Frostbite Primer

Frostbite occurs when the body is so cold that ice crystals form in the space surrounding body cells. Damage to tissue occurs as the cells freeze. Frostbite mainly affects hands, feet, ears, nose and cheeks.

As with burns, frostbite severity is measured in degrees:

First-degree frostbite: Temporary tenderness and reddened skin. This probably would not result in permanent damage.
Second-degree frostbite: Blisters and some damage to tissues and nerves. This can result in permanent hypersensitivity to cold and increase the risk of future frostbite.
Third-degree frostbite: Tissue death, requiring skin grafting and reconstructive surgery. Low temperature and wind velocity combined with moisture can increase the risk of frostbite.

Frostbite symptoms

Tingling and burning are early symptoms and a warning to get out of the cold immediately. If this isn't possible, move around vigorously to increase circulation.
The next stage is numbness. By this time you probably have frostbite.
In the third stage, skin may appear pale or white and cold to the touch.
In the final stages, swelling, bleeding, and blisters may form after the skin thaws.

All frostbite, regardless of severity, should be examined by a physician as soon as possible. Prompt treatment increases chances for complete recovery.

How to prevent frostbite

Keep your skin dry. Wet skin freezes more rapidly.
Dress in layers of light rather than bulky, heavy clothes.
Wear a hat. The body loses the greatest amount of heat through the scalp, and the skin and underlying tissues of the ears are thin, so ears are especially prone to frostbite.
Use a scarf or ski mask to protect your face.
Light cotton socks topped by wool or synthetic socks will keep your feet warm. Boots should be high enough to cover your ankles. Avoid boots that are too tight; they decrease circulation.
Protect your hands with mittens rather than gloves so fingers can warm each other.
Don't wear earrings outside in the cold; metal conducts cold and increases the risk of frostbite.
Have an emergency kit in your car that includes food, blankets, extra clothing, boots, matches, etc.
Avoid contact with gasoline and metal, as it may be super-cooled.
Avoid alcoholic beverages because they increase the rate at which the body cools. They can cloud judgment and the sense of touch.
Avoid smoking, which decreases circulation.

First aid for frostbite

Avoid rubbing the area, especially with snow, which will worsen the injury.
Don't walk on frostbitten feet or use a frostbitten area. If you must walk, the feet will suffer less damage if left frozen and padded. If feet are thawed, have someone carry you if possible.
Avoid thawing an area if you are far from help or if there is a chance of re-freezing, as this will cause more damage.

If you are in a permanent shelter and can thaw the frostbitten area:

Immerse area for 20-45 minutes in tepid (98 to104 degree F) water. Avoid using hot water, which may burn the area, causing more damage. As the area thaws it will turn pink or bright red and sensation may return.
Do not put salves or creams on the frostbite.
Protect the frostbite area from re-freezing with towels and blankets and seek medical attention.

For more information on frostbite or treatment, call the Dwan Burn Center at SMDC Medical Center at (218) 786-2815. The burn hotline is answered 24 hours a day, seven days a week.