Keep Your Skin Safe from Frostbite

By Mary Ann McNeil, M.A., NREMT-P

Mittens, scarves, hats, coats, and boots; all important clothing designed to keep out Minnesota's winter weather. These layers are especially important to prevent frostbite.

Almost everyone has experienced the milder version of frostbite, frost nip, at some point in his or her life. The skin reddens and starts to tingle, but the sensation goes away within 15 to 30 minutes of exposure to a warm environment. Frostbite, however, is more serious, as it actually freezes the skin.

There are four degrees of frostbite; the higher the number, the deeper the skin is frozen. In superficial, or first-and second-degree frostbite, the skin begins to freeze, becoming hard, numb, and white. With third-degree frostbite, the freezing continues; clear blisters begin to form and the skin swells. This injury should be seen by a physician. The fourth degree of frostbite is characterized by blood-filled blisters. Do not break these. Instead, treat the skin with care and go directly to an Emergency Department.

Superficial frostbite is the most common of the bunch, and it can usually be treated at home. First, get out of the cold and remove any wet clothing. Do not attempt to re-warm yourself while still in the cold. Using disposable heating packets can make frostbite even worse. Although the packets temporarily warm the affected area, they will eventually give out, causing the skin to refreeze. In addition, rubbing the body part to stimulate warmth will do further damage.

The most effective method of re-warming superficial frostbite is by taking a warm bath, between 104 and 107 degrees Fahrenheit. Avoid hot water, it will burn the skin. Showers should also be avoided. The beating of the water will damage skin. Stay in the bath for 15 to 30 minutes, making sure to keep the water tepid by constantly refilling the tub. Along with a bath, drink warm decaffeinated liquids. It may be painful as the skin begins to defrost.

Tissue around the site should be warm and pliable after re-warming. In three to four hours the skin may begin to swell. Elevate the area to reduce swelling. A non-prescription pain medication will help the swelling and reduce pain. In severe cases, a loss of sensation can be permanent. If the swelling persists after five days, consult a physician.

Taking preventative measures against frostbite is vital during winter. Layers should be worn while outside during below-freezing temperatures; cover all exposed skin. Wool, silk, or high tech clothing are preferable to cotton and other absorbent materials. These will soak up moisture from melting snow and perspiration, wicking heat away from the body at a fast rate.

Being well hydrated during the winter months is difficult, but important to help guard against dry, damaged skin. Make sure you drink plenty of water and use those skin creams you may have lying around the house. If you're planning on spending an extended period of time outside, abstain from using alcohol or drugs. They slow circulation and reduce awareness. It's important to remember that the most effective treatment for frostbite is prevention.

Mary Ann McNeil is administrative director for the Department of Emergency Medicine at the University of Minnesota Medical School.

Health Talk & You is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu. For comments or questions about Health Talk & You e-mail buss@umn.edu.