Injury to the skin caused by exposure to extreme cold is called frostbite. This happens when you are exposed to temperatures below the freezing point of your skin.
Injury to the skin caused by exposure to extreme cold is called frostbite. This happens when you are exposed to temperatures below the freezing point of your skin. Exposed skin in cold and windy weather is most susceptible to frostbite, but it can also occur on skin covered by clothing. They commonly affect the body parts that are farther away from the heart, meaning the parts that have less blood flow, like feet, toes, nose, ears, cheeks, chin, hands and fingers. Cold exposure might cause the top layer of the skin to freeze. The skin becomes very cold, red, numb, hard, and pale. Frostbites require immediate medical attention, as it can damage the underlying tissues, muscles, and bones. Severe frostbite may also cause infection and nerve damage. A milder form of frostbite called frostnip does not cause permanent skin damage and can be treated with first-aid measures and rewarming the affected skin.
In icy conditions, the body sends signals to the blood vessels in the extremities to constrict and slow the blood flow to them. This makes the body able to carry more blood and oxygen to the vital organs of the body and prevent further decrease in body temperature. When the brain senses that there is a danger of hypothermia, the blood vessels in the arms and legs stay constricted, thus preventing them from pumping cold blood to the internal organs. This is the beginning of frostbite.
It can be a result of either:
The signs and symptoms are:
As the cold causes skin to go numb, you might not realize you have frostbite until someone tells you.
The risk factors are as follows:
The complications that follow frostbite are:
Frostbite can be prevented by following these measures:
Frostbite occurs in many stages, which are,
It is a milder form and does not cause any permanent damage. Here, the skin turns red and cold to touch. Further cold exposure may cause numbness, burning, itching, and prickling sensation.
Simple first-aid measures like preventing further cold exposure and rewarming. Rewarming is done by immersing the affected part in warm water for 15 to 30 minutes. Heat sources like stove and heat pads are contraindicated as they might cause burns. When your skin warms up, you might feel some pain or tingling sensation. Over-the-counter pain medications like Ibuprofen can be taken for the pain.
In this stage of frostbite, the skin turns pale or blue from red. The affected area is hard and frozen to touch. After this, due to inflammation, the skin may feel warm and swollen, which is the first sign of tissue damage. Immediate medical treatment is needed to prevent any further damage. Mostly, people recover from superficial frostbite without any permanent damage. But, some people face permanent problems like pain and numbness.
The affected areas should be warmed as soon as possible. The doctor might administer pain medication and intravenous (IV) fluids. After the area is warm, the doctor will wrap the area to protect it. Sometimes, blisters develop after rewarming, in such cases, the doctor might drain it. And if the blister looks infected, antibiotics are prescribed.
It is the most severe form of frostbite, as it affects both the skin and underlying tissues. The affected skin turns white or bluish-gray and looks splotchy. You might experience numbness, loss of sensation, and pain. The muscles close to the affected part might not function properly. In severe cases, blood-filled blisters can be seen.
Like all other stages, rewarming of the area is done. The doctor will give you pain medicine, IV fluids, and wrap the area. If you have developed blood-filled blisters, the doctor might give you a medicine called a “clot-buster.” This improves the blood flow to the affected area. After rewarming, the area is black and hard, due to tissue death. After 24 to 48 hours, large blisters might also develop. Depending on the damage, the affected area might need surgery to remove the dead tissues (debridement) or the area might be amputated.
After these home remedies, if you do not see any improvement or if your child is in a lot of pain or if the affected area changes color and becomes hard, take your child to the emergency room.It often takes months for the damaged tissue to heal. So, doctors wait for months to see the changes after frostbite, to avoid surgical removal of tissues that may heal eventually or to leave tissues behind that might subsequently die. After the initial waiting period, 65 % of people suffer from permanent symptoms like pain, excessive sweating, and increased sensitivity to cold or heat. Always remember the signs of frostnip, as it is the first stage of frostbite. If you see yourself or somebody else developing those signs, cover yourself up, find a warm place, and seek medical attention immediately!
For frostbite to heal completely, the tissue has to be free from any infection or damage. It might take up to three months for the removal of the dead tissues. The patient should be kept under observation for three months.
When the frostbite begins to progress, it will start affecting all three layers of the skin. The skin begins to turn whitish or grayish in color. The patient will have extreme numbness and pain in the affected area.
The time for frostbite to heal depends on the tissue damage and its severity. If there are other infections, then the frostbite will take a long time to heal. In some patients, it might take up to three months for the complete tissue damage to heal.
The skin will turn bluish or black in cases of severe frostbite. If the injured area is warmed, it will develop into big blisters within one or two days. This area later transforms into dark skin because of the tissue death in that area.
Frostbite does not cause any permanent damage. First-aids measures are beneficial for treatment for frostbite. If the frostbite occurs only on the superficial layer of the skin, then the complete recovery is possible.
Frostbite occurs when the skin experiences extreme cold. Cold conditions make the skin feel numb and pale. Some patients experience pricking sensation. There will be a reduced feel for touch. Blister formation will be painful for the patients.
You need not worry about frostbite if you are adapted to cold weather. If you suddenly experience abnormal symptoms like reddish skin or swelling, then you might need emergency medical care.
There will be a certain degree of tissue loss in cases of severe frostbite patients. The tips of the toes and fingers can be completely lost due to untreated frostbite. The finger can separate and fall off in some patients.
The skin will turn into black only after the formation of blisters. It might take around 24-48 hours for the skin to become dark in color. This happens only in the part of the skin that has been rewarmed.
The following things are to be followed for frostbite.
- Initially, it is necessary to check the body temperature. A very low temperature will be a complication.
- You have to protect your skin from severe damage.
- Stay away from the cold.
- Gently rewarm frostbitten areas.
- Drink warm liquids.
- Consider taking medications for pain.
After having frostbite, certain people are left with permanent issues, such as increased sensitivity to cold, stiffness, pain, and numbness in the affected area. However, not much can be done to treat numbness, sensitivity to cold, or stiffness.
Below steps must not be followed when you have frostbite. They are:
- Avoid moving or roaming to cold areas.
- Avoid walking with frostbitten toes and feet as it can cause excess damage.
- Avoid wet clothing. It is better to replace wet clothing with soft and dry clothing to stop further heat loss.
Deep frostbite is the third degree of frostbite. It is the most severe stage of frostbite. It is known to affect both the underlying skin tissues. The part of the skin which has deep frostbite might appear bluish. The skin would have become numb, and it would not have any sensation to the pain and cold.
The occurrence of frostbite happens in the following stages.
- Frostnip. This is a mild form of frostbite.
- Superficial frostbite. It appears as reddened skin that turns pale or white.
- Deep frostbite (severe). As frostbite grows, it affects all skin layers, including the tissues that are below.
For milder frostbite cases, consume over-the-counter drugs like Ibuprofen. It can help reduce inflammation and pain. For superficial frostbite that has been rewarmed, some people find it soothing to apply lotion or aloe vera gel to the affected area numerous times a day. Better to avoid further exposure to wind and cold climate.
Frostbite affects superficial layers of the skin initially. It causes reddish appearances of the skin. It will later turn into pale and white form. Rewarming of the skin at this stage can cause mottling of the skin. It may be accompanied by swelling and a burning sensation.
If the frostbite is left untreated, then the skin is known to become very hard. It would also turn reddish or purplish with a mottled appearance. This is known to happen within three days. Sometimes, blister formation will occur along with the filling up of fluid.
The long term effects of frostbite are abnormal sensitivity to cold. This will be seen along with the stiffness and numbness in the affected areas. Pain caused due to long term effects of frostbite will be high. In some cases, it becomes difficult to treat frostbite.
You need not be worried unless you detect some extreme symptoms. If you notice blister formation and the swelling, then this is the time you must visit the doctor immediately.
A mild degree of frostbite can be treated with necessary home remedies. The affected part of the skin should be soaked in warm water for about half an hour. Rubbing or massaging the frozen area of the skin should be avoided. If all these techniques do not help, you can consult a doctor for further treatment procedures.
We can identify whether frostbite is reversible or irreversible by determining the degree of cellular damage and extent of the skin's damaged region. In most cases, frostbite reverses itself after giving a warm water bath. It is not helpful, and then you should proceed to reverse the ice-crystal formation in superficial frostbite. You should seek a doctor's help for this.
Last reviewed at:
27 Feb 2019 - 5 min read
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