Frostbite: What you need to know

Have you ever been outside in cold weather for too long, leaving your extremities red, stinging and burning soon after coming indoors? You may have thought nothing of it as you went back indoors, but in reality, you were experiencing the first stages of frostbite.

What is frostbite?

Frostbite is a dangerous medical condition that results in the damage of skin and underlying tissue after being exposed to extremely cold temperatures. Frostbite is a natural result of the body trying to preserve warmth in cold temperatures by the narrowing of the blood vessels at the skin's surface in extremities, which forces blood inward toward the torso to keep internal organs warm. These blood vessels will expand and contract to stay as warm as possible, but if temperatures become cold enough, ice crystals can begin to form within these skin cells, freezing the tissue and potentially causing lasting damage to these extremities.

How do I spot frostbite?

Frostbite takes on a series of stages depending on the temperature/wind chill and how long extremities are exposed to extreme temperatures or direct contact with ice, freezing metals or very cold liquids. These stages include:

Frostnip: This is the earliest stage of frostbite that does not permanently damage the skin. During this stage, the skin of the extremities turns red and feels cold to the touch, but over time could lead to prickling pain and numbness, which can persist as the skin re-warms.

Superficial Frostbite: After an extended period of time in extreme temperatures, exposed skin will advance from reddish numbness and begin to lose its color and become pale as ice crystals form in the underlying skin layers. However, during this stage, as the skin begins to re-warm, it can result in blisters, swelling and bruises.

Severe Frostbite: If frostbite continues unabated, extreme temperatures will continue to penetrate through the skin layers to affect the deeper tissue. This condition is known for its extreme numbness and loss of sensation of cold or pain, as well as a deterioration of the joints and muscles. After re-warming, black blisters will form in the days following, and if significant amounts of tissue die, this could lead to gangrene and possible amputation of the extremity.

How is frostbite treated?

The best treatment for frostbite is prevention. Before heading outdoors, be sure to check the weather forecast and dress appropriately for the temperature, wind speed and precipitation. However, if you suspect that frostbite symptoms are present, you should keep the following tips in mind:

Gently re-warm affected areas: Warm (not hot) water is the best option to slowly re-warm injured areas, so keep them submerged for 15 to 30 minutes until they have returned to a normal temperature. Shop for hot/cold packs.

Take an oral pain medication: Over-the-counter (OTC) pain relief medications are a wise choice when re-warming your extremities, as this process can be extremely painful and these medications can limit your discomfort. Note: OTC medications require a prescription for FSA reimbursement.

Protect affected areas: Even after re-warming, pay particular attention to those areas of skin that were exposed to extreme temperatures in the following days. Keep them wrapped to promote healing and monitor their condition for signs of bruising or blistering.

Consider medical attention: As a rule of thumb, if you have frostbite symptoms more advanced than frostnip, you should seek medical attention. However, if you do not consult a doctor, be sure to reconsider if blistering, bruising or numbness persists for several days, or if wounds begin to feel hot or extremely painful, the signs of an underlying infection.

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