How to Treat and Prevent Frostbite

For three years, I lived in a suburb of Salt Lake City, Utah. There I sometimes experienced cold weather down to minus 20 degrees Fahrenheit during the wintertime. Frostbite was a real threat and you could readily find all kinds of information about how to identify, treat, and prevent frostbite. I have to admit, when I was asked to write a blog about frostbite, I did ask the question, “Frostbite in Los Angeles?” I was quickly reminded of how close Los Angeles is to mountain resorts with altitudes up to 7,000 feet where there is plenty of snow and freezing weather during the winter months. So whether you live in Los Angeles or somewhere that commonly has freezing temperatures in the winter, frostbite can definitely be a problem, especially if you are not well prepared.​

What is Frostbite?

Frostbite happens when parts of the body freeze. The most common areas of frostbite are areas that are the furthest away from the middle of the body, or body core, such as feet, toes, hands, fingers, nose, cheeks and ears because these are furthest from the heart. Frostbite can occur when the body part is exposed to freezing temperatures for an extended amount of time, or a more brief exposure to cold temperatures when it is also windy. Everyone is at risk in these conditions, but those more at risk are those who are diabetic, take heart medications called ‘beta blockers, have circulation problems, are smokers, drink alcohol during freezing conditions or are elderly or young children.

Three Levels of Frostbite

1. Frostnip: This is when only the surface of the skin gets affected from exposure to the cold. The skin can become red at first and then can turn cold and become numb. The skin remains soft and moveable. There are usually no long-term problems after frostnip. In fact, frostnip can even occur when a first-aid ice pack is applied with no protective layer, such as a towel, placed between your skin and the ice pack. It can also occur if an ice pack is left on the skin for longer than 20 minutes.
2. Superficial frostbite: The skin can freeze and become hard, and it becomes waxy in appearance. Blisters will often occur following this degree of frostbite and can turn black and appear worse than they actually are. This level of frostbite usually heals within one month with proper treatment.
3. Deep frostbite: This is severe. The skin, muscles, tendons, blood vessels and nerves can all become damaged from freezing. The skin is hard and waxy and is not flexible or moveable. Initially, the injury may be painless. Depending on how long and how deep the tissue is frozen, permanent nerve and tissues damage can occur. This level of frostbite may even result in the affected area needing to be amputated.

Treatment for Frostbite

If you have any of the above signs of frostbite, seek medical attention. If medical attention is not available or possible immediately here are some steps that you can take:

1. Get indoors or into a warmer environment as soon as possible and remove any wet clothing. If hands are affected, you can start the rewarming process by using body heat, for instance, holding your hands in your armpits.
2. Do not rub any frostbitten area or walk on frostbitten toes because this can cause further tissue damage. However, if walking outside is absolutely necessary, and the feet are deeply frozen, do not thaw, walk on them while they are still frozen.
3. If re-freezing of the affected area is likely to happen, do not rewarm the frostbitten area because re-freezing can cause additional tissue damage.
4. Rewarm the frostbitten area by application of warm, NOT HOT, water. This can be painful. Medication like ibuprofen or acetaminophen may help. Sometimes, narcotic medication is needed if the pain is severe and unbearable. Warming up by using warm water should be done gradually.

How to Prevent Frostbite

Preventing frostbite is a matter of staying dry, warm and wearing the right clothing for cold temperatures. Here are some recommendations:

Stay Dry

Protect yourself from the cold environment by wearing the right clothing. Wear clothes that are made to pull any sweat or moisture away from your body core, waterproof gloves and footwear.

Keep Your Body Core Warm

Choose good quality clothing and use the layering system.

a) A fitting inner layer, like long underwear, that is made to keep moisture away from your skin

b) An insulating layer over the fitting inner layer to trap the air and circulate warmth between the layers

c) A protection layer on the outside like a shell jacket and pants to guard against the weather

d) Wear a hat (60 percent of body heat can escape from an uncovered head)

e) Wear gloves or mittens that are breathable and waterproof

f) Wear warm socks in waterproof shoes or boots

g) Avoid cotton clothing because it can actually absorb moisture and therefore make you colder in the long run

h) Wear a face mask if you are in windy, cold weather to keep your nose and cheeks covered

I hope that this blog post leaves you knowing a little bit more about frostbite, even if you live in Los Angeles. Next time you are planning a trip to cold weather, be sure and dress with layers, know the signs of frostnip and frostbite and have a great trip!