How To Prevent Frostbite

At home or away on a winter vacation, forecasts of freezing temperatures may leave you wondering how to keep your skin safe from frostbite in cold weather. Fortunately, there are simple steps you can take to prevent frostbite.

To avoid frostbite, it is important to anticipate the weather conditions around you - it may be best to minimise your time outdoors if it is extremely cold. Take care to dress appropriately - warm, well-fitting clothes that wick moisture are best. To catch the early signs of frostnip or frostbite, check the appearance of your skin regularly. 

Understanding the causes of frostbite is the first step to avoiding it. Read on to learn how to recognise the warning signs.

What is frostbite?

Frostbite is an injury caused by exposure to intense cold. It most often occurs in the extremities of the body (hands, feet, ears, and nose). 

Blood vessels respond to extreme cold by constricting, which reduces blood flow to the affected body part. Frostbite may develop when this effect is sustained and intensive. Prolonged inadequate blood supply can lead to cell or tissue death. Ice crystals may form inside the frostbitten tissue - this can cause damage on a cellular level by bursting membranes and disturbing structures.¹ 

Symptoms of frostbite

Frostbite injury is divided into four phases that may overlap as the condition progresses - the severity of the frostbite can also vary within the same limb.¹ 

List of stages 

1. Frostnip 

Frostnip is a superficial cold injury that may develop when the skin is exposed to very low temperatures. Where the cold causes the blood vessels to constrict sharply, the affected skin will become pale and numb. 

Frostnip does not cause long-term damage, and can usually be easily remedied by warming up. However, the appearance of frostnip serves as a warning that the weather conditions are conducive to frostbite - it is important that you wrap up warm as soon as you notice its signs.

2. First degree frostbite

As frostnip progresses to mild frostbite, a firm, white or yellow patch may emerge on the affected area. Red, scaly skin is often observed around the frostbite injury. As fluid becomes trapped in the tissues, mild swelling may develop.¹

3. Second degree frostbite

As the cold injury progresses to second degree frostbite, blisters appear on the skin surface. The blisters are filled with a clear or milky fluid, and are surrounded by red, swollen skin.¹

4. Third degree frostbite

An indication that the cold injury has extended past the superficial layer of skin is when the blisters are filled with blood - this cold injury would be classified as third degree frostbite.¹

5. Fourth degree frostbite

Fourth degree frostbite describes an injury that has deepened beyond the dermis (the middle layer of the three major layers of skin), and may involve tissue under the skin, as far as the muscle or bone of the affected body part.¹ 

Frostbite injury can also be classified into two simpler stages:¹

• Superficial frostbite corresponds to first and second degree frostbite. It is expected that there will be no tissue loss in the affected patient 
• Deep frostbite corresponds to third and fourth degree frostbite, and may indicate that the deeper injury could lead to loss of some tissue

Frostbite emergency symptoms

All frostbite requires medical attention to ensure that the affected body part is rewarmed and treated safely - this can help prevent tissue damage. If you observe mild frostbite, call your doctor for advice. If your symptoms are severe, go to your nearest hospital as soon as possible. 

What causes frostbite?

The severity of the frostbite injury depends on environmental temperature, wind chill factor, and duration of exposure. Frostbite is often caused by staying out too long in cold weather, or not wearing warm enough clothing. However, it can also occur due to contact with freezing materials or very cold liquids. 

Risk factors

Ensure that you pay special attention to weather forecasts if you experience underlying health conditions. Previous cold injuries can make you more susceptible to frostbite - take extra care if this applies to you.² 

Certain mental conditions can impair your judgement of temperature or weather conditions, while some medical conditions (such as diabetes or poor circulation) can influence your responses to the cold.

Treatment and home remedies

Home remedies may be appropriate for frostnip, such as rewarming with blankets or a water bath. 

However, all frostbite requires medical attention to avoid tissue damage - seek medical help as soon as you can when you notice the symptoms. While awaiting medical attention, shield the area from further cold, and avoid the frostbitten area from refreezing after it has thawed.¹ Replace any wet clothing with clean, dry clothing if possible.

Complications

Complications of frostbite may emerge months or years after the initial cold injury - certain symptoms can be observed even in healthy individuals who experienced only superficial frostbite.² Possible complications on the affected body part include:

• Increased susceptibility to frostbite
• Increased sensitivity to cold
• Long-term numbness
• Skin colour changes
• Infection
• Chronic pain
• Frostbite arthritis 

How to prevent frostbite

There are proven steps you can take to stop frostbite in its tracks:

1. Plan ahead: Ahead of an outing in a cold area or season, pay attention to weather forecasts and wind chill readings. Avoid environmental conditions that pose a risk of frostbite (below -15^oC), even with low wind speed. Stay hydrated and ensure that you have enough food
2. Dress well: Protect your skin from moisture, wind, and cold by wearing appropriate clothing. Wear insulated mittens rather than gloves, as these provide better protection. Ensure that your socks are not too tight, as this can restrict blood flow and put you at greater risk of frostbite
3. Be ready to respond if conditions change: Stay aware of changes in the weather conditions and check your exposed skin regularly.  Avoid alcohol and drugs if you plan to be outdoors in cold weather, as this can affect perception and judgement

Look out for early signs of frostbite and hypothermia

Hypothermia and frostbite can occur simultaneously, as both result from prolonged exposure to cold environments. As the core body temperature falls below 35^oC, shivering can signal the onset of hypothermia, but this symptom may diminish as the condition worsens.³ A person with moderate to severe hypothermia may experience confusion, difficulty speaking, and may lose consciousness.³ Seek medical attention immediately if you or others around you display symptoms of hypothermia. 

When to seek medical attention

Seek medical attention if you notice symptoms of frostbite or hypothermia in yourself or others around you. If you experience frostnip, you can treat the affected area at home by gently rewarming - but only do this if you are certain this is not frostbite. 

Summary

Frostbite can be caused by prolonged exposure to extreme cold. The severity and risk can vary depending on the weather and some underlying health conditions. Stay warm and safe this winter - ensure that you are prepared for changes in the weather during your time outdoors, and wear appropriate clothing.