Frostbite is a kind of injury which takes place when the skin is exposed to extreme cold. Exposure to extremely low temperatures causes the topmost layer of the skin and certain underlying tissues to freeze. Frostbite happens to extreme parts of the body like fingers, toes, cheeks, ear, chin and nose. Though exposed skin is most vulnerable, frost bite could also affect skin covered by gloves or clothing. Frostbite can lead to permanent physical damage. In severe cases, it might even lead to amputation. Frostbite requires immediate medical attention as it can damage even muscles, nerves and bones. So, let us take a closer look at this skin injury caused by extremely low temperatures.
What is Frostbite:
When a person experiences extremely cold temperatures or freezing conditions for an extended duration, blood-flow to specific parts of the body can drop down to dangerously low levels. When these certain parts do not get to receive as much oxygen-rich blood as they need, the cells and tissues start to die. First, the skin turns cold and red, followed by numbness. Finally, the skin becomes hard and pale. At freezing point, i.e. zero degree Celsius or 32 degrees Fahrenheit, you might start to feel pain after a few seconds. This is when you will be experiencing what is known as Frostnip, which is the milder and earlier stage of Frostbite. When temperatures drop even further, worsened by wet conditions, blood vessels start to get narrowed in order to try to preserve heat at the body’s center. Circulation decreases, tiny blood clots form and the tissues & fluids in the affected, exposed parts freeze and die. This may also result in Gangrene and need amputation.
Symptoms of Frostbite:
Signs and symptoms of frostbite are as follows:
- Firstly, a cold and prickling feeling on the skin
- Hard, waxy-like skin
- Skin turning red, white, bluish-white or greyish-yellow
- Joint and muscle stiffness
- Blisters after rewarming
Stages of Frostbite:
In a similar way to burns, doctors categorize frostbite in three different stages, depending upon their degrees or severity.
- First degree frostbite: This stage is commonly known as frostnip. This is a very mild stage and does not harm your skin permanently. This only affects the surface of the skin. Early symptoms are numbness, itching pain and prickling. The skin starts to develop white and yellow patches. It may make your skin lose sensitivity to heat and cold for a short period of time.
- Second degree frostbite: This stage is referred to as the superficial frostbite stage. The skin turns reddish, to whitish and even a bluish color. The skin may freeze and become hard. Ice crystals form on the skin. Your skin may start to feel warm and swell up which is an indicator that tissue damage has begun. Rewarming should be done as soon as possible. You will experience a stinging and burning sensation. This may lead to blisters after 12 to 36 hours which become black and hard, taking up to a month to heal.
- Third degree frostbite: The final stage is the deep and severe frostbite stage. It affects all the layers of the skin, including the underlying tissues. The skin turns blue and splotchy, feels smooth and waxy. Muscles, vessels, nerves and tendons freeze up. Blood-filled blisters appear, skin loses all forms of sensations and some people may have to lose their extremities forever.
Causes of Frostbite:
Frostbite takes place when your skin and underlying tissues freeze. The main cause of frostbite is being exposed to cold weather. Others include:
- Wearing clothes which are very tight and do not protect you against the cold, windy or wet weather.
- Coming in direct contact with ice, cold packs, cold liquids or frozen metals.
- Exposure to cold and wind for a prolonged period.
- When you are at higher altitudes that have low temperatures and restricted oxygen levels.
Risk factors include:
- Alcohol or substance abuse
- History of frostbite or cold injury
- Certain medications like beta blockers as they affect blood circulation
- Medical issues like exhaustion, excessive sweating, circulatory problems, hunger, dehydration, diabetes and malnutrition.
- Fear, panic or mental illnesses as they hamper your sense of judgment and ability to make a decision in freezing temperatures.
- Both infants and older adults as they have a harder time generating and retaining body heat
Treatment for Frostbite:
The treatment for this condition mainly focuses on the warming and thawing of the frostbitten parts. The treatment techniques may range from general first aid, rewarming, medications, taking care of the wounds, surgery and various other therapies, depending on the stage and severity.
- Rewarming: Rewarming is done by soaking the affected skin in warm (not hot) water for a time of 15 to 30 minutes. Rewarming needs to be done with a warm water bath and not by stoves and heating pads. The skin turns softer and reddish and can be gently touched or moved. Aloe Vera gel and lotions are applied on the affected areas after rewarming.
- Oral pain killers: To cope with the pain of the warming process, the doctor will prescribe you drugs like ibuprofen to relieve the pain and swelling.
- Protecting injuries: After the skin is thawed, the doctor will loosen up the area and wrap it with sterile towels and dressings. The affected areas may be elevated to reduce the swelling.
- Whirlpool therapy: Soaking your skin in a whirlpool bath i.e. hydrotherapy helps to aid and heal the skin. The skin becomes clean and the dead tissues are naturally removed.
- Infection-fighting medicines: If your skin or blisters get infected, your doctor will suggest certain oral antibiotics.
- Wound care: A number of wound care techniques are used on the skin, depending on the intensity of injury.
- Clot-busting medicines: The doctor may give you an intravenous injection of a drug which would help to restore the blood flow, like tissue plasminogen activators. TPA lessens the risk of amputations. These drugs are generally used within the first 24 hours and in the gravest of situations.
- Surgery: People who undergo severe frostbite need to go for surgeries or amputations which would remove the dead and decaying tissues and body parts.
Prevention of Frostbite:
Frostbite happens when the skin is damaged due to cold exposure. It has several stages. Frostbite can be prevented in various ways. The following tips will help you to stay safe and warm in such extreme conditions:
- Limit the time you are outdoors and spend in cold, wet and windy weather. You need to pay attention to the weather forecasts, wind chill readings and plan your outings accordingly.
- Wearing hats, headbands, ski masks etc. that covers your ears and woolen and windproof materials which will protect you from the cold is necessary.
- Dress up in several layers of loose, warm clothing as these layers will act as insulation against the cold, wind, snow and rain.
- Wearing mittens will provide better protection than gloves.
- Wearing socks, sock liners, hand and foot warmers will hold moisture and provide insulation.
- Watch out for the early signs of frostbite and seek warmth immediately.
- You should get out of wet clothes as soon as possible.
- Carry emergency supplies and first aid with you. Let others know about your return route and date. Also carry supplementary sources of oxygen at altitudes of 10,000 feet or above.
- Do not drink alcohol in cold weather situations as they cause your body to lose heat faster.
- You need to eat well-balanced, nutritious meals and stay hydrated.
- Also, remember to keep moving. Slight exercises and motion will help you to stay warm.
Anyone who is planning to spend long periods of time in freezing temperatures must follow the correct preventive measures and stay protected of the cold and wind. As soon as you start to notice the early signs of frostnip and frostbite, you need to rewarm the skin and seek medical attention. Don’t ignore these signs as severe cases might even lead you to lose the affected body parts permanently