Frostbite

Is this your symptom?

  • Frostnip or frostbite

Some Basics...

  • Frostbite and hypothermia are two different problems.
  • Frostbite results from a cold injury to the skin. It occurs when nerves, blood vessels, and skin cells are frozen for a short time. It happens most often to the ears, nose, penis, fingers, and toes. A person can have frostbite if the body's core temperature is normal.
  • In contrast, hypothermia signals a large decrease in the body's core temperature. A person with hypothermia may not have frostbite. Hypothermia is defined as a body temperature less than 95°F (35°C), measured rectally. Hypothermia can be deadly without intervention.

Symptoms

Frostbite can be classified like burns:

  • Frostnip: This is mild frostbite. It may cause cold, tingling, or painful skin.
  • First Degree: Skin will be white and hard while frozen. There may be mild swelling after re-warming.
  • Second Degree: Same as first degree. There will be blisters after 24 hours.
  • Third Degree: Blue blisters that turn into dead skin.

Risk Factors

  • Alcohol, Mental Illness: These impair a person's judgment. They reduce normal self-protective actions.
  • Medical Conditions: May make a person predisposed to frostbite. People with diabetes, congestive heart failure, peripheral vascular condition, and Raynaud's disease are all at risk. People who have had frostbite are also at risk.
  • Type of Contact: Frostbite is much worse if skin and clothing are wet. Touching bare hands to cold metal can cause frostbite right away. Touching bare hands to products that are stored outside in the cold can also cause frostbite. An example is gasoline.
  • Length of Contact: The longer the exposure, the greater the heat loss and chance of frostbite. The wind-chill index on a cold day plays a part in how quickly frostbite happens.

Prevention

  • Change wet gloves or socks right away.
  • Limit time spent outdoors when the wind-chill temperature falls below zero.
  • Know the first warnings of frostbite. Pain, tingling, numbness are early signs to go indoors.

Frostbite Prevention - Clothing

  • Clothing: Dress in layers for cold weather. The first layer should be long underwear. This should be made of polypropylene or polyester, which takes moisture away from skin. The middle layer(s) should be fleece or wool. The outer layer serves as a windbreaker. It also needs to be waterproof. The layers should be loose, not tight.
  • Hand Protection: Mittens are warmer than gloves. Wear a thin glove under the mitten for extra protection.
  • Footwear: Do not wear shoes that are too tight. They can decrease circulation. Wear 1-2 pairs of socks made from wool or a wool blend. Wear a thin liner sock under the wool socks for extra protection. This should be made from polyester or polypropylene, which takes away moisture from skin.
  • Headwear: Wear a hat. Over 50% of heat loss comes from the head.

When to Call for Frostbite

Call 911 Now

  • Unconscious (not moving, not talking, or not responding to stimulation)
  • Slurred speech
  • Confused thinking
  • Stumbling or falling
  • Body temperature is less than 95° F (35° C) rectally
  • Body temperature is less than 94° F (34.4° C) orally
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Skin was white, hard, fully numb (before being rewarmed)
  • Skin color has not returned to normal after 1 hour of re-warming and still missing feeling in skin
  • Exposed to severe cold and have any other signs of frostbite
  • Looks infected (spreading redness, red streak, pus)
  • You think you have a serious injury
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Frostbitten skin develops blisters
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Minor frost injury and last tetanus shot was more than 5 years ago
  • You have other questions or concerns

Self Care at Home

  • Mild frostbite

Care Advice for Mild Frostbite

  1. What You Should Know:
    • Frostbite is called frostnip, first, second, or third degree based on the amount of damage it causes.
    • You can treat mild frostbite at home.
    • Here is some care advice that should help.
  2. Frostbite Treatment - Re-warming:
    • Re-warm the area rapidly with wet heat.
    • Move into a warm room.
    • For Frostbite of Fingers and Toes: Put the body part in very warm water. A bathtub or sink is often the quickest option. The water should be very warm (104° to 108°F, or 40° to 42°C). It should not be hot enough to burn you. You should keep soaking in this warm water for about 30 minutes. A pink flush means circulation has returned to the body part. At this point, the numbness should be gone.
    • For Frostbite of the Face: Put a warm wet washcloth on the area. You should keep doing this for about 30 minutes.
    • With more severe frostbite, the last 10 minutes of re-warming can be quite painful.
    • If you are not using a tub, keep the rest of your body warm. Cover yourself with plenty of blankets.
  3. Frostbite Treatment - Common Mistakes:
    • Do not put snow on the frostbitten area. This can cause damage to thawing tissues.
    • Do not re-warm with dry heat. This includes a heat lamp or electric heater. You could burn yourself but not feel it.
    • Do not re-warm if it could freeze again in the next couple hours. Freezing-warming-freezing causes more damage than freezing-warming.
  4. Drink Warm Liquids: Drink warm liquids (such as hot chocolate).
  5. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  6. Aloe Vera Ointment: Put aloe vera on the area 2 times a day for 5 days.
  7. Tetanus Booster Needed Every 5 Years:
    • For a frost injury, a tetanus booster is recommended if it has been more than 5 years since your last tetanus shot.
    • You should try to get the tetanus booster as soon as possible.
    • Try to get the booster within 3 days of the injury.
  8. Call Your Doctor If:
    • Color and feeling do not return to normal after 1 hour of re-warming
    • Frostbitten part develops blisters
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 8/21/2017 1:16:36 AM
Last Updated: 5/7/2017 1:36:06 PM

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Frostbite of the Ear
First Aid - Frostbite

Rewarm the frostbitten area rapidly with wet heat.

  • Move into a warm room.
  • For frostbite of fingers and toes: Place the frostbitten part in very warm water. A bathtub or sink is often the quickest approach. The water should be very warm (104 to 108° F, or 40 to 42° C), but not hot enough to burn. Keep soaking in this warm water for about 30 minutes. A pink flush means circulation has returned to the body part.
  • For frostbite of the face (such as ears, nose): Apply warm wet washcloths to frostbitten area of the face. Continue doing this until a pink flush signals the return of circulation to the frostbitten area (usually 30 minutes).

Special Notes:

  • Do not rewarm a frostbitten area if there is a chance of refreezing.
First Aid - Hypothermia
  • Remove wet clothing.
  • Wrap in warm blankets. You can also use clothing, a sleeping bag, or even newspaper.
  • Move into a warm space like a home, building, car, or tent.

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