This year’s Farmers’ Almanac calls for “teeth-chattering cold” across much of the nation. If you find yourself in the deep freeze, remember this: frostbite doesn’t appear frosty. The damage from this dangerous condition occurs under the skin - not at the surface. Symptoms vary and people sometimes don’t realize frostbite is occurring because their skin doesn’t feel cold. Be alert to these signs:
- Redness, stinging, burning, throbbing or prickling sensation
- White, bluish-white or grayish-yellow skin
- Unusually firm or waxy skin
The nose, ears, cheeks, chin, fingers and toes are most often affected, and damage occurs in stages.
Frostnip is mild and doesn’t cause permanent damage, though you may feel pain and tingling as skin warms.
Superficial frostbite is more serious and skin may turn pale, sting, burn, swell and even form blisters after rewarming.
Deep frostbite is severe and affects all skin layers. Skin turns white or bluish-gray and goes numb. Large blisters occur a day or two after rewarming. Tissue dies and the area turns black and hard. Severe cases can require amputation, which is why prompt medical attention is essential.
If you experience signs of frostbite, follow these Do’s and Don'ts:
- Do get inside a warm place.
- Do remove wet or tight clothing.
- Do put the affected areas in warm (comfortable to the touch) water.
- Do warm the affected area using body heat if warm water is not available.
- Do seek medical care; frostbite should be evaluated by a health care professional.
- Do go to the ER immediately if skin turns gray, or sensation fails to return.
- Don’t walk on feet or toes that may be affected.
- Don’t rub or massage the frostbitten area.
- Don’t put affected areas in hot water.
- Don’t use a heating pad, heat lamp or other heat source for warming. Numb areas can burn more easily.
While frostbite typically occurs from prolonged exposure to weather below 32°Fahrenheit, it can also occur in a few minutes when temperatures are extremely low. You’re most at risk if you have poor blood circulation or if you are not dressed for cold temperatures. To avoid frostbite:
- Dress in three layers:
- Synthetic material (such as polyester) which wicks moisture from the body
- Insulating material such as wool or fleece
- Windproof/waterproof material such as a down parka (and ski pants)
- Protect your feet with layers:
- Moisture-wicking socks
- Wool or wool-blend socks
- Boots which are waterproof and cover your ankles.
- Protect your head with a heavy wool or fleece hat. Cover your face with a scarf or facemask.
- Wear insulated mittens rather than gloves, but gloves are better than bare skin.
- Avoid wearing cotton. It absorbs sweat and can fail to insulate against the cold.
- Drink water. Dehydration increases your risk of developing frostbite.
- Avoid drinking alcohol. It causes your body to lose heat, lowers your awareness and increases the risk of falling asleep in the cold, which is a common cause of frostbite.
Prevention is the best way to avoid frostbite, so take the time to bundle up this winter and stay alert to signs of trouble.
(Jon S. Solberg, MD, is the Medical Director of CHI St. Alexius Health’s Emergency and Trauma Department. He is a Fellow of the American College of Emergency Physicians and Fellow of the Academy of Wilderness Medicine and holds a Diploma in Mountain Medicine.)