What is frostbite?
Being too cold can cause problems. Hypothermia happens when the body temperature drops too low. Frostbite happens when body tissues are damaged after exposure to cold temperatures or cold water. Both hypothermia and frostbite are medical emergencies.
Who is at risk for frostbite?
Anyone that has exposed skin in extremely cold temperatures is at risk. A higher risk of frostbite is likely for people who:
- Take medicine for high blood pressure.
- Have diabetes.
- Have peripheral vascular disease, a serious condition involving blood vessels.
- Have Raynaud’s disease or phenomenon, a condition that involves periodic narrowing (or spasms) in the blood vessels.
- Have poor circulation.
- Have not dressed appropriately for cold weather.
- Are infants.
- Are elderly.
- Have been drinking alcohol or taking drugs.
What causes frostbite?
Frostbite is caused by exposure to very cold temperatures or water, or very long exposure to less cold temperatures. Frostbite usually affects fingers, toes, faces, and ears. The cold can affect both the skin and the tissues under the skin, such as muscles, nerves, and joints. Frostbite can be mild, moderate, or severe.
What are the symptoms of frostbite?
- A feeling of “pins and needles”
- Hardening of uncovered skin exposed too long in the cold
- Redness (mild frostbite)
- Pale or waxy color and feel (more severe frostbite)
- Blisters or scabs
Diagnosis and Tests
How is frostbite diagnosed?
Typically, frostbite is diagnosed by physically looking at the area and evaluating symptoms.
Management and Treatment
How is frostbite treated?
If you are experiencing any symptoms of frostbite, seek medical help right away. If medical attention is available, remove all wet clothing, wrap area in a sterile (clean) cloth, and go to the hospital immediately. At the hospital, they will:
- Warm the area.
- Test blood flow in the area.
- Provide medicines to prevent infection (medication may also include a tetanus shot) and to reduce pain (ibuprofen [Advil ®, Motrin ®], for example).
- Rehydrate the patient.
- Surgery may be required to remove dead skin and tissue after healing (healing may take several days).
If medical attention is not an option, and you can be sure you will stay warm and not refreeze, begin the thawing process. If the unthawed areas re-freeze, you might have further damage.
For thawing, follow these steps:
- Remove wet clothing.
- Elevate the injured area slightly.
- Begin the warming process by soaking the area in warm water (around 105 degrees Fahrenheit). Since the affected area may be numb, be careful not to burn the skin with hot water. Burning could cause more damage to the tissue. When the skin becomes soft, you can stop the warming process.
- Cover area with sterile cloth. If frostbite has affected fingers and or toes, wrap each digit individually. You want to keep them separated.
- Try not to move the area at all. Do not walk on injured toes and/or feet.
- Do not rub the areas because rubbing could cause tissue damage.
How can you prevent frostbite?
When you know you are going to be in cold temperatures, dress warmly. Layer your clothing, wear two pairs of socks, hats, mittens (never gloves), and scarves. You want to keep your ears covered. It is important to prevent heat loss from your head and neck area. Wear windproof and waterproof clothing.
Make sure your boots and clothes are not too tight. This can cause poor circulation. Stay away from cramped positions. Keep moving to maintain blood flow to avoid poor circulation.
Outlook / Prognosis
What is the outlook for someone with frostbite?
Some patients with severe or “deep” frostbite might experience:
- Damage to tendons, muscles, nerves, and bone
- Gangrene (blackened, dead tissue)
- Amputation of infected area
- Arthritis, bone deformities, scars, and skin and nail changes or weakness
Patients with mild to moderate frostbite often become sensitive to cold and pain and may experience ongoing numbness.
- Centers for Disease Control and Prevention. Frostbite Accessed 3/6/2018.
- Biem J, Koehncke N, Classen D, Dosman J. Out of the cold: management of hypothermia and frostbite. CMAJ February 04, 2003 168 (3) 305-311. Accessed 3/6/2018.
- Centers for Disease Control and Prevention. Avoid, Spot, Treat Frostbite & Hypothermia. Accessed 3/6/2018.
- Ikäheimo TM, Junila J, Hirvonen J, Hassi J. Chapter 202. Frostbite and Other Localized Cold Injuries. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011. library.ccf.org. Accessed 3/6/2018.
- Expertise of Cleveland Clinic staff, Vascular Medicine.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
This document was last reviewed on: 11/07/2017