WHAT IS IT?

Freezing of the skin and body tissue is known
as frostbite. Parts of the body most susceptible to frostbite are fingers, toes, nose, cheeks, and chin, as they typically have wavering blood flow.1 But any part exposed to the above conditions can become frostbitten. When circulation to a body part slows, body temperature lowers—that allows the tissue to freeze. The severity of frostbite depends on exposure to freezing conditions and longevity of low body temperature and slowed circulation.

SIMILAR TO BURNS, FROSTBITE HAS DEGREES OF INJURY

First degree frostbite is the most minor, and only the first few (superficial) layers of the skin are affected. The skin hardens and might maintain indents when touched. Usually, the tissue is still viable and not damaged.

Second degree frostbite penetrates deeper layers of the skin. Symptoms usually include a pale, grey-blue skin color that’s waxy and feels numb and or firm. Redness, blisters, and minimal tissue damage might occur upon thawing the skin.
Third degree frostbite begins to freeze the deepest dermal layers. Though the skin looks similar to second degree frost bite, the succeeding blisters contain a dark, hemorrhagic fluid. Permanent tissue loss is likely.
Fourth degree frostbite pertains to the progression of frozen tissue also affecting muscle and bone. This is when the body part will feel like a “chunk of wood.”1

WHAT YOU SHOULD DO?

Regardless of degree, one should go to the nearest hospital so injuries and risk for hyperthermia can be assessed and treated. Depending on the circumstances, medical attention might be delayed or not possible for a while. There are ways to manage frostbite before receiving treatment from a medical professional.

HOW TO PREVENT IT

Research weather conditions when planning for any outdoor activities and prepare appropriately. While outside, keep skin covered and dry by layering in wind and waterproof clothing. Do not wear clothing or boots that are too tight; this will impair blood flood and increase the risk of tissue freezing. If limbs begin to get cold, you can move around to promote circulation or use a hot pack. Overall, if you do not need to be outside for an extended period of time, if at all, stay indoors.

HOW TO TREAT IT

Staying warm is integral to initially treating frostbite. First, minimalize further exposure to freezing conditions and check for hypothermia. Remove any wet clothing and jewelry that’s on the affected body part. Use blankets, a sleeping bag, and other clothing to elevate body temperature, insulate the heat, and encourage blood flow, which will also prevent or slow the progression of hypothermia.1If conscious, offer or drink warm fluids. Then, evaluate the skin to determine the degree of injury.

If there isn’t risk for refreezing, consider thawing the injury in a warm bath. Carefully swirl the frostbitten body part in warm water at a temperature of 98.6° F to 102.2° F for about 30 minutes.1 Test the water before immersing the frostbitten body part if you do not have a thermometer. For areas like the nose, ears, and chin, a warm compact can be repeatedly applied.

The skin should be softer and present a blush-like color after thawing. Let the body part air-dry for a bit and apply aloe gel to encourage wound healing. Edema, fluid that forms and collects in the tissue, and blisters will occur once the skin has been thawed, depending on the degree. Wrap the area in a loose, sterile dressing and keep the body part slightly elevated to reduce fluid build-up. Monitor the injuries for infection or further trauma.

When outdoors or in the same freezing conditions, focus on staying warm, instead of thawing, to avoid hyperthermia. If properly equipped, splint or pad the frostbitten area to delay/isolate any tissue damage until help arrives.