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Frostbite

Temporary or permanent tissue damage from exposure to subfreezing temperature. Ice crystals form in the skin and blood vessels, leading to tissue injury or tissue death, depending on the temperature and length of exposure.

It most commonly affects the toes, fingers, earlobes, chin, cheeks and nose, body parts which are often left uncovered in cold temperatures. Frostbite can occur gradually or rapidly. The speed with which the process progresses depends upon how cold or windy the temperature conditions are and the duration of exposure to those conditions.

Causes

The following factors make frostbite more likely:

• Constriction of blood vessels in the extremities by too-tight clothing.
• Wet skin.
• Blood-vessel disease such as Raynaud's phenomenon (a circulatory-system disorder affecting fingers and toes).
• Smoking.
• Excess alcohol consumption.
• Windy weather, which increases chilling.
• Any chronic disease.

Signs and symptoms

The following are the most common symptoms of frostbite. However, each individual may experience symptoms differently. Symptoms may include:

• redness or pain in a skin area
• a white or grayish-yellow skin area
• skin that feels unusually firm or waxy
• numbness

Diagnosis

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-rays of damaged areas.

Treatment

First Aid- The following instruction apply to emergency care until medical care is available:

• Upon reaching shelter, remove clothing from the frostbitten parts.
• Never massage damaged tissue.
• Immerse the affected parts in warm water (about 100F or 37.8C). Use a thermometer, if available. Higher temperature may cause further injury.
• Drink warm fluids with a high sugar content, If available.
• Don't smoke.
• Apply dry, sterile dressing to the frostbitten areas. Put dressings between frostbitten fingers or toes to keep them separated.
• After re-warming, cover the affected areas with soft cloth bandages.
• Don't use affected limbs until you have medical attention. If feet are involved, don't walk.

Medication

• Your doctor may prescribe:
  Analgesics, including narcotics, to relieve severe pain. Don't use strong pain killers longer than 4 to 7 days.
  Antibiotics to fight infection.
• You may use non-prescription drugs, such as acetaminophen, for minor pain.

Prevention

• Anticipate sudden temperature changes. Carry a jacket, gloves, socks, hat, knit face mask and scarf.
• Don't drink alcohol or smoke prior to anticipated exposure.
• DO NOT disturb blisters on frostbitten skin.
• Wear waterproof skin moisturizer on exposed areas.
• If caught in a severe snowstorm, find shelter early or increase physical activity to maintain body warmth.
• Avoid going outdoors during extremely cold weather.