Frostbite (2024)

Overview

When the temperature plummets, being outdoors for even a few minutes without proper protection from the elements can put you at risk for developing frostbite. While frostbite is typically a treatable condition, in severe cases, it may result in amputation.

Frostbite means the skin—and sometimes the tissues underneath the skin—freezes. That’s because 64% of skin consists of water. Just like water turns to ice in freezing temperatures, ice crystals can form inside the cells of skin exposed to cold temperatures for extended periods of time if not properly covered.

Circulation issues can increase the risk of frostbite, which usually occurs in peripheral areas of the body located farther from the heart. (To help preserve warmth in the body’s core, where the major organs are located, the vascular system will decrease blood flow [vasoconstriction] to the extremities in extreme cold.)

“Infants and young children are particularly at risk because they can’t always communicate their symptoms and lose heat from the skin more readily,” says Sara Perkins, MD, a Yale Medicine dermatologist.

People of all ages should be on alert for frostbite, though. “Temperature changes, moisture, and underlying health conditions can all influence the risk for developing frostbite,” she adds.

  • Redness
  • Stinging or burning sensation
  • Numbness
  • Throbbing
  • Aching
  • Prickly, pins-and-needles feeling
  • Pale, yellow, or bluish areas on the skin
  • Blackened areas of skin (gangrene)
  • Thick, hardened skin

What increases the risk of frostbite?

Prolonged periods spent outdoors in very cold temperatures, as well as wet and/or windy conditions, can lead to frostbite. Below are other things you should be aware of that decrease blood flow, which can increase your risk:

What should you do if you think you or your child may have frostbite?

If you recognize symptoms of frostbite, immediately go indoors where it is warm. Try to gradually warm up and bring back feeling to the skin. (But avoid rubbing frostbitten skin—the friction can further damage skin cells.)

Remove any jewelry or constrictive clothing. And don’t warm up in front of a fire or heater. Because frostbitten skin is numb, you may not realize how close you are to the heating source and may burn your skin.

A method dermatologists recommend is to apply a warm washcloth to the affected area to bring gradual warming. Follow this by immersing the affected area in warm (never hot or cold) water or simply wrapping yourself up in blankets. You can also use your body heat to warm your child’s skin.

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When should you seek medical help for frostbite?

If you notice your skin developing a gray, white, yellow, blue, or black discoloration, or if you do not feel sensation returning to numbed skin after trying to rewarm the area, seek medical attention immediately at a hospital emergency room. In addition to being assessed for frostbite, you’ll be checked for hypothermia. This is a serious medical condition in which the body temperature is so low that brain function is affected, causing confusion, low energy, drowsiness, memory loss, altered speech, shivering, and exhaustion.

Frostbite can affect not only deeper layers of skin, but also muscles, bones, and blood vessels. If the blood vessels are damaged, they may never recover. Without proper blood flow to the affected area, gangrene can develop, which occasionally can only be treated by amputating the affected limb.

What medications are used to treat frostbite?

Medications may be used to relieve pain and prevent infection and, in some cases, amputation. They may include:

  • Pain medications. Rewarming affected parts of the body can cause significant pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce pain and inflammation. Aspirin may be used to reduce pain, though it may slow healing. Opioids may also be given to treat pain.
  • Antibiotics. In some cases, infections can occur in parts of the body affected by frostbite. Intravenous antibiotics may be given as part of treatment.
  • Tetanus vaccine. Because people with frostbite are at increased risk for bacterial wound infections, such as tetanus, a tetanus shot may be given.
  • Medications to prevent blood clotting and improve blood flow. Blood clots can form in small blood vessels in parts of the body affected by frostbite. Clots can restrict blood flow in the affected parts of the body. Blood flow to frostbitten tissue may cease, leading to the need to amputate affected tissue. Medications called thrombolytics (or thrombolytic therapy) may be given to break up blood clots and vasodilatory drugs may be given to widen blood vessels, thereby improving blood flow and reducing the need for amputation.

    These drugs are usually given intravenously (by IV) or intra-arterially (into the arteries). Drugs in these categories include:

    • Thrombolytic therapy with heparin. Heparin, a blood thinner, may be used in combination with a thrombolytic drug such as alteplase.
    • Iloprost. This drug, sold under the brand name Aurlumyn™, is a vasodilator, meaning it works by dilating, or widening, blood vessels, thereby improving blood flow through the vessels. In February 2024, the Food and Drug Administration (FDA) approved iloprost for the treatment of severe frostbite in adults to lower the risk of amputation of fingers or toes. It is given by IV infusion.

How can I prevent frostbite?

Proper preparation is the key to preventing frostbite. The American Academy of Dermatology shares the following tips:

  • Dress in loose, light, comfortable layers: Wearing loose, light layers helps trap warm air. Your first layer should be made of a synthetic material, which can wick moisture away from your body. The next layer should be insulating—wool and fleece hold in more heat than cotton fabrics. Choose a windproof and waterproof (or water-resistant) outer layer.
  • Cover up: Be prepared with proper winter wear. What you believe to be a brief time outdoors could easily turn into hours in frigid temperatures due to unforeseen events, like a car accident (or breakdown) or locking yourself out of the house.
  • Protect your feet: If you take part in cold-weather activities, double up your socks to protect feet and toes. Wear a moisture-wicking pair of socks to keep the feet dry, then add a wool or wool-blended sock for warmth. Be sure your boots are insulated and high enough to keep snow out.
  • Hats: Hats protect your head and ears, and scarves and face masks can help prevent frostbite on the ears, nose, cheeks, and chin.
  • Avoid metal: Since metal conducts cold, do not to touch metal surfaces with bare skin.
  • Keep skin dry. Seal out snow, ice, and rain with waterproof or water-resistant outerwear, and change out of clothing that becomes damp from the elements or perspiration.
  • Stay hydrated: Drink a glass of water before you head outside, and sip water or a sports drink before and throughout outdoor workouts—dehydration slows blood circulation.

What is Yale Medicine's approach to treating skin affected by frostbite?

“A thorough understanding of the scenario, careful physical examination, and prompt management are key, but there’s also an important opportunity for education about the condition, assessment of underlying risk factors, and review of tools for prevention,” Dr. Perkins says.

Frostbite (2024)

FAQs

What is the solution to frostbite? ›

Warm the frostbitten parts in warm (not hot) water for about 30 minutes. Place clean cotton balls between frostbitten fingers and toes after they've been warmed. Loosely wrap warmed areas with clean bandages to prevent refreezing. Give your child acetaminophen or ibuprofen for pain.

How do you respond to frostbite? ›

If possible, soak the skin with frostbite in a tub or sink of warm water for about 30 minutes. For frostbite on the nose or ears, cover the area with warm, wet cloths for about 30 minutes. Drink a warm, nonalcoholic beverage. Take a nonprescription pain reliever if needed.

How fast is frostbite in 0 F? ›

When the temperature is zero degrees Fahrenheit or below, it takes about 30 minutes for exposed skin to get frostbite. At 15 degrees below zero with even a little bit of wind, frostbite is possible within 15 minutes.

What is the frostbite rule? ›

If you suspect frostbite, gently rewarm the affected area in warm, not hot, water for 20-30 minutes. Seek medical attention if symptoms persist or you suspect severe and deep frostbite.

Does vaseline prevent frostbite? ›

Use moleskin cut-outs on cheeks to prevent frostbite. Vaseline is used by some skiers, but is not proven to reduce risk. Help other skiers by pointing out areas of whiteness that may suggest frostnip or frostbite.

Can frostbite be saved? ›

Mild frostbite gets better with rewarming. Seek medical attention for anything more serious than mild frostbite because the condition can cause permanent damage to skin, muscle, bone and other tissue.

Can frostbite be repaired? ›

Second-stage frostbite can take up to six months for your skin to heal. You may experience skin scabbing and skin discoloration throughout the healing process. The third and most severe stage of frostbite can cause permanent skin damage. You may need surgery to repair this type of skin damage.

Is frostbite permanent? ›

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.

What is the new treatment for frostbite? ›

A synthetic drug first developed in Germany in 1980s, iloprost, also known by the brand name Aurlumyn, is given by injection. It works as a vasodilator, meaning it widens blood vessels, improves blood flow and prevents risk of blood clotting.

How cold is too cold to be outside? ›

In general, when the wind chill is 32° and above, it's safe to be outside. In temperatures 13° to 31°, indoor breaks should happen every 20-30 minutes. For wind chills of 13° and below, you should move activities indoors and outside of the cold as frostbite can set in very quickly.

Where is the coldest recorded place on Earth? ›

From Dr. Stephen Warren, University of Washington (8/22/2007): The world record for low temperature was set at Vostok Station, Antarctica, on 21 July 1983. Cerveny et al. (2007) give this temperature as -89.4°C in their Table 2, quoting Krause and Flood (1997), who gave the same value.

Can dogs get frostbite? ›

Any dog exposed to freezing temperatures can develop frostbite, though those that are not acclimated to winter weather are at increased risk, along with those with thinner hair coats. Younger and older dogs are both more likely to develop the condition, as they are more prone to unstable body temperatures.

What does 2nd degree frostbite look like? ›

Second degree frostbite is when you see light colored blisters and your skin starts sloughing or shedding. Blood filled blisters are signs of third-degree frostbite. These may occur after you have rewarmed your skin. The worst type of frostbite, fourth degree, is when bone, tendon, or muscle has frozen.

Why do fingers turn black from frostbite? ›

Frostbite is another cause of blackening fingertips due to cold weather. Frostbite causes tissue damage at temperatures below 32 degrees. 7 People with frostbite may notice that their fingertips become dark purple if the blood vessels cannot function properly and blood pools in the area.

Is frostbite painful? ›

The affected area will feel hard and frozen. When you're out of the cold and the tissue has thawed out, the skin will turn red and blister, which can be painful. There may also be swelling and itching. This is known as superficial frostbite, as it affects the top layers of skin and tissue.

What is the best prevention for frostbite answer? ›

To stay warm and prevent frostbite, follow these tips from dermatologists:
  • Dress in loose, light, comfortable layers. ...
  • Protect your feet and toes. ...
  • Protect your head. ...
  • Protect your hands. ...
  • Make sure snow cannot get inside of your boots or clothing. ...
  • Keep yourself hydrated. ...
  • Recognize the symptoms.

What is the first aid of frostbite? ›

Handle the area gently; never rub the affected area. Warm gently by soaking the affected area in warm. water (100–105 degrees F) until it appears red and feels warm. Loosely bandage the area with dry, sterile dressings.

Can frostbite be removed? ›

For severe cases of frostbite, your provider may need to perform surgery to remove any dead skin and tissue after you heal. It may take days or even months to determine if you need surgery.

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