Don’t Get Frostbitten: A Guide to Prevention, Signs, and Treatment

As the temperatures plummet, winter enthusiasts, outdoor workers, and even those just running errands are exposed to the risks of cold-related injuries. One of the most serious is frostbite, a condition that occurs when skin and underlying tissues freeze.

Knowing how to prevent it, recognize the warning signs, and treat it promptly is crucial for a safe winter. Here is your general guide to staying safe in the cold.

Part 1: Prevention is Key: How to Stay Warm and Dry

The best defence against frostbite is proper preparation and smart clothing choices.

  • Dress in Layers: Wear loose, light, and warm layers. Air trapped between the layers acts as an insulator.

    • Base Layer: Wicks sweat away from your skin (e.g., synthetic materials like polypropylene or wool).

    • Middle Layer: Provides insulation (e.g., fleece, down, or heavy wool).

    • Outer Layer: Protects against wind and moisture (e.g., waterproof/windproof jacket and pants).

  • Cover Extremities: Frostbite most often affects areas farthest from the heart, which is why covering your hands, feet, nose, and ears is essential.

    • Hands: Mittens are generally warmer than gloves because they keep your fingers together.

    • Feet: Wear wool or synthetic socks. Avoid cotton, which traps moisture. Ensure boots are waterproof and not too tight, as this can restrict blood flow.

    • Head/Face: Wear a hat that covers your ears and a scarf or balaclava to protect your face and nose.

  • Stay Dry: Wet clothing dramatically increases the rate of heat loss. Change wet socks, gloves, or other garments immediately.

  • Avoid Constriction: Tight boots, gloves, or straps can reduce blood flow, making tissues more susceptible to freezing.

  • Limit Exposure: Pay attention to wind chill factors. On very cold, windy days, limit your time outdoors and take frequent breaks in a warm, dry shelter.

  • Stay Hydrated and Nourished: A well-nourished and hydrated body is better equipped to regulate its temperature. Avoid alcohol and nicotine, as they constrict blood vessels and increase heat loss.

Part 2: Know the Signs: Recognizing Frostbite

Frostbite is a progressive injury. Recognizing it early can prevent permanent damage. It typically progresses through three stages:

Stage 1: Frostnip (Superficial)

This is a mild form of injury where only the top layer of skin is affected.

  • Sensation: A “pins and needles” feeling, itching, or tingling.

  • Appearance: Skin is cold, waxy, and usually turns a reddish color.

  • After Warming: May feel a burning sensation and slight swelling.

Stage 2: Superficial Frostbite

The skin appears white or pale yellow and feels hard and frozen. The tissue beneath is still soft.

  • Sensation: Numbness; you may lose the feeling of cold or pain.

  • Appearance: Skin is waxy and firm to the touch.

  • After Warming: Blisters filled with clear or milky fluid may form within 24–36 hours. Swelling will occur.

Stage 3: Deep Frostbite (Severe)

This is an emergency. All layers of the skin and underlying tissue (including muscle and bone) are frozen.

  • Sensation: Complete numbness.

  • Appearance: The area feels hard and cold, and the skin may look white, blue, or mottled.

  • After Warming: Large, deep blisters may appear. The tissue will turn black and hard (necrosis). This stage can lead to permanent damage and amputation.

Part 3: What to Do: Immediate Action

If you suspect you or someone else has frostbite, seek medical attention immediately. While waiting for help, follow these steps:

DO

  1. Get to Safety: Move to a warm environment as quickly as possible.

  2. Remove Wet/Tight Clothing: Carefully remove any wet, constricting, or frozen clothing.

  3. Gently Warm the Area:

    • Use your own body heat (e.g., place frostbitten hands in your armpits).

    • If available, use warm (not hot) water immersion (ideally 40°C to 42°C / 104°F to 108°F). Do this for about 15–30 minutes until the skin becomes soft and returns to a natural color.

    • Note: Warming should only be done if there is no risk of refreezing. If you warm it up and then have to go back out into the cold, leave it frozen, as refreezing causes more severe damage.

  4. Protect the Area: Cover the thawed area with sterile, dry dressings, keeping fingers and toes separated with sterile cotton or gauze.

  5. Offer Warm Fluids: Give the person warm, non-alcoholic, and non-caffeinated drinks.

DON’T

  • DO NOT Rub or Massage: Rubbing the frozen tissue causes ice crystals to damage the cells further.

  • DO NOT Use Direct Dry Heat: Do not use a fireplace, stove, or heating pad. The numb skin can be easily burned.

  • DO NOT Walk on Frostbitten Feet: This can cause severe tissue damage.

  • DO NOT Break Blisters: Blisters protect the underlying skin and should be managed by a healthcare professional.

Stay vigilant this winter. By taking simple preventative steps and knowing how to act quickly, you can ensure your outdoor adventures remain safe and enjoyable! Please make sure you consult a physician as soon as you feel or see signs of frost bite.