Tips for preventing and treating frostbite

Frostbite is caused by direct or indirect exposure to extreme cold. Usually, the extremities are affected. Skin that is exposed is most vulnerable, but frostbite can also occur even when the extremities are protected.

How Frostbite Happens
When you are outside in winter, your body works to maintain its core temperature. This means that blood moves away from extremities, like your hands, and toward your heart and lungs. It’s simple survival – the body sends blood to the organs that keep you alive. The problem is that this re-direction increases the risk of injury due to cold to your hands and other extremities.

When body tissues are frostbitten, they actually become frozen. Ice crystals are created in the cells, altering their chemistry and causing physical damage. Then, when the ice crystals melt, other changes occur that can cause further damage, and even cell death.

There are two levels of frostbite. If only the surface of the skin is affected, the frostbite is said to be superficial. Deep frostbite occurs when the underlying tissues are also affected.

Risk Factors
The main risk factor is, of course, exposure to cold. Children and the elderly are particularly vulnerable. Additional risk factors include previous exposure to frostbite, medical conditions (like diabetes) that can affect the circulation, using beta-blocking medications (decreasing the blood flow to the skin), and consuming nicotine or alcohol.

Symptoms
The first sign of frostbite is numbness in the affected area. Eventually the skin may feel frozen but the underlying area still feels soft (superficial frostbite), or the whole area may feel hard (deep frostbite). Additionally, the skin may appear white, grayish or waxy.

Treatment
If you suspect that you have frostbite, you should seek medical care immediately. If left untreated, the outcome can be extremely serious. The lack of blood flow to the skin can result in permanent tissue damage which could lead to loss of your extremities – in the best case scenario, perhaps just the tips of your fingers, but in the worst case perhaps one or both of your hands.

If medical care cannot be immediately obtained, while you are waiting for help to arrive, remove any wet clothing and attempt to rewarm the frostbitten area gradually. Never use hot water. Instead, immerse the hand in warm water for half an hour or so, until it begins to feel warmer and sensation begins to come back. It is possible that there will be pain as the area thaws, and it may also change color and swell. Never massage the affected area.

It is far easier to prevent frostbite than it is to treat it, so if you are venturing out into the cold, make sure to dress warmly. Protect your hands and other extremities. Keep in mind, too, that you lose a lot of heat through your scalp, so be sure to wear a warm hat. Two pairs of socks – cotton covered with wool – can help to ensure that your feet stay warm. And of course, make sure that your hands are well-protected. Mittens are far better than gloves. And, if you feel overly cold and you have the option to go inside, do it.

Contributed by: Dr. Avery Arora is a surgeon at Avery Arora, MD practice in Southfield and Livonia. He is also a member of The Physician Alliance, one of Michigan’s largest physician organizations representing more than 2,100 physicians in metro Detroit.

This blog is for informational purposes only and should not be considered medical advice. Please consult your doctor for more information or if you have a medical concern.