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What is Frostbite?

December 16, 2019 | Dr. Nimitt Patel

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As we get closer to winter, the weather gets colder here in Northern Ohio. Especially on windy days, you may notice your skin feeling especially cold or even numb. Frostbite can be serious but there are things you can do to prevent it this year.

What is Frostbite?

Frostbite is an injury to the skin that occurs in extreme cold. It is caused by the freezing of the skin and underlying tissues. It is most common on fingers, toes, nose, ears, cheeks, and chin because those areas are the most likely to be exposed in cold, windy weather. However, in extreme cold, frostbite can occur on skin covered by clothing.

Frostbite should not be confused with frostnip. Frostnip does not cause permanent skin damage and can be treated at home with first aid measures such as rewarming the affected skin. Frostbite requires medical attention because it can damage skin, tissues, muscle, and bones.

Frostbite occurs in several stages:

  • Frostnip is mild and is characterized by numbness in the affected area. As you warm up, you may feel pain and tingling but frostnip does not cause permanent damage to the skin.
  • Superficial frostbite is characterized by red skin that turns white or pale and may feel warm as a sign of serious skin damage. A blister may appear 12 to 36 hours after rewarming.
  • Deep frostbite is characterized by skin turning white or bluish gray along with numbness, the loss of all cold sensation, and pain or discomfort in the affected area. Joints or muscles in that area may not work and large blisters may appear 24 to 48 hours after rewarming. Later, the area can turn black and hard as tissue dies.

Signs & Symptoms

If you think you may be experiencing frostnip, it is safe to treat at home by warming up the affected area. However, you should seek medical attention for frostbite if you experience any of the following:

  • Signs and symptoms of superficial or deep frostbite
  • Increased pain, swelling, redness, or discharge in the affected area
  • Fever
  • New, unexplained symptoms

You should go to the emergency room if you have signs of hypothermia—when the body loses heat faster than it can produce it—such as:

  • Intense shivering
  • Slurred speech
  • Drowsiness and loss of coordination

Preventing Frostbite

Before braving the cold this winter, there are things you can do to help you stay safe and warm, and avoid frostbite.

Limit the time you spend outside. When it is cold, wet, and/or windy, exposed skin can develop frostbite in minutes. Keep track of weather forecasts and pay special attention to the wind chill factor.

Dress in loose, warm layers. When you dress in loose layers, the air trapped in between them acts as insulation. A good rule of thumb is a water wicking bottom layer, a warm fleece middle layer, and a windproof and waterproof outer layer.

Keep your ears covered. Wear and hat or headband mad of heavy woolen or windproof materials that fully covers your ears.

Wear mittens over gloves and warm socks. Because mittens keep your fingers together allowing them to share heat, they are better at keeping your hands warm. Alternatively, you can wear thin moisture-wicking gloves under heavier gloves. Make sure your socks are moisture-wicking and provide adequate insulation. On extremely cold days, or when you will be outside for longer periods you can also try hand and foot warmers as long as they don’t make your shoes so tight they restrict blood flow.

Watch for frostbite. Be on the lookout for red or pale skin, prickling, and numbness and seek shelter if you notice them.

Plan ahead. When traveling in the winter, always carry emergency supplies, warm clothing, and keep your cell phone charged.

Eat balanced meals, stay hydrated, and don’t drink alcohol. Eating and drinking properly before going out in the cold will help you stay warm. Conversely, alcoholic beverages cause your body to lose heat quickly.

Keep moving. Staying active and moving with get your blood flowing and help you stay warm.

Dr. Nimitt Patel is the Medical Director of Trauma Services at Fisher-Titus and is a MetroHealth Trauma Surgeon. Fisher-Titus has been a Level 3 Trauma Center since 2009 and has had a Trauma Partnership with MetroHealth since October 2018.