This winter hasn’t been particularly cold.
Yet, the U.S. is facing unusually low temperatures and heavy snowfall, leading to dangerous conditions in various regions.
Hospitals nationwide are seeing an increase in injuries related to the cold, including everything from fractures from falls to heart problems triggered by shoveling snow and cases of frostbite.
Frostbite poses a serious threat because it can numb the nerves, meaning individuals might not realize they’ve suffered damage until it’s quite severe.
Dr. Emily R. Nadelman, a dermatologist associated with George Washington University and the University of Maryland, discusses the signs of frostbite and the factors that heighten the risk of developing it.
What are the stages of cold exposure leading to frostbite?
- Pre-freeze stage: Here, tissue temperature drops, blood vessels narrow, and circulation declines without ice crystals forming.
- Freeze-thaw phase: Ice crystals can form inside or outside of cells, causing cell damage. If the tissue warms up too soon, inflammation and further injury can set in.
- Vascular stagnation phase: At this point, circulation becomes unstable.
- Late ischemic stage: In this advanced stage, increasing inflammation, blood vessel narrowing, and clot formation lead to tissue death.
What are the key symptoms of frostbite?
“Initially, frostbite can make the skin feel extremely cold, tingly, or even painful, and it may go numb when temperatures drop below 50 degrees Fahrenheit,” Dr. Nadelman notes.
“Affected skin may begin red, then turn waxy and white, feeling hard or ‘woody,’ and the full extent of the injury is often revealed once thawing occurs.”
First-degree frostbite may cause numbness and redness, while second-degree frostbite often results in clear or cloudy blisters.
Third-degree frostbite involves severe damage and blood-filled blisters, whereas fourth-degree frostbite penetrates deeper into fat, muscle, and bone, frequently resulting in permanent loss of tissue.
“Frostbite can affect any exposed area, but it particularly targets extremities and parts of the face where blood flow is restrained to conserve core temperature,” Nadelman explains.
“Fingers, toes, cheeks, ears, and noses are especially at risk—interestingly, fingers might freeze even at higher temperatures than the cheeks do.”
How is frostbite treated?
Dr. Nadelman emphasizes the importance of rapid rewarming for treating frostbite, suggesting soaking the affected skin in water heated between 99 and 104 degrees Fahrenheit for about 20 to 30 minutes.
“The water shouldn’t be hot—just comfortably warm, slightly above body temperature,” she advises. “If hot water isn’t available, air warming can be an alternative.”
It’s essential to remove any jewelry or tight clothing before swelling occurs.
Avoid walking, applying pressure, or rubbing the frozen area since frozen tissue cannot sense damage.
If the frostbite is severe, emergency treatment might be necessary.
“For individuals with deep frostbite, especially if it affects the finger joints, quick transport to a facility equipped for rapid rewarming and advanced imaging is crucial,” Dr. Nadelman states.
“In the most severe situations, specialized burn centers may be required for treatment.”
Seeking treatment within the first 24 hours is vital to minimize amputation risks.
How does frostbite differ from Raynaud’s syndrome?
Frostbite isn’t the only issue related to cold sensitivity.
Raynaud syndrome involves small artery spasms in the fingers and toes in response to cold or stress, leading to a change in skin color to white or blue.
Unlike frostbite, there’s no ice crystal formation, and episodes typically last just minutes to hours.
“While Raynaud’s triggers reversible color changes and discomfort, frostbite results in actual cell damage and can progress to tissue death,” Dr. Nadelman comments.
Raynaud’s primarily affects women aged 15 to 30, potentially influenced by hormonal and physical factors, making them more vulnerable to frostbite in cold conditions.
What factors increase frostbite risk?
Besides Raynaud’s disease, factors like peripheral vascular disease, diabetes, hypothyroidism, and cardiovascular issues also elevate frostbite risk.
People who smoke, use blood vessel constricting drugs, males, children, the elderly, individuals of African descent, and anyone with a history of cold injuries are generally at higher risk.
The threat significantly rises at high altitudes, where oxygen is scarce, or in frigid ocean waters where tissue can freeze at just 31 degrees Fahrenheit.
“Experts recommend steering clear of cold exposure if you’re sick and avoiding substances that hinder blood flow, like alcohol and nicotine,” Dr. Nadelman adds.
How can frostbite be prevented?
Dr. Nadelman suggests that frostbite prevention includes keeping exposed skin warm and dry while enhancing circulation. Layering clothing, opting for mittens instead of gloves, using hand warmers, and avoiding tight outfits can help.
If you find yourself in extreme cold, minimize outdoor exposure, regularly check for numbness or pain, and warm any affected areas as soon as possible.
