When the Weather Outside Is Frightful: Preventing and Treating Frostbite

Protect your fingers, toes and nose. It's those parts of your body that are most at risk for frostbite when the weather takes a frigid turn for the worse. Anyone can get frostbite and it can cause tissue damage before you realize it's happening. Older adults and young children are especially vulnerable to this wintertime scourge.

Frostbite is literally the freezing of your body's tissue. Ice crystals form in the cells, causing permanent damage. This happens with prolonged exposure to freezing temperatures or even brief exposure to very cold temperatures. Wind and water add to the risk. You are most likely to get frostbite in your fingers, toes, nose, ears or cheeks. Consequences range from skin redness, numbness or pain to - in severe cases - tissue death (gangrene).

Who is at greatest risk for frostbite?
Anyone who is not protected against the elements can get frostbite. If you work or play outside in the cold and wet months, you could be at risk. You are at greater risk if you have circulation or nerve problems from conditions such as diabetes or atherosclerosis. These conditions can limit your ability to feel cold temperatures or injuries. Some medications, nicotine and the use of alcohol can also blunt your ability to feel the effects of cold and increase the risk for frostbite. Also, if you've had frostbite before, you are at greater risk of getting it again.

Warning signs and symptoms of frostbite include:

• Discolored skin (grey, white, blue or red)
• Skin that feels firm or waxy to the touch
• Numbness, tingling or pain

Tips for helping to prevent frostbite

• Dress in loose layers and wear:
• A hat; most heat is lost from the scalp.
• Ear muffs.
• A scarf or knit mask that covers your cheeks and nose.
• Mittens (which are warmer than gloves)
• A water-repellent top layer.
• Two pairs of socks (wool over cotton ones).
• Well-fitting boots.
• Never touch a cold surface with your bare hands.
• Do not smoke.
• Don't drink alcohol or caffeine.
• Keep moving. Wiggle your fingers and toes if they hurt or feel numb.
• Check yourself every half hour for signs of frostbite.

What to do if you get frostbite
If you or someone you're with has symptoms of frostbite, seek emergency medical help right away.

• Get out of the cold and remove any wet clothing.
• Keep warm with clothes and blankets.
• Don't rub the area; this can increase the damage.
• Do not use hot water or a heating pad. The affected area may be numb and can be easily burned.

Rewarming frozen tissue can be a dangerous and painful process.

Even when you're not planning to be outside for very long, it's important to be prepared during these winter months. A dead battery, inconvenient parking or unexpected changes in weather can put you at risk.

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External Sources Centers for Disease Control and Prevention. Emergency preparedness & response. Winter weather FAQs. Accessed December 13, 2007. Jurkovich GJ. Environmental cold-induced injury. Surgical Clinics of North America. 2007;87(1):247-267. Kanzenbach TL, Dexter WW. Cold injuries. Postgraduate Medicine Online. 1999;105(1). Accessed December 13, 2007. New York State Department of Environmental Conservation. Recognition and treatment of heat and cold stress. Accessed December 13, 2007. American Red Cross. Health & safety tips: staying safe in cold weather. Accessed December 13, 2007.

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