Next Steps - Follow-up
Symptoms follow a predictable pathway. Numbness initially is followed by a
throbbing sensation that begins with rewarming and may last weeks to months.
This is then typically replaced by a lingering feeling of tingling with
occasional electric-shock sensations. Cold sensitivity, sensory loss, chronic
pain, and a variety of other symptoms may last for years.
The treatment of frostbite is done over a period of weeks to months.
Definitive therapy, possibly in the form of surgery, may not be performed for
up to 6 months after the initial injury. Therefore, establish a working
relationship between you and your doctor that will continue throughout the
The first step in preventing frostbite is knowing whether you are at
increased risk for the injury.
- Most cases of frostbite are seen in alcoholics, people with psychiatric
illness, car accidents or car breakdowns in bad weather, and recreational drug
- All of these conditions share the problem of cold exposure and either the
unwillingness or inability of a person to remove himself or herself from this
- Tobacco smokers and people with diseases of the blood vessels also are at
increased risk because they have an already decreased amount of blood flow to
their arms and legs.
- Homelessness, fatigue, dehydration, improper clothing, and high altitude
are additional risk factors.
Although people don't always know or acknowledge these dangers, many of the
dangers can be reduced or prevented.
- Dress for the weather.
- Layers are best, and mittens are better than gloves (keeps your warm
fingers together while warming each other).
- Wear 2 pairs of socks, with the inner layer made of synthetic fiber, such
as polypropylene, to wick water away from the skin and the outer layer made of
wool for increased insulation.
- Shoes should be waterproof.
- Cover your head, face, nose, and ears at all times.
- Clothes should fit loosely to avoid a decrease in blood flow to the arms
- Always travel with a friend in case help is needed.
- Avoid smoking and alcohol.
People with diabetes and anyone with vessel disease should take extra
precautions, as should the very young, very old, and unconditioned.
Be especially wary of wet and windy conditions. The "feels like"
temperature (windchill) is actually much lower than the stated air
A common saying among surgeons who have treated people with frostbite is
"frostbite in January, amputate in July." It often takes months before
the final separation between healthy and dead tissue may be determined. If
surgery is performed too early, the risks of removing tissue that may
eventually recover or leaving behind tissue that may eventually die are great.
Some radiographic techniques currently are being investigated that may be able
to make this division much sooner, thus permitting earlier definitive
Beyond this waiting period, 65% of people will suffer long-term symptoms
because of their frostbite. Common symptoms include pain or abnormal sensations
in the extremity, heat or cold sensitivity, excessive sweating, and