Frostbite

What Is Frostbite?

Frostbite is when exposure to freezing temperatures damages areas of your skin and the tissues underneath. It’s a treatable but potentially serious condition.

What Are the Symptoms?

When it's cold out, skin that’s not covered may get red or sore. This is called frostnip, and it’s an early warning sign of frostbite. If this happens, find warm shelter quickly.

Symptoms of frostbite depend on how deep it goes into the body. There are three stages. Early frostbite affects the top layers of the skin. More advanced cases can go all the way to the muscles and bones.

Early stage

  • Skin turns a pale yellow or white
  • It may itch, sting, burn, or feel like "pins and needles."

Intermediate stage

  • Skin becomes hard
  • It looks shiny or waxy
  • When the skin thaws, blisters filled with fluid or blood form

Advanced stage

  • Skin is very hard and cold to the touch
  • Skin darkens quickly. It may look blue and later turn black

Some people don't know they have frostbite because as it gets worse, you can't feel the area anymore. That's why you need to look for changes in skin color.

Frostbite Emergency Symptoms

Go to the emergency room right away if you suspect frostbite. Some warning signs may include:

  • Your skin color changes color or becomes hard.
  • Your skin stays numb (you can't feel anything).
  • You have severe pain as your skin thaws.
  • Skin blisters start.

Frostbite Causes

Just like water turns to ice when the temperature drops, your fingers, hands, toes, feet -- even your nose and ears -- can freeze if exposed to extremely cold weather or you touch something very cold, like ice or frozen metal. Being farther away from your core, these are the first areas affected by decreased blood flow in response to cold.

You’re more likely to get frostbite if you don’t dress properly for cold, windy, or wet weather, or you wear clothes that are too tight in those conditions.

How soon frostbite happens depends on how cold and windy it is outside. It can happen faster than you may think. In frigid weather it’s possible for frostbite to happen in just 5 minutes.

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Frostbite Diagnosis

There’s no specific test for frostbite. Your doctor will ask how long you were out in the cold and what the temperature was. They’ll look closely at your skin and may recommend an X-ray or another kind of scan to see if there’s any serious damage to bone or muscle.

Frostbite Treatment

Frostbite home care

First, get to a warm place. Don't rub your skin. That can damage it if it’s frozen.

Don’t place cold hands or feet in a tub of hot water. If your skin is numb, you may not be able to feel if the water is too hot. That could cause further damage. Instead, soak the affected hands and feet in warm water (104 F to 107 F), or place a washcloth with warm water on the affected areas that can’t be submerged, like nose and ears, for at least 30 minutes.

Your skin should start to heal quickly. As it thaws, it may get red. You may also feel painful stinging or prickling sensations, like “pins and needles.”

Frostbite hospital care

At the hospital, the staff will try to warm you up, restore blood flow to the affected area, and stop further damage. You may:

  • Have warm sponges placed on your nose, ears, or other frozen body areas
  • Be given pain medicine for nerve pain that may flare as your skin warms up
  • Get imaging tests, like an MRI, to see how many layers of skin are damaged
  • Have skin that is dead scraped off

Some studies suggest that aspirin or other blood thinner meds may help restore blood flow in body parts with severe frostbite if your doctor gives you them within 24 hours of rewarming. A treatment called hyperbaric oxygen therapy, in which you get 100% oxygen in a controlled setting, is also being studied as a possible treatment. So far, the results are mixed.

In extreme cases -- like if you have blackened skin tissue and blood flow won’t come back -- you may need surgery to remove that area. This is to stop it from becoming infected and causing more damage.

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Frostbite Prevention

These cold-weather clothing tips can help:

Layer your clothing, loosely. Tight clothing raises your risk of frostbite. Instead, choose loose layers that allow body heat to get around.

You want three layers:

  • The first should be of a material that helps keep you dry.
  • The second goes over the first and should be made of an insulator like wool or fleece.
  • The third should be worn on top and should be windproof and waterproof.

Make sure your hat covers your head and ears. Get yourself a wool or fleece one with ear flaps. This will keep your ears warm and protected.

Choose insulating mittens or gloves. Don't take them off to use your smartphone. If texting is a must, look for a pair with textured fingertips that allow you to swipe.

Don't skimp on socks or shoes. Feet are very vulnerable to frostbite. Layer a pair of wool socks over some that resist moisture. Wear warm, waterproof boots that cover your ankles.

If you sweat, unzip at least for a few minutes. Wet clothing -- either from snow or sweating -- makes you more likely to get frostbite. Make sure snow can't sneak inside your winter outfits.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on September 22, 2020

Sources

SOURCES:

CDC: "Frostbite."

National Weather Service: "Wind Chill."

Health Guidance: "Stages of Frostbite."

Cayuga Medical Center: "Risk of Frostbite."

American Academy of Dermatology: "Frostbite Prevention and Treatment."

Nemours Foundation, Kids Health: "Frostbite."

NHS: "Frostbite Symptoms."

Flatt, A. Baylor University Medical Center Proceedings, July 2010.

Zafren, K. High Altitude Medicine & Biology, March 2013.

Cauchy, E. New England Journal of Medicine, January 13, 2011.

Handford, C. Extreme Physiology and Medicine, April 22, 2014.

Merck Manual: "Frostbite."

Mayo Clinic: “Frostbite.”

Cleveland Clinic: “Frostbite: Diagnosis and Tests.”

 

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