When you’re outdoors in the cold, you might notice that your fingers or toes feel numb or tingly. That could be a sign of frostbite, which is when your skin and tissue freeze because they’re exposed to cold.
Frostbite is worse than just feeling cold. It can cause long-lasting damage if you’re not careful. Jasjot Johar, MD, an emergency department medical director with Banner Health, explained more about what frostbite is, the symptoms, how to treat it and how to prevent it.
What happens in the body during frostbite
“Our bodies are made mostly of water. And we all know that water can freeze. Unfortunately, that also means that the cells inside of our body can freeze when they are exposed to cold for too long. Muscle, skin, fat and even our blood can freeze,” Dr. Johar said.
“There are two parts to the injury,” said Dr. Johar. “First, the freezing causes ice crystals to form within cells, causing damage. And second, when blood is moving very slowly it can lead to blood clots and loss of blood flow to skin, muscle and even bone.”
The freezing process can destroy cells. Your fingers, toes, nose and ears are at risk of superficial frostbite. Deep frostbite can damage muscles, tendons and bones. The loss of blood flow and oxygen causes cells to be seriously damaged or even die and some of these body parts may never recover.
“Frostbite injury can be a temporary inconvenience or a permanent loss,” Dr. Johar said. “The worst injuries occur when tissues freeze, thaw with rewarming and then re-freeze.” This cycle leads to an increased risk of amputation.
Who is at risk for frostbite
Anyone who’s out in the cold for too long or isn’t prepared for cold weather could get frostbite.
The risk of developing frostbite is higher for people who:
- Have dementia and wander from their home or facility
- Are very young or very old
- Are homeless
- Are using drugs or alcohol
- Take part in outdoor activities
- Are shoveling snow
- Are victims of motor vehicle accidents
If you’re a parent or caregiver of a baby or young child, you should make sure they are well-protected from the cold.
“Babies are especially susceptible to frostbite. They have less ability to control their body temperature and they lose heat faster. Also, babies and younger children may not be able to communicate when they are getting uncomfortably cold,” Dr. Johar said.
Symptoms of frostbite to watch for
Spotting the early signs of frostbite can give you time to treat it right away and reduce your risk of more serious health problems. Watch for:
- Numbness, tingling or a “pins and needles” feeling in a body part. “Sometimes we think it’s normal for our fingers, toes, nose or ears to go numb when we get very cold. But this is not safe or healthy. Numbness, tingling or a burning sensation can be the first signs of unhealthy or excessive cold exposure,” Dr. Johar said.
- Hands or feet that feel cold or clumsy.
- Skin changes, which can be an early symptom of frostbite. “Waxy skin, pale white skin or a dusky dark discoloration to the skin are all signs that deeper damage is occurring,” Dr. Johar said.
- Loss of feeling and stiffness in fingers, toes or other exposed parts.
- Later signs like blistering, swelling or tissue that’s dark after warming. “Unfortunately, sometimes you won’t notice symptoms until you start to rewarm. That’s when pain can be severe, blisters can form or color might not return to normal,” Dr. Johar said.
Treatment for frostbite: How to respond safely
“The first step is to stop exposure to cold,” Dr. Johar said. “If you are wet, make sure you remove clothing immediately.” Wet clothing can make your skin and cells freeze more quickly.
After that, for treating frostbite you should:
- Warm the affected area, using warm (not hot) water that’s about 100°F. If you don’t have access to warm water, you can use body heat. For example, you can place your fingers under an armpit. “We recommend rewarming as long as there is no risk of refreezing, which is often devastating,” Dr. Johar said.
- Cover the area in dry, loose bandages.
- Avoid rubbing or massaging the area, using heating pads or exposure to open flames. “That can cause more cellular damage,” Dr. Johar said.
- Keep the affected area elevated to reduce swelling.
- Separate fingers or toes to prevent damaged tissue from sticking together.
Get medical care for:
- Blistering
- Discoloration that doesn’t improve after rewarming
- Frostbite in fingers or toes that does not improve very quickly
- Deep tissue damage
- Frostbite that affects large areas
In some cases, doctors can give you medication to thin your blood, dissolve clots and get your blood flowing again.
Emergency department doctors might refer you to a burn center. “Frostbite is considered a ‘cold burn’ and is frequently managed in burn centers,” Dr. Johar said. “The burn center specializes in wound healing and pain management in an environment designed to prevent infection.”
After health care providers treat frostbite, follow-up care may include wound care, rehabilitation and pain management.
Healing from frostbite can take a long time. “If someone gets frostbite in January, they may still require surgery for that frostbite in June,” Dr. Johar said.
After frostbite, you might still notice burning pain, sensitivity or numbness in damaged tissues. You’ll need to be extra careful to protect those areas from frostbite in the future.
Why prevention matters and how to protect yourself
“Even with the best of care, many people do not fully recover. It is important to focus on ways to prevent frostbite,” Dr. Johar said.
In cold weather, staying dry and warm is key. “Water conducts cold temperatures much faster than air. You will lose heat significantly faster in wet clothing. If you do accidentally get wet, it’s important to remove the wet clothing immediately and seek warmth and shelter,” Dr. Johar said.
“For example, if you’re on a winter hike and you accidentally step through a frozen puddle or even just get your socks wet, turn around and head for your car right away. Continuing on your hike can be extremely hazardous unless you are prepared with extra dry clothing,” he said.
These tips can also help you protect yourself against frostbite:
- Limit the time you spend in extreme cold and monitor your body temperature and exposed areas.
- Don’t drink alcohol before or during cold exposure. Alcohol doesn’t help keep you warm. Instead, it dilates blood vessels and reduces body temperature control.
- Protect your fingers, toes, nose and ears with gloves, warm footwear, hats, scarves and masks.
- Take breaks in a warm place when you’re out in the cold.
- Build good habits: Check the weather, plan for cold temperatures and always have a backup plan.
Key takeaways
- Frostbite is more than feeling cold. It can cause real tissue damage and long-term health issues.
- Preventing frostbite is much easier and safer than trying to fix serious injuries later.
- Recognizing symptoms of frostbite early and treating them can minimize damage.
- Seek medical help if you suspect deep frostbite.
- If you’ll be spending time in cold weather, talk with a Banner Health provider about how to stay safe.
