University of Iowa Health Science Relations and
Hans House, MD
Assistant Professor of Emergency Medicine
First Published: 2000
Last Revised: October 2004
Peer Review Status: Internally Peer Reviewed
Many times people don't know they've been frostbitten until they come in from the cold.
That's why Iowans should be on their guard outside during winter months, particularly against damage to nose, ears, toes and fingers, explains Dr. Hans House, an emergency medicine physician at University of Iowa Hospitals and Clinics.
Several factors determine how much damage is done by the cold, he notes. Temperature, dampness, and the duration of exposure are among factors, of course, but, also, immobility of the victim--a person injured in a fall, for example--increases the chance of signficant injury. Tight clothing restricts blood flow that would ordinarily warm the skin's surface, and wind quickly cools the arms and legs.
Although the victim may experience numbness, stiffness and pallor, the signs of frostbite become apparent upon re-warming the area. First degree frostbite is diagnosed when swelling and redness occur; second degree frostbite also includes blistering of the skin. More severe cases are indicated by a dark discoloration of the skin, a sign that tissue is badly injured and necrotic. In extreme cases, gangrene may appear and make amputation necessary.
Treatment for frostbite includes rapid re-warming of the affected area in warm--not hot--water. The water should be only slightly warmer than body temperature--about 110 degrees F--and the area should be warmed only when it can be kept warm afterward. More damage will result if an area is warmed and then chilled again. The injured area should be elevated and protected, and the victim should be given protection against tetanus.
Specialized wound care, available at burn centers, can help the healing process. Be sure to seek medical attention for any frost-bitten extremity, House says.