FROSTBITE Signs Symptoms and Treatment

FROSTBITE is the term used to describe an injury to the skin caused by exposure to cold, leading to freezing of the skin and underlying tissues, sometimes completely impairing the function of the affected area and or organ/organs.

Common Sites for Frostbite

Extremities are the most commonly involved because of poor circulation. It mostly affects the fingers and toes of the hands and feet respectively. In the face, the nose, ears, cheeks and chin are more vulnerable. The sudden loss in temperatures in USA and Canada have led to a higher number of Frostbite cases and you should be careful when leaving your house or office. If you plan to go skiing take extra precautions. You may even want to read about Skiing accidents and their treatments.

Causes of Frostbite

1) Exposure to Cold Weather

The most common cause is exposure to cold. The exposed parts of the body are more likely to get frostbite, however, the skin covered with clothing, like extremities covered in gloves and socks are also at risk, if the temperature is too low.

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2) Direct and prolonged contact with

a) ice
b) Freezing liquids
c) frozen metal substances
d) cold packs

Depending upon the air temperature and wind speed, a person can get frostbite on exposed skin in less than 30 minutes, especially if the temperature falls below minus 15-degree centigrade and the person’s clothes are not suitable for the weather conditions he or she is experiencing.

Specific Risk Factors

These conditions further increase your chances of getting frostbite.

Certain medical conditions like SLE, scleroderma and diabetes which leads to the poor blood supply to the skin and affect your nervous system in a way that you either can’t feel or respond to heat and cold.
Alcohol abuse.
Smoking and drug abuse.
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Extremes of age, that is infants and very old people, who can’t produce or retain enough body heat.
Living at high altitude where oxygen supply is very low to the skin.
Mental illnesses which impair your ability to respond to extremes of temperature, pain etc.

Stages of Frost Bite

The skin injury due to frostbite goes through different stages as the damage progresses.

Frostnip

The first stage of frostbite is called frostnip. It’s reversible. The skin first becomes pale or white and then red. It feels very cold, followed by prickling sensation and numbness of the affected areas. At this stage, rewarming the skin reverses the damage but may cause pain and tingling sensation in the skin as it’s temperature rises.

Superficial frostbite

The 2nd stage of frostbite ensues when the superficial skin layers are damaged, with reddening of the skin later becoming pale/ white. Ice crystals may form in the affected tissues making the skin harder at such places. It might feel warm rather than cold if the injury is severe, damaging superficial pain and temperature nerve endings. Stinging plus burning sensation and swelling may occur if one tries to rewarm the skin at this stage. Fluid-filled blisters may also appear a day or two after rewarming the affected areas.

Deep frostbite

As the cold exposure continues, all layers of the skin are damaged including subcutaneous tissues, affecting the function of different muscles and joints in the area. All sensations are lost. At this stage, the area feels numb with no pain warmth or cold sensation. It becomes increasingly uncomfortable. The skin turns dark blue to black as the tissue dies. Rewarming at this stage leads to blister formation and sloughing off of the dead skin.This stage leaves the affected area completely damaged and disfigured.

Complications arising due to Frostbite

Hypothermia.
Exposure to extreme cold which is enough to cause frostbite may also cause hypothermia, a condition in which body temperature falls to a degree at which the circulatory and nervous system cannot work normally and if left untreated can lead to heart failure and respiratory depression causing ultimate death.
Cold Sensitivity.
Feeling extreme cold in mild to moderate cold windy weather conditions can occur in a person with the previous history of frostbite as he or she develops increased sensitivity towards cold as a feedback mechanism of the body.
Increased risk of developing frostbite again in areas which were previously mildly damaged by the cold exposure.

Frostbite Arthritis

Due to damage to the cartilage between the joints, one may develop debilitating arthritis.

Long-term numbness due to nerve damage in the affected area.
Tetanus and other infections.
Damage to growth plate may lead to permanent growth defects in children.

Gangrene

Exposure to extreme cold interrupts blood flow to the area resulting in tissue death and may lead to amputation.

How to Prevent Frostbite?

Following precautionary measures can be taken to prevent frostbite.

When it’s too cold, don’t go outside or limit your time outdoors when it’s absolutely necessary to go out as exposed areas of skin can develop frostbite under such conditions in a matter of minutes.
Change out of waste clothes especially socks and gloves as soon as possible as your extremities are more prone to develop frostbite.
Wear woolen head covers that completely cover your head and ears.
Use mittens instead of gloves if possible as they provide better protection against cold.
Take care of your hand and feet. Wear hand/foot warmers below gloves and socks for extra warmth.
Watch weather forecast before you leave for a long journey in cold.
Plan your journey beforehand. Keep warm clothes and emergency supplies with you.
Inform someone close about your location, departure and arrival timings.
Beware of the different signs of frostbite especially if you are traveling alone as sometimes numbness is so severe that the person is unaware of the actual serious damage.
Look for skin color changes i.e pale/white turning purple or black, stinging burning feeling or swelling of any part should never be ignored.
Consume a well-balanced meal before leaving the house, hotel or shelter.
Try to stock high caloric hot food items with you for your time outdoors like hot chocolate.
Keep yourself well hydrated. Avoid consumption of alcohol like substances that make your body lose heat more quickly.

Immediately consult a doctor if you observe any of the following signs.

Pain, numbness, prickling or stinging sensation in an area with increasing intensity and color changes like skin becoming pale white or purplish blue-black.
Severe fever with rigors and chills
Blister formation
New unexplained symptoms like sudden loss of the function of a joint etc
Be constantly on the move as exercise keeps you warm by increasing blood flow. However, don’t exhaust yourself as that could harm you if you are stranded in such extreme cold conditions for long periods of time.

Frost Bite First Aid Measures

If you observe any of the above-mentioned signs of a frostbite in any part of your body try the following measures.

Move inside take shelter as soon as possible
Cover that area with warm clothes, hot pads etc.
Try to rewarm the affected area as soon as possible because as the time passes the damage becomes permanent.
Seek medical attention as soon as possible and never underestimate the damage.
Especially look for color changes in your skin. If it’s turning purplish-black most probably it’s a gangrenous patch already.
Drink/eat something sweet and hot if possible to keep yourself warm.
Don’t go outside again in the cold unless the initial signs of frostbite are completely gone.