Frostbite: What You Need to Know

Bitterly cold – that’s what the weather report says – danger of frostbite.

Did you know that if you have frostbite, your skin freezes and ice crystals form inside your cells?

Did you know that no matter what you might have seen in old movies, rubbing or massaging frostbitten skin only makes things worse?

Signs and symptoms of frostbite (Courtesy Mayo Clinic)

  • A slightly painful, prickly or itching sensation
  • Red, white, pale or grayish-yellow skin
  • Hard or waxy-looking skin
  • A cold or burning feeling
  • Numbness
  • Clumsiness due to joint and muscle stiffness
  • Blistering, in severe cases

Many of us who live in New England and love to be outdoors in the wintertime have probably experienced superficial frostbite or frostnip, as it’s sometimes called. Your skin feels like pins and needles and may be pale and numb. Ignore it and stay out a little longer and your skin will feel hard and frozen. If you get out of the cold at this point, when your skin thaws it will probably turn red and blister, but hopefully, you won’t have any lasting damage.

If frostbite goes deeper, your skin will become white, blue or blotchy and the tissue underneath will be hard and cold and have no feeling.  If deeper tissue is frozen and blood vessels are affected, you may also have damage in your tendons, muscles, nerves and bones.  In the worst-case scenario, tissue dies (gangrene) and amputation may be necessary to prevention infection.

All degrees of frostbite should be evaluated by a medical professional, but it’s vital to get emergency care when frostbite is deep.

Frostbite typically affects smaller, more exposed areas of the body—  your fingers, toes, nose, ears, cheeks and chin. Because your skin is likely to be numb,  you may not realize you have frostbite until someone else points it out.

Frostbitten hands

Photo courtesy winkyintheuk via Wikimedia Commons

Frostbite treatment dos and don’ts

  • DO get to a warmer place
  • DO replace wet clothing with soft dry clothing
  • DO wrap in blankets to warm and protect frostbitten areas (separate affected fingers and toes with any kind of clean material)
  • DO soak the affected area in warm, not hot, water for about 20 to 40 minutes
  • DO wrap in gauze after re-warming, separating affected fingers and toes
  • DO NOT use direct heat such as fire, heating pad or hair dryer to thaw – it can burn already damaged tissue
  • DO NOT re-warm frostbitten tissue if it can’t be kept thawed – re-freezing can worsen tissue damage
  • DO NOT rub or massage frostbitten skin – it can cause further damage

Dr. John Southall, a board certified emergency medicine physician and editor and section chief for the prestigious journal the Annals of Emergency Medicine, says frostbite is one of his most “angst-provoking” diagnoses because, in general, it is avoidable. He’s practiced in Colorado and Maine, so has seen his fair share of frostbite cases, and he doesn’t mince words when he describes his frustration. “We do not see a lot of frostbite in sober and competent adults,” says Dr. Southall. “We see it occasionally in outdoorsmen, who often accept this risk as part of their thrill-seeking, however more often we see it in the intoxicated who misjudged their exposure. This is more of a social commentary than medical.”

Most tragically, adds Dr. Southall, is that “we see it in those who cannot adequately speak for themselves: our young children, and even pets. Please remember when you are outdoors that your child’s young fingers, toes and cheeks are more susceptible to environmental exposure than their larger adult counterparts.”

When it’s 8 below, which it was at my house this morning, I’d say it’s extremely important to heed Dr. Southall’s advice. Bundle up in layers, wear mittens, two pairs of socks and cover your head and ears and nose. Then you won’t have to worry about whether or not you should rub frostbitten skin – which you should not.

And now, because the snowblower is at the repair shop — Murphy’s Law definitely at work here — I need to bundle up myself, and help my husband shovel. Stay warm and safe everyone.

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