What is frostbite?

Frostbite is an injury caused by freezing of the skin and the body tissues under the skin. The most common body parts to get frostbite are toes, feet, fingers, hands, nose, and ears.

You may have full recovery from frostbite if just the skin and uppermost tissue layers were affected. However, it may take weeks for frostbitten areas to get full feeling and strength back.

What is the cause?

Frostbite happens when part of your body is exposed to temperatures or wind chills below freezing for long periods of time. Very cold temperatures cause your skin temperature to drop below freezing, your blood flow to decrease, and the skin and tissues just below the skin to freeze.

How long it takes to develop frostbite depends on many things, such as the temperature, wind, the altitude, the clothing you wear, whether your skin and clothing are wet, and your general health. If you have poor circulation because of health problems such as diabetes, thyroid problems, or a stroke, you may be at higher risk of frostbite when you are exposed to cold temperatures. You can also get frostbite in just a few minutes if you are exposed to extremely cold temperatures, such as below 14°F (-10°C).

What are the symptoms?

The symptoms of frostbite can be mild to severe. Symptoms may include:

• Skin that is pale (gray, white or blue), and cold
• Skin that feels hard to the touch
• Parts of your body that tingle or feel numb
• Skin that blisters, swells, or turns black (in severe cases)

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you.

What is the treatment?

Get medical care right away. Frostbite can cause permanent damage if you do not receive proper medical care. If medical help is not available, ways to treat frostbite include finding warm shelter and rewarming the skin right away. To rewarm and thaw frostbitten skin:

• Remove wet socks or gloves.
• Place your hands under your armpits or your feet against a warm person’s belly.
• Dry and cover the area with warm clothes and then layers of blankets.
• Put the area in warm water (104°F to 108°F, or 40°C to 42°C). Don’t use a heating pad or any intense heat because frostbitten skin is easily burned.
• Use a warm, wet washcloth on frostbitten nose or earlobes.
• Continue rewarming until the skin is pink and no longer numb or until medical help arrives. Do not to rub the frostbitten areas.
• Rewarming takes up to an hour and can be painful. Take acetaminophen, ibuprofen, or aspirin for the pain. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Cover the thawed area, which may become blistered, with a clean bandage or cloth.
• Drink hot fluids such as coffee or tea. Do not drink alcohol during the rewarming.
• Do not put snow on frostbitten areas.
• Don’t walk on your feet or toes if they are frozen.

Treatment at the hospital may include:

• A shot of a strong pain reliever
• Hyperbaric oxygen (oxygen given in a special chamber to deliver high levels of oxygen to frostbitten tissues)
• A tetanus shot

Depending on how bad the injury is, you may have some permanent numbness or tingling, joint stiffness, or muscle weakness. You may also lose finger or toenails, or have some peeling or cracking of your skin. After the area heals, it may be more sensitive to cold in the future.

If blood vessels are injured, tissues can die because of lack of oxygen. The dead area may have to be amputated. However, amputation does not have to be done in every case. Blackened areas of severe frostbite may heal if you receive proper medical care. It may take several weeks to month for tissues to heal and to know whether an area needs to be amputated.

How can I help prevent frostbite?

The best way to prevent frostbite is to be prepared and dress properly. Wear several layers of clothes rather than a single, thick layer. The best layers provide good insulation and keep moisture away from your skin. Materials that do this include polypropylene, polyesters, and wool. Wear an outer garment that is waterproof but will also “breathe.” Wear a hat and keep your neck covered to help retain body heat. Be sure your clothing protects your head, ears, nose, hands, and feet.

When you are outdoors in cold weather follow these safety guidelines:

• Be prepared for a sudden change in the weather. Carry proper clothing and emergency supplies in a backpack so you are prepared for bad weather.
• Don’t begin an outdoor activity too late in the day.
• Take off any clothing that is wet and put on warm, dry clothes.