Frostbite: How to Spot, Treat, and Prevent It

Now that we are deep in the season of single- and negative-digit temperatures, it’s important to take steps to protect yourself from frostbite.

While rare, frostbite happens when the fluid in the tissue of your body becomes so cold it freezes. The ice crystals that form can damage or even destroy the tissue and nearby blood vessels. In severe cases, the damage can lead to gangrene and amputation.

However, there is more to getting frostbite than just frigid temperatures. Wind chill can also play a role as it removes heat from the body faster, making your tissue more susceptible to frostbite. The faster the wind blows, the more quickly frostbite can set in. 

The parts of the body most susceptible to frostbite include: ears, nose, cheeks, fingers, and toes. 

If you are spending time outdoors in cold and blustery conditions, there are several signs of trouble to look out for.

In the earliest stages of frostbite, your skin may feel cold and prickly and may appear red. As the condition advances, the affected area may feel numb to the touch. As the frostbite worsens, your skin may appear white or bluish white, followed by grayish yellow. In extreme cases, skin may feel firm and waxy and turn purple, brown, or even ashen. You may also find it difficult to move naturally as your muscles stiffen from the cold.  

If you see or feel any of these signs, it’s important to act quickly to warm your skin.

Immediate Care

• Move to a warmer place
• Take off any wet or tight clothes

Warming Up

Note: Warming a body back up should be done slowly. The process may cause pain or discomfort; this is completely normal.

• Use your own body heat by placing cold and numb fingers under your arms in your arm pits.
• Place affected body parts in warm water for no more than 30 minutes. Do NOT use hot water on frostbite as this can cause burns.

• DO NOT USE DRY HEAT, like heating pads, fireplaces, or blow dryers as they can cause burns.
• DO NOT RUB OR MASSAGE frost bitten areas as this can increase skin damage/irritation.

Routine Care

• If you used warm water to warm up, pat dry, do not rub
• Cover skin with bandages or clean, dry material until
• Seek urgent evaluation at ExpressCare or Primary Care Clinic

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

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

• Dress for the cold: Choose windproof and waterproof outer garments to protect against wind, snow, and rain. Wear layers of light, loose clothing. The air between the layers will work to keep your skin warm without causing sweating. (Note: wet skin is more at risk of frostbite than dry skin). Be sure to cover areas most at risk of frostbite (ears, nose, cheeks, fingers, toes). When possible, choose wool over cotton and wear mittens instead of gloves.
• Stay dry: As noted, wet skin is more at risk of frostbite than dry skin. For that reason, 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 immediately.
• 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.

Bentley Munsell BSN, RN, CEN, is the Clinical Nurse Manager for ExpressCare at Southwestern Vermont Medical Center.