Frostbite is damage to skin and tissues from prolonged exposure to below-freezing temperatures. Frostbite severity is based on the depth of tissue injury. The most severe frostbite can lead to permanent damage and/or amputation.
The most common parts of the body to become frostbitten include your fingers, toes, ears, nose, chin, or cheeks.
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Exposure to below-freezing temperatures can cause the body tissue to freeze. Ice crystals form within the frozen body part. Blood cannot flow through the frozen tissue. This causes the frozen tissue to be deprived of blood and oxygen. The combination of freezing and oxygen deprivation causes tissue damage or tissue death. Rewarming may also ultimately lead to tissue death.
Factors that may increase your chance of getting frostbite include: Exposure to below-freezing temperatures without adequate covering
Low body temperature, a condition known as
hypothermiaBeing very young or very oldHomelessnessFatigueHistory of previous cold weather injuryHigh-altitude cold exposureWorking in below-freezing conditionsParticipating in winter sports or high-altitude sportsWearing wet clothing
Suffering from a condition that affects your mental status such as:
Head injuryMental illness
Use of mind-altering drugs or
alcoholInability to move
Using drugs that cause your blood vessels to become constricted
Medical conditions, such as:
MalnutritionThyroid problemsInfectionDisease of the blood vesselsArthritisDiabetesRaynaud's phenomenon
Early stages of frostbite may cause: Weakness or clumsiness with extremities, such as with your hands or feetNumbness, stinging, burning, or tingling sensationAreas of white skin blended with or next to healthy-looking skinColdness or firmness of tissuePain, especially during the thawing processInflammation may occur during the thawing process
Later stages of frostbite may cause: Waxy appearance of the skinBlisters that may be filled with clear or bloody fluidColor ranging from white to blue, depending on severityJoint pain
You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is usually based on symptoms and the findings of the physical exam.
Rapid rewarming in a warm (100°F to 110°F [37.8°C to 43.4°C]) water bath is the treatment of choice. Slow rewarming may cause more tissue damage.
If you are stranded with frostbite and unable to get medical help: Try to get to a warm location. Wrap yourself in blankets.Do not put snow or hot water on the injured area.Do not rub affected areas.Tuck your hands into your armpits to try to rewarm them.If it's available, use warm water (at about 105°F [40°C]) to rewarm your frostbitten area.Avoid refreezing the affected area. This can result in more severe injury.Walking on frozen feet and toes can cause damage. It may be more important to find shelter.Drink warm liquids.Avoid alcohol and sedatives.Cover the injured area with a clean cloth until you can get medical help.
Rewarming can be intensely painful. To relieve pain, take an over-the-counter pain medication such as acetaminophen or ibuprofen.
If you're able to get medical assistance, treatment may include moving you to a warm place and wrapping you in blankets.
The injured body part may be soaked in warm (not hot) water.
Other treatments may include: Opening and emptying blistersAntibioticsPrescription pain medicationNonsteroidal
anti-inflammatory drugs (NSAIDs) to reduce inflammationAloe vera gel or other ointments to relieve inflammation and promote healingDrugs to prevent blood clots in the first 24 hoursVasodilators after 24 hours if needed due to lack of improvementElevation of the injured body part above your heart
tetanus booster shotHyperbaric oxygen therapy
—this is a special chamber that uses oxygen under greater pressure than normal to help with blood flow and tissue repair
Amputation of all or part of the affected body part in severe cases
To help reduce the chance of frostbite, take these steps:
Dress properly when going outside in cold weather:
Cover your head, face, hands, and feet adequately.Wear layers of clothing.Wear materials that provide good insulation, such as wool, polyester, or polypropylene. It should keep moisture away from the skin.Wear a waterproof outer layer and stay dry.Avoid drinking alcohol when you will be in cold weather.Stay hydrated by drinking water.Recognize signs of early frostbite, such as numbness, paleness, and difficulty grasping objects with your hands.Treat early frostbite promptly with the body heat of a companion by using their abdomen or armpit for warmth.
Frostbite. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated December 15, 2011. Accessed September 25, 2014.
Frostbite. Kids Health—Nemours Foundation website. Available at:
http://kidshealth.org/parent/firstaid_safe/emergencies/frostbite.html. Updated April 2011. Accessed September 25, 2014.
Winter weather: frostbite. Centers for Disease Control and Prevention website. Available at:
http://emergency.cdc.gov/disasters/winter/staysafe/frostbite.asp. Updated December 3, 2012. Accessed September 25,2014.
Last reviewed August 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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