Facts about Frostbite

Here in New England, we tend to glibly throw out the word frostbite when it’s cold. But the reality is that frostbite is not a joking matter. Under the right conditions, frostbite can occur within 5-10 minutes. That’s roughly the same amount of time it takes to scrape the snow and ice off a car. 

Frostbite occurs when the fluid in your skin and even the tissue under your skin becomes so cold it freezes. The ice crystals that form can damage and destroy the tissue and nearby blood vessels. Damage to blood vessels may be permanent and can lead to gangrene and even limb loss.  

Because frostbite can set in so quickly, it’s important to recognize the warning signs and take proper action to protect and preserve the body.

In the earliest stages of frostbite, your skin may feel cold and prickly and appear red. As the frostbite worsens, your skin may feel numb to the touch and initially appear white or blueish-white, followed by grayish-yellow. In extreme cases, the skin may feel hard and waxy and turn purple, brown, or even ashen. 

If you see or feel any of these signs, take these steps to warm your skin:

• Move to a warmer place

• Take off any wet or tight clothes

• Take steps to warm the body including:

• using your own body heat by placing cold and numb fingers under your arms in your armpits

• placing affected body parts in warm water for no more than 30 minutes. Do NOT use hot water on frostbite, which can cause burns. When drying wet skin, pat it dry. Do NOT rub the skin dry.

When warming up affected areas, DO NOT USE DRY HEAT, like heating pads, fireplaces, or blow dryers, which can cause burns.

In addition, DO NOT RUB OR MASSAGE frost-bitten areas as this can increase skin damage/irritation.

WHEN TO SEEK EMERGENCY CARE

• If the person exposed to cold is passing out, having trouble speaking, appears confused or clumsy, is not shivering, or displays difficulty or abnormal breathing. These could be signs of hypothermia, a life-threatening condition in addition to frostbite.

• If the skin is hard, waxy, or has turned black.

•  If you do not feel sensation returning to your body after trying warming efforts, or if the skin begins to turn gray.

To reduce your risk of frostbite, follow these steps whenever venturing out in the cold for extended periods of time:

• Dress in layers: Begin with layers of light, loose moisture-wicking synthetic clothing.  Top that with an insulating layer of wool or fleece. And because wet skin is more at risk of frostbite than dry skin, wear a wind- and waterproof outer layer.

Protect your head and face with a wool or fleece hat that covers your ears and a wool or fleece scarf wrapped to mask your face. Choose insulated gloves, wool—not cotton—socks, and waterproof boots that reach above your ankles

• Stay dry: Because wet skin is more susceptible to frostbite than dry skin, take precautions to keep snow out of your boots, mittens, and clothing. If you get wet, go inside immediately and remove wet clothing.

• Stay hydrated: Be sure to drink plenty of water before, during, and after spending time out in the cold.

• Stay alert: If you’re outside for stretches longer than 30 minutes, be sure to check yourself for signs of frostbite every 30 minutes. If you see or feel signs of frostbite, head indoors at once.

• Stay sober: Drinking alcohol can cause the body to lose heat faster than normal. Save the alcoholic beverages for when you’ve safely returned indoors.

• Minimize time outdoors: If you have a condition that causes poor circulation, such as diabetes, peripheral artery disease, and peripheral neuropathy, avoid extended exposure to cold temps and always dress appropriately to minimize your risk.

Lisa Moulton, FNP is a member of the care team at SVMC’s Deerfield Valley campus.