Long Logo

Main Line Pediatrics

Are You Sick?

Frostbite

Is this your symptom?

  • Frostbite is a cold injury to the skin
  • Affected areas include fingers, toes, feet, nose, ears and cheeks
  • Symptoms range from cold tingling, and painful skin to white, hard, or numb skin

Symptoms of Frostbite

  • Cold, tingly and painful skin.
  • White, hard, numb skin. It can be serious. It always needs medical care after re-warming.

Cause of Frostbite

  • Health Conditions. You are more likely to get frostbite if you have Raynaud’s Disease, diabetes or have had frostbite in the past.
  • Clothing. Wearing wet clothes makes frostbite worse. Touching bare hands to cold metal during freezing weather can cause frostbite right away.
  • Length of Time in Cold. You are more likely to get frostbite the longer you are in freezing weather. Wind-chill causes you to get frostbite quicker.
  • Other Causes. Some medicines, smoking, alcohol and recreational drugs all raise your risk of frostbite.

Frostbite Severity. Frostbite can be described like burns:

  • Frostnip(mild frostbite). Cold, tingly and painful skin. No skin changes after re-warming.
  • 1st Degree. White and hard skin while frozen. Mild redness and swelling after re-warming. No blisters.
  • 2nd Degree. Same as 1st degree, plus blisters after 24 hours.
  • 3rd Degree. Blood-filled blisters leading to long-term skin damage and scarring.

When to Call for Frostbite

When to Call for Frostbite

Call 911 Now

  • Can't be wakened, or if wakened falls asleep again quickly
  • Speech is slurred
  • Acts or talks confused
  • Stumbling or falling
  • Body feels very cold to the touch (not just hands and feet)
  • Ice crystals on the skin
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • White, hard, numb skin (before rewarming)
  • Skin color and feeling does not return to normal after 1 hour of rewarming
  • Severe shivering still present after re-warming and drying
  • Severe pain still there after rewarming and taking pain medicine
  • You think you have a serious cold injury
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Frostbite skin becomes blisters
  • Blisters start to look infected (spreading redness or pus)
  • Skin damage and last tetanus shot more than 10 years ago
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Mild frostbite

Call 911 Now

  • Can't be wakened, or if wakened falls asleep again quickly
  • Speech is slurred
  • Acts or talks confused
  • Stumbling or falling
  • Body feels very cold to the touch (not just hands and feet)
  • Ice crystals on the skin
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • White, hard, numb skin (before rewarming)
  • Skin color and feeling does not return to normal after 1 hour of rewarming
  • Severe shivering still present after re-warming and drying
  • Severe pain still there after rewarming and taking pain medicine
  • You think you have a serious cold injury
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Frostbite skin becomes blisters
  • Blisters start to look infected (spreading redness or pus)
  • Skin damage and last tetanus shot more than 10 years ago
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Mild frostbite

Care Advice for Mild Frostbite

  1. What You Should Know About Frostbite:
    • Frostbite is caused by exposure of parts of the body to temperatures below freezing for a period of time.
    • It most often affects the fingers, toes and feet, but can also affect the nose, cheeks or ear lobes.
    • Frostbite means the nerves, blood vessels and skin were frozen for a short time.
    • Often occurs to military personnel, people who work outside in the cold, those who do winter sports.
    • The homeless and the elderly are especially at risk.
    • Most frostbite is mild. Most often, it gets better with warming up.
    • Here is some care advice that should help.
  2. Rewarming With Wet Heat:
    • Move into a warm room.
    • For Frostbite of Fingers or Toes. Place the body part in warm water. A bathtub or sink is often the best method. The water should be very warm (104° to 108° F, or 40° to 42° C). It should not be hot enough to burn. Keep soaking in the warm water for about 30 minutes. A pink flush means blood flow has returned to the body part. At this point, the numbness should be gone. The affected part may feel painful as blood flow returns.
    • For Frostbite of the Face(such as ears, nose). Put a warm wet washcloth on the area. You should keep doing this for about 30 minutes. A pink flush means blood flow has returned to the area.
    • With more severe frostbite, the last 10 minutes of rewarming can be painful.
    • If not using a tub, keep the rest of your body warm. Cover with blankets.
  3. Common Treatment Mistakes:
    • A common mistake is to put snow on the frostbitten area or to rub it. Both can cause damage to thawing tissues.
    • Do not re-warm with dry heat. Do not use heat lamps, heating pads or electric heaters. Reason: skin that has frostbite can't sense burning.
    • Do not re-warm if could freeze again in the next few hours. Freezing-warming-freezing causes more harm than freezing-warming.
  4. Drink Warm Liquids:
    • Drink lots of warm liquids such as tea or hot chocolate.
  5. Pain Medicine:
    • To help with the pain, take a ibuprofen product (such as Advil).
    • Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  6. Aloe Vera Ointment for Pain:
    • Put aloe vera ointment on the frostbite.
    • Use twice daily for 5 days.
  7. What to Expect:
    • Frostnip does not cause any damage to the skin. After rewarming, skin feeling, color and softness come back in less than 1 hour.
    • Mild frostbite: After rewarming, the skin may be flushed and tingly. This lasts for a few hours.
  8. Prevention of Frostbite:
    • Cold sensitivity and recurrent frostbite is common if you have had severe frostbite in the past.
    • Dress in layers for cold weather. The first layer should be thermal underwear. The outer layer needs to be waterproof. The layers should be loose, not tight. Mittens are warmer than gloves. Do not use tight gloves or shoes. They might interfere with blood flow.
    • Wear a hat, because over 50% of heat loss occurs from the head.
    • Change wet gloves or socks right away.
    • Make sure you know the first warning signs of frostbite. Tingling and numbness are signs to go indoors.
  9. Call Your Doctor If:
    • Color and feeling do not return to normal after 1 hour of re-warming
    • Frostbite gets blisters
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

Share by: