Protecting Yourself in Cold Temperatures: Preventing and Treating Frostbite

Christopher Freer, DO, FACEP, Senior Vice President of Emergency and Hospitalist Medicine at RWJBarnabas Health, discusses the lasting dangers of frostbite as well as ways to prevent and treat this serious condition to minimize lasting effects.

As winter rolls on, we continue to see temperatures dip well below freezing (below 32 degrees Fahrenheit. While this may seem like winter as usual, there is nothing ‘usual’ about frostbite.

Did you know it takes less than 30 minutes to get frostbite once temperatures dip below freezing, especially with wind chills as a factor? And once wind chill increase to -20 to -30 degrees, frostbite can occur within just 10 minutes.

While it’s ideal to avoid exposure to frigid temperatures, that is not always possible. Many people have to work outside or, following a snowstorm, they need to clean their cars and property. Some even get stuck on the road and have to wait for assistance.

As the cold rages on, it’s important to recognize the signs of cold injury, like frostbite, and how to prevent it.

Tips for Preventing Frostbite

If you must be outside in frigid temperatures, dress smart. Use common sense when dealing with cold weather. Do not allow your skin to be exposed to the cold and wind for a prolonged period of time – as that is how frostbite occurs.

Specifically, wear:

  • Mittens, instead of gloves
  • Wind-proof, layered clothing
  • A headband or earmuffs to cover your ears
  • A hat or scarf to cover your head

Throughout the winter, it’s also a good idea to keep a warm blanket and proper winter clothing in your car in the event of hazardous conditions or a vehicle breakdown that causes you to have sustained time in the cold. This simple safety precaution can prevent serious injury.

Remember, if you think frostbite is occurring, get indoors as soon as possible. But in order to know when frostbite is starting, you must be aware of the symptoms and stages.

Know the Symptoms

There are three degrees of cold injury: frostnip, superficial frostbite and deep frostbite. Frostbite is caused when body tissue — usually exposed body parts away from your core like fingers, toes, ears or nose — freeze due to prolonged exposure to cold and a low wind-chill factor.

Frostnip, a mild form of frostbite, occurs when only the skin freezes. Signs of frostnip include:

  • Skin that appears yellowish or white, but feels soft if touched
  • Painful tingling or burning sensation

Superficial frostbite, a moderate form of frostbite, occurs when the reddened skin turns pale. Signs of superficial frostbite include:

  • A "pins and needles" feeling, followed by numbness
  • Hard, pale and cold skin
  • A warm sensation
  • Red and painful as the skin thaws
  • Aching or throbbing
  • Lack of sensation of the affected body part when touched

Deep frostbite, the most severe form, occurs when the skin and lower layers of tissue are damaged. Signs of deep frostbite include:

  • Skin that appears blue or blotchy
  • Numbness to temperature and pain

It’s important to note that the longer the exposure, the worse frostbite will get.

What to do if Frostbite Occurs

Although it may be your first instinct to quickly warm yourself, do not use a heating pad, fireplace or radiator for warming. The affected areas are likely numb and can easily be burned.

At the first sign of frostbite, move to a warm location as fast as possible. Soak the affected area in warm, not hot, water. You can also warm the affected area using body heat; frostbitten fingers, for example, can be warmed under your armpits.

The sooner frostbite is identified and treated, the less likely extensive treatment will be needed. Once you have signs of superficial or deep frostbite, seek immediate emergency medical help.

Winter can be an enjoyable and adventurous time. Just remember to dress appropriately, be aware of your surroundings, and follow simple safety guidance so that you and your family are ready to handle whatever the weather throws at you.