Frostbite

When your skin is exposed to cold for a long period of time, the underlying tissues may freeze and suffer permanent damage. This condition is called frostbite. Commonly affected areas include the feet, hands (especially the fingers), nose, and ears. People with poor circulation, the elderly, people with poorly controlled diabetes, and people with alcoholism are at greater risk for frostbite. Frostbite ranges in severity from mild and reversible to severe with possible permanent tissue death and loss.

DIAGNOSIS

Frostbite is diagnosed when areas of the skin appear gray or pale and feel hard. There may be a lack of feeling in the area, or there may be severe pain. As the frostbitten part warms, a red color may return to the area, and there is usually increased pain.

TREATMENT

When frostbite is present there may also be hypothermia. This is a drop in the temperature of the entire body. It is important to check the temperature and make sure it is normal (98.6° F [37° C]). It is important to warm frostbitten parts as soon as possible to avoid permanent damage. The following steps can be taken to help:

  • Get out of the cold. Warm hands in your armpits. Cover the nose and ears with gloved hands. Removing the person from a cold environment is the number one priority, if possible.

  • Do not rub affected areas or use them. Do not walk on frostbitten feet unless it is necessary to get to a warm place.

  • If emergency help is not available, the frostbitten parts may be submerged in lukewarm water. The water should not be hot.

  • If pain occurs with warming, this is a good sign. It means circulation is returning. If there is no pain or lack of feeling remains, it is necessary to seek immediate medical help.

  • After you warm the affected area it is very important that this area is not re-exposed to cold. Stay out of the cold.

  • Do not smoke. Smoking reduces your circulation.

PREVENTION

  • Wear warm clothing in layers, starting with long underwear and adding additional loose-fitting garments.

  • Wear mittens. Mittens lock in air, and the fingers help warm each other.

  • Wear 2 pairs of socks. Wear cotton socks next to the skin and wool socks over the cotton socks.

  • Wear waterproof boots or shoes that are not tight-fitting.

  • Wear a pull down cap or hood covering the head, ears, neck, and face if necessary.

  • Avoid alcohol. This increases heat loss and increases chances of frostbite.

  • Avoid smoking. Nicotine causes blood vessels to constrict in your hands and feet.

  • Pack food when you plan to be in the cold. Increasing your caloric intake to a high level increases your internal heat.

  • Carry extra blankets and clothing in the car during cold weather.

  • Be aware of the wind chill factor and dress accordingly. Wind is an important factor that can increase the risk of frostbite. Avoid high winds when low temperatures are present.

  • Always avoid situations where it is impossible to get out of the cold if needed.

  • At the first signs of frostbite (numbness, pain, extreme redness), you should immediately get out of the cold.

HOME CARE INSTRUCTIONS

  • If bandages (dressings) were applied, change them as directed.

  • Follow up with your caregiver. Keep any appointments with specialists as directed. Failure to follow up could result in infection, loss of tissue, and chronic pain or disability.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a fever.

  • You develop redness, lose tissue, or there is yellowish-white fluid (pus) coming from the frostbitten area.

  • You develop increasing pain in the frostbitten area.

  • The frostbitten area begins to turn a dark color.

  • You see a red streak going away from the frostbitten area.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.