Frostbite occurs when the skin is exposed to extreme
or prolonged cold. The skin freezes, as do tissues beneath the surface
of the skin. In extreme cases, muscle, nerves, and blood vessels may
also freeze.
Skin may freeze within minutes when exposed to
temperatures that fall below freezing. Even if temperatures are above
freezing, the skin is likely to freeze if it’s wet or exposed to severe
wind chills.
Frostbite also occurs when your skin directly
contacts very cold surfaces. This type of exposure may immediately
freeze the skin that touches the frozen surface.
Risks
Who Is at Risk for Frostbite?
You’re more likely to suffer frostbite when exposed to cold weather under any of the following circumstances:
- you’re not appropriately dressed for freezing conditions
- your body is weakened due to fatigue, hunger, dehydration, physical labor, injury, or alcohol consumption
- you smoke (smoking narrows blood vessels and slows down circulation, allowing frostbite to advance more rapidly)
- you suffer from medical conditions such as diabetes, depression, cardiovascular disease, or peripheral vascular disease (these conditions may weaken your ability to notice and appropriately respond to the cold)
- you take beta-blocker medications
Young children and the elderly are also more likely to suffer from frostbite.
Symptoms
What Are the Symptoms of Frostbite?
Most cases of frostbite include the following symptoms:
- skin feels prickly and/or numb
- skin is discolored (red, white, gray, or yellow)
- pain around the exposed area
Frostbite is severe when the following symptoms emerge:
- blisters on the skin
- skin turns black
- joints and muscles are stiff or not functioning
Regardless of the severity of frostbite, seek medical care if you have frostbite and any of the following:
- fever
- dizziness
- swelling, redness, or discharge in the frostbitten area
Diagnosis
How Is Frostbite Diagnosed?
Most cases of frostbite are diagnosed based on a
physical exam, and your description of where, when, and how the
frostbite occurred. If frostbite is severe, X-rays or bone scans may be
used to assess damage to bone and muscle.
Treatment
How Is Frostbite Treated?
For immediate first aid treatment, do the following:
- Seek shelter from the cold.
- Warm your hands by tucking them under your arms.
- If possible, go indoors and remove wet clothing and jewelry.
- Once inside, place your hands and feet in warm water, and cover the rest of your body with a blanket.
- Avoid sources of heat such as lamps, fire, or heating pads. These can burn frostbitten skin.
- If you think you’re dehydrated, drink warm drinks.
- See a doctor as soon as possible.
You can treat most cases of frostbite by warming the
affected areas in water. A doctor will also sterilize the affected skin
and wrap it in dressings. When skin is raw from frostbite, you're prone
to getting an infection. If your skin is infected, your doctor may
prescribe antibiotics.
In the most extreme cases, bone, muscle, and nerves
experience damage. Amputation surgery may be necessary. Doctors may try
to repair tissues with drugs called thrombolytics, which they’ll deliver
intravenously (through a vein). These drugs can cause severe bleeding,
and are usually a last resort to avoid amputation.
Complications
What Are the Complications of Frostbite?
Your body’s natural response to extreme cold is to
direct blood to your heart and lungs. Keeping these organs warm prevents
hypothermia. Hypothermia occurs when your body can't produce enough
heat to protect itself from the cold.
You should treat hypothermia before treating
frostbite. While frostbite is painful and can result in permanent damage
to exposed areas, hypothermia is a more serious cold weather threat.
Frostbite on your arms and legs can indicate hypothermia because it
takes a while for frostbite to spread that far. Frostbite usually occurs
on your toes, nose, cheeks, ears, and chin.
Prevention
How Can I Prevent Frostbite?
The best thing you can do to prevent frostbite is to dress
appropriately for severe weather. Be aware of weather forecasts before
you go out. Don’t plan to spend an extended amount of time outside when
the weather is below freezing. Avoid going outside when temperatures
fall below 0ºF.
If you plan to be outside in cold weather, wear
multiple layers of clothing. Be sure that none of your skin is exposed.
Your clothing should be loose-fitting and waterproof.
Sometimes, you can’t anticipate frostbite. You never
know when your car will break down. For that reason, it's good to keep
an emergency kit handy with blankets, gloves, hats, and nonperishable
snacks. Being prepared helps you stay protected.
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