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Understanding Frostbite -- Diagnosis and Treatment

How Is Frostbite Diagnosed?

Frostbite is initially diagnosed based on symptoms and a physical exam. 

Various imaging techniques may be used to determine the severity of tissue damage three to five days after re-warming. 

Understanding Frostbite

After one to three weeks, imaging may also be used to help evaluate the condition of any potentially damaged blood vessels and to identify severely frostbitten areas that may need to be amputated.

What Are the Treatments for Frostbite?

Most people recover completely from frostbite, though the affected area may be more susceptible in the future to discomfort from cold weather, repeat frostbite, and damage from the sun. The first goal of treatment is to re-warm the affected area.

Frostnip can be treated at home. If you think you may have frostnip, get out of the cold as soon as possible. If your clothes are wet, change into dry clothing. Immerse the affected area in warm water (100º to 105º Fahrenheit) to thaw the frozen tissue. Do not use hotter water as this may burn your skin. If warm water is not available, use your own body heat by, for instance tuck your hands into your armpits or cover your nose, ears, or face with dry hands.

CAUTION: Do not rub the affected area because this may increase damage to the tissue. Do not use a heating pad, heat lamp, stove, fireplace, or radiator to rewarm the affected area. These methods may warm your skin unevenly or may burn your skin, particularly if it’s numb and you cannot tell how hot the skin is getting.

If the skin tingles and burns as it warms, your circulation is returning. The skin may turn red, but should not blister or swell. If the skin does not seem to warm, if it remains numb, or if it does blister or swell, seek immediate medical attention.

Frostbite requires emergency medical care. If you think you may have frostbite, get out of the cold as soon as possible. If you cannot get medical help immediately and there's no risk that the area might be re-frozen before you get help, warm the affected area as you would for frostnip.

CAUTION: If the affected area might be re-frozen before you get medical help, do not warm it; this greatly increases the risk of damage. Also, do not walk on frostbitten feet or toes unless it's absolutely necessary.

At the hospital, frostbite is usually treated comprehensively because its severity cannot be diagnosed in the first few days. Usually, patients need to be admitted for observation. Initially, the hospital staff will probably do the following:

  • Rapidly warm the affected area in water for 15 to 30 minutes.
  • Remove blisters that contain clear or milky fluid and cover them with a topical antibiotic, petroleum jelly, or aloe vera gel. Blisters that contain blood may not be removed.
  • Splint and elevate the affected area and wrap it in a loose bandage.
  • Administer ibuprofen to limit inflammation, tetanus toxoid to prevent tetanus infection, and antibiotics to prevent or treat infection. Narcotic drugs may be needed to treat pain as sensation returns.

Later hospital treatment may include whirlpool therapy and physical therapy to promote circulation. Surgery, including amputation of the affected area, is sometimes necessary. Amputation is performed only if the tissues are dead. This determination is typically made between three and six weeks after the injury.

 

WebMD Medical Reference

Reviewed by David T. Derrer, MD on April 05, 2014

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