not be the focus of the producers' efforts?

 In "Iron Will,"

 ...actor Mackenzie Astin...

 ...endures all for his dog sled team.

 #1 on his wish list? Warmer gloves.

Minghella could easily have followed the lead of the Disney drama, "Iron Will (1994)." This overlooked inspirational trifle stars Mackenzie Astin (younger brother of Hobbit Sean Astin!) who bravely leads a dog sled team to victory. This win is not achieved without sacrifice, and the character's skin takes the fall (and the winter, for that matter). After an intense day of sledding, Astin suffers frostbite, the result of prolonged exposure to cold temperatures. Mild forms have the hip-hop-like handle: "chilblains." Typically involving the fingers, toes, and even the face, chilblains shows redness and swelling. In frostbite the tissue is actually fully frozen, and the damage is more extensive, with skin breakdown, ulcers, and possibly necrosis (black skin from tissue death). Rapid re-warming of the skin in hot water is important, and blood-thinning medicines like aspirin insure better circulation. Fortunately, in "Iron Will," Astin's toes and face are as strong as iron and no loss of the skin or digits occurs.

How did "Cold Mountain" drop the ball of ice? Even anti-romantic Adam Sandler incorporated a frostbitten black foot into the humanistic work of art, "Mr. Deeds." In "Cold Mountain," Jude Law is shot, beaten, starved, and chained to a group of corpses. How unbearably romantic would it be if Jude Law survived a climactic bout of frostbite over his love for Kidman? That would send cold chills down anyone's spine.


Runners up, Missed derm opportunity:



 No Ringworm in "Lord of the Rings"

 No sunscreen product placement in "Under the Tuscan Sun"


© 1996-2008 Vail Reese M.D.

Dr. Reese's office