Frostbite is an injury that occurs when skin and underlying tissues freeze due to prolonged exposure to cold temperatures, often below 32°F (0°C). This can cause ice crystals to form within cells, leading to damage. While any part of the body can be affected, frostbite most commonly impacts extremities like the fingers, toes, ears, nose, cheeks, and chin. The severity of frostbite depends on factors such as air temperature, duration of cold exposure, wind chill, and dampness.
Spotting the Initial Indicators
Frostnip, the earliest stage of frostbite, presents with sensory changes and altered skin appearance. The affected skin may feel cold, accompanied by a pins-and-needles sensation, tingling, or a burning or stinging feeling. This can progress to numbness, indicating reduced sensation.
Visually, the skin might appear pale, red, purple, or lighter than natural skin tone. These color changes may be subtle on some skin tones. When touched, the affected skin may feel cold, firm, or waxy, yet it often remains soft and pliable underneath, distinguishing it from more advanced stages. Frostnip typically causes only temporary skin damage if addressed promptly.
Identifying the Stages of Injury
As frostbite progresses, symptoms become more pronounced, reflecting deeper tissue involvement. In superficial frostbite, the second stage, the skin may feel warm, even as ice crystals form within its layers. The skin’s color can shift from reddish to pale, blue, or white. Swelling may develop, and the area can sting or burn upon rewarming. Blisters, typically containing clear fluid, often appear 12 to 36 hours after rewarming.
In deep frostbite, all layers of the skin and underlying tissues, including muscles, tendons, and bones, become frozen. Complete numbness sets in, and the affected area may be difficult or impossible to move.
The skin in deep frostbite can appear white, blue-gray, purple, or black as tissue cells die. The texture becomes hard, cold, waxy, and unresponsive, sometimes described as feeling “like a block of wood.” Large, blood-filled blisters may emerge 24 to 48 hours after rewarming, signaling more extensive damage. Over time, the tissue may turn black and harden, a condition known as dry gangrene, which may necessitate surgical removal.
Taking Immediate Action
Prompt action minimizes tissue damage. First, move to a warm, sheltered environment and carefully remove any wet clothing or jewelry from the affected area.
Gentle rewarming is a main step. This typically involves immersing the affected body part in warm (not hot) water, ideally between 98.6°F and 102.2°F (37°C and 39°C), for 20 to 30 minutes. For areas like the nose or ears, warm, moist cloths can be repeatedly applied. Avoid rubbing or massaging the frostbitten area, as this can cause further harm to delicate tissues. Direct heat sources like heating pads, stoves, or fireplaces should also be avoided, as numb skin can easily sustain burns.
Individuals with frostbitten feet or toes should avoid walking on them if possible, as this can worsen the injury. After initial rewarming, seek professional medical attention for any frostbite beyond mild frostnip. Seek medical attention if symptoms are severe, include blistering, or if there are signs of hypothermia, such as intense shivering, slurred speech, or confusion.