What is frostbite?

Frostbite is an injury that can happen in a situation of extreme cold. In frostbite, body tissues become frozen, and permanent damage may happen if the affected area is not treated promptly. Amputation of a body part may be needed in the most severe cases. Most commonly, affected body parts include the nose, ears, fingers, toes, cheeks, and chin.

Some conditions may lead to an increased risk for frostbite, such as:

• Reduced blood circulation from conditions, such as peripheral arterial disease (PAD), diabetes, peripheral neuropathy, or Raynaud phenomenon

• Constricted blood flow to the extremities due to gloves, boots, socks, or other clothing items that are too tight

• Lack of appropriate clothing to match weather conditions

• Windy conditions, which cause more rapid cooling of the skin and body 

• Certain medicines like beta blockers 

• Smoking

• Alcohol or drug intoxication that results in prolonged exposure to extreme cold 

What are the symptoms of frostbite?

The following are the most common symptoms of frostbite:

• Redness or pain in a skin area

• A white or grayish-yellow skin area

• Skin that feels unusually firm or waxy

• Numbness

• Blisters (filled with clear fluid or possibly blood-filled in more severe cases) 

• Gangrene (black dead skin and tissues) in severe cases   

In most cases, the victim is unaware of frostbite because the frozen tissues are numb. The symptoms of frostbite may look like other medical conditions or problems. Always check with your healthcare provider for a diagnosis.

What to do if frostbite happens

If there are symptoms of frostbite, seek medical attention immediately. Frostbite and hypothermia both result when skin is exposed to cold surroundings and body temperature falls. Hypothermia is a more serious medical condition and needs emergency medical assistance.

If frostbite happens, protect the victim or yourself with the following recommendations:

• Get into a warm room as soon as possible. Remove any wet clothing.

• Cover the person or area in warm blankets.

• Avoid walking on frostbitten feet or toes to avoid more serious damage.

• Immerse the areas affected by frostbite into warm (not hot) water until normal skin color returns. Do not soak the affected area too long (no more than 30 minutes).

• Warm the affected area using body heat.

• Do not rub or massage the affected area as this can cause further damage.

• Do not use anything hot, such as a heating pad, stove, or furnace, to warm the affected area, as these areas are numb and may burn easily due to a lack of sensation.

• The frostbitten area should be gently washed, dried, and wrapped in sterile bandages and kept clean to avoid infection.

• Consult your healthcare provider about the use of an oral antibiotic or topical ointment.

Because refreezing of thawed tissue can worsen damage to the tissue, it is very important that thawing of frostbitten tissues not be attempted unless it is certain that refreezing will not happen. Delay thawing frozen tissue until a safe and warm location can be reached.

A frostbite condition is most often resolved over a period of weeks or months. Sometimes, however, surgery is later needed to remove the dead tissue.