Frostbite

Frostbite is an injury that happens when the skin and tissue beneath the skin freezes. The most common areas for frostbite include the fingers, toes, chin, nose, and ears.

What increases my risk for frostbite?

  • Older age
  • Alcohol and tobacco use
  • Constricting clothing
  • Medical conditions including poor circulation, arthritis, diabetes, or heart disease
  • High altitude
  • Not being able to move
  • Medicines including sedatives or blood pressure medicine

What are the signs and symptoms of frostbite?

  • Your skin first becomes cold and red. Then it gets numb and hard, and it turns white. Your skin color changes from white to red as it warms. You may feel pain, tingling, and burning as your skin warms. Your skin may swell, and you may develop blisters.
  • With more severe frostbite, you may develop blisters filled with blood. The most severe type of frostbite causes gangrene. With gangrene, the skin turns black and the tissue dies. Healthcare providers may not know how much tissue damage has been caused by frostbite for several weeks.

How is frostbite diagnosed?

Your healthcare provider will examine your skin. Tell him or her how long you were exposed and what you were doing when exposed. You may need imaging tests to check for damage to blood vessels and tissue under your skin.

How is frostbite treated?

  • A warm bath or whirlpool for 20 to 45 minutes will help rewarm your limbs. Do not rub while you are warming up. The water temperature should be 96.8°F to 104°F (37°C to 40°C). Air dry after the bath.
  • Bandages may be applied to the frostbitten areas of your body. Clean, sterile, bandages will help keep these areas from getting infected. Gauze pads may be put on and between injured fingers or toes.
  • Medicines:
    • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
    • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
    • Td vaccine is a booster shot used to help prevent tetanus and diphtheria. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.
    • Antibiotics may be needed to prevent bacterial infection.

How do I manage my symptoms?

  • Elevate your frostbitten area above the level of your heart as often as you can. This will help decrease swelling and pain. Prop the area on pillows or blankets to keep it elevated comfortably.
  • Ask your healthcare provider about activity. It is usually a good idea to use or move the frostbitten area as much as you can. This will help blood flow to the area and improve healing.
  • Use a foot cradle to keep bedding off your feet. Cut 2 sides off a large cardboard box. Put the box under your sheets at the foot of your bed. Put one of the open sections facing the head of the bed and the other open section against the mattress.

How can I help prevent frostbite?

  • Avoid long-term exposure to cold temperatures.
  • Drink liquids as directed. You may need to drink more liquids, such as water, when you spend time in cold weather.
  • Wear several layers of loose, warm clothes. Choose fabrics that absorb sweat and prevent heat loss. Good choices are polyester, synthetic wool, or polypropylene. Wear an inner fleece or wool layer for insulation. Put these layers under a windproof and waterproof coat. Cover your face, head, neck, and ears. Wear gloves or mittens. Make sure your shoes or boots are insulated and water-repellant.
  • Use the buddy system when you are outside for long periods. Check each other for white areas on your face and ears.
  • Do not drink alcohol or smoke before you go out in the cold. Alcohol impairs decisions and tobacco decreases circulation to your limbs. This increases your risk for frostbite.

When should I seek immediate care?

  • You have swelling, redness, or pus in the area that was frostbitten.
  • You have a fever.
  • The skin with frostbite turns black.
  • You lose feeling in the area that was frostbitten.

When should I call my doctor?

  • You have blisters filled with blood.
  • Your pain gets worse.
  • You have questions or concerns about your condition or care.