Extreme Cold Exposure: What Veterans Should Know

Medically Reviewed by Poonam Sachdev on May 23, 2022
4 min read

Veterans face many health risks during and after their military service. A common cause of injury that affects many soldiers and veterans is extreme cold exposure. Cold exposure can happen in many situations and cause mild to severe injuries. Veterans can take steps to prevent extreme cold injuries or get treatment.

Extreme cold exposure injuries can happen if you're exposed to a cold environment indoors or outdoors without the right protection or for long periods of time. They can also happen from contact with very cold chemicals and materials. Extreme cold exposure can cause:

Hypothermia. Hypothermia happens when the body’s internal temperature becomes too low. Typically, your body temperature is between 97.5°F and 98.9°F. A body temperature below 95°F or 35°C is the starting point of hypothermia. A rectal thermometer can help you get the most accurate temperature.

Symptoms of hypothermia include:

  • Shivering
  • Mumbling
  • Sleepiness
  • Confusion
  • Weak pulse

Frostbite. Frostbite happens when skin exposure to cold air or cold material causes it to freeze. Mild cases can heal without lasting damage. More extreme frostbite injuries can lead to infections or amputation.

The ears, fingers, cheeks, toes, nose, and chin are the most common areas to get frostbite. Symptoms of frostbite include:

  • Redness of the skin
  • Numb skin
  • Waxy or hardened skin
  • Blisters that are clear, white, blue, or bloody
  • Stinging pain
  • White, yellow, or gray-tinted skin
  • Blackened skin, in extreme cases

Frostbite often happens at the same time as hypothermia.

Chilblains. Chilblains are patches of red, irritated skin that can appear after being in the cold. They usually go away on their own. They can be itchy or feel like they’re burning. Chilblains are most common on fingers and toes, which can become swollen.

Trench foot. Trench foot, or immersion foot, happens when the feet are cold and wet for too long. Its name comes from soldiers who got this illness from spending time in cold, wet dirt tunnels called trenches.

You don’t need to be in freezing conditions to get trench foot. Some symptoms of trench foot are:

  • Redness of the foot’s skin
  • Swollen feet
  • Numbness in the feet
  • Leg pain and cramps
  • Heavy or prickling sensations in the feet
  • Blisters
  • Foot soreness or pain
  • Skin peeling or falling off

Trench foot can go away after drying, resting, and warming the feet. It can cause permanent damage to the feet if left without treatment. This can result in amputation in extreme cases.

Extreme cold exposure injuries often happen from spending time in cold environments with temperatures below 32°F. Snowy, wet, and windy conditions outdoors can raise the risk of getting a cold exposure injury. Soldiers can spend long periods of time in these environments during military training or missions.

Extreme cold injuries can also happen through work with machinery or chemicals. Air conditioning, refrigeration, and other military equipment use certain cooling gases. Unprotected contact with these gases can cause frostbite.

Smoking cigarettes, drinking alcohol, diabetes, and certain medications can raise your risk of getting an extreme cold exposure injury in the military. Younger and more junior soldiers can be more likely to get cold exposure injuries. They may be hesitant to speak up if they're feeling cold.

Hypothermia and frostbite have similar treatments for milder cases. Nonmedical cold injury treatment can include moving to a warmer room or area, removing wet clothing, and using others’ body heat.

Access to an army first-aid kit can also help treat extreme cold exposure injuries. This can include matches and other fire-starting materials, a foil blanket, and a water container that can be heated.

Light exercise raises body temperature, which can help reverse mild hypothermia. Medical treatments for severe cases of hypothermia include heated blankets, IV treatment with warmed liquid, and breathing in warmed air.

Home frostbite treatment can include holding the skin under warm water. Avoid holding the skin up to a fire, radiator, hot water bottle, or other very hot surface. This can result in burns since the skin is numb.

A doctor can also give a whirlpool treatment to re-warm frostbitten skin.

Dressing for cold weather can usually prevent most extreme cold injuries. Proper layering includes:

  • An innermost clothing layer of moisture-wicking fabric
  • Looser jackets and pants made of fleece or other thick material
  • Outer layers of wind-blocking material
  • Avoiding cotton, which absorbs water.

Socks shouldn’t be too tight. This can increase the risk of frostbite by cutting off blood flow that keeps the skin warm. Sock layering should be similar to clothing layering. Choose a moisture-wicking inner pair and a thicker outer pair made of wool.

Shoes should be waterproof. Make sure they’re tight enough that snow doesn’t get inside them. Avoid wearing shoes that are too tight.

Gloves, hats, scarves, mittens, and earmuffs can also protect your skin from extreme cold. You can layer gloves in the same way as socks and clothing. Putting extra clothes inside sleeping bags also helps maintain warmth during sleep.

Active-duty soldiers may receive nonemergency care for extreme cold exposure injuries from a military clinic or hospital. In remote areas far from any military clinic, certain military health plans can cover care from a different provider. In an emergency, you can go to a nonmilitary hospital.

The effects of cold weather on the human body can cause lasting damage long after active service is over. Veterans’ insurance can cover some of these permanent problems from extreme cold exposure. These problems can include:

  • Skin cancer in frostbite scars
  • Lasting pain, cold sensitivity, and numbness in frostbitten areas
  • Blood loss and numbness in fingers
  • Muscle weakness
  • Heart issues like irregular heartbeat
  • Repeated fungal infections

Veterans can contact a Department of Veterans Affairs Environmental Health Coordinator for more information on getting treatment for extreme cold exposure injuries.