January To Your Health: Frostbite
Hello and welcome to this chilly edition of the HCAM medical segment, To Your Health. I’m Dr. Jim Kenealy.
You knew it was coming and it’s finally here – the cold, frosty weather and snow that makes New England a winter play-land. It’s time to break out the skates, skis, or snowboards, and fire up the snowmobile. As you enjoy your particular version of frigid fun, beware of frostbite. Though we often think of it as a minor nuisance, it can lead to pain, disfigurement, and even amputation.
Frostbite is an injury to the body that is caused by tissues freezing. Ice crystals form in our cells and disrupt them, causing damage – a cold burn, if you will. Blood cannot flow adequately 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. Frostbitten areas have a loss of feeling and color. They become white or grayish-yellow, are very cold, and have a hard or waxy texture. The skin may itch, burn or feel numb. Severe or deep frostbite can cause blistering and hardening. As the area thaws, the flesh becomes red and painful. And, like burns, frostbite injuries can be rated in severity. First-degree frostbite, or frost nip, is the mildest. Fourth-degree frostbite is the most severe.
Frostbite most often affects exposed areas, such as the nose, ears, cheeks, chin, fingers, or toes. The risk of frostbite is increased in people with reduced blood circulation and among people who are not dressed properly for extremely cold temperatures. High altitude, wind chill, fatigue, wet clothing, young or advanced age, and certain medical conditions, such as diabetes, thyroid disease, arthritis, and poor circulation, all present an increased risk of frostbite. Contrary to popular belief, consuming alcohol makes the problem worse, not better.
To prevent frostbite, bundle up, in layers, with dry clothing. A wicking base layer keeps sweat from freezing on your skin, while a waterproof outer layer keeps you from getting wet. Mittens conserve heat better than gloves and warm socks with insulated boots are a must. Provide protection and coverage for your ears, nose and lips. If it is extremely cold, or there is a significant wind chill, snow goggles can protect your corneas from freezing.
If you do suffer frostbite, do not try to reinvigorate the area by rubbing it with snow, massaging it, or slapping it against your body. This just increases tissue injury. Unless absolutely necessary to find shelter, do not walk on frostbitten feet or toes—this also increases the damage.
You can take advantage of natural body heat by tucking frostbitten fingers in your armpits or groin. The most important thing is to seek shelter in a warm, dry place. Rapid rewarming in a warm (100°F to 110°F) water bath is the treatment of choice, as slow rewarming may cause more tissue damage. Don’t use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for rewarming. Frostbitten areas are numb and are easily burned. Avoid refreezing the affected area. This can result in more severe injury.
Rewarming can be intensely painful. For pain relief take either Acetaminophen (Tylenol) or Ibuprofen (Advil, Motrin). Elevating the frostbitten area, wrapping oneself in warm blankets, and drinking warm liquids are all helpful home remedies.
For anything other than minor frost bite, it’s important to seek immediate medical attention. For more severe injuries a tetanus shot, antibiotics, narcotics, draining blistered tissue, hyperbaric oxygen therapy, and even surgery may be required.
So layer up, stay warm and dry, and enjoy this cold snap! The heat and humidity of summer is only a few months away.
For HCAM-TV, speaking To Your Health, I’m Dr. Jim Kenealy.
Frostbite Websites:
American Academy of Family Physicians
< ahref="http://www.bt.cdc.gov/disasters/winter/staysafe/frostbite.asp">Centers for Disease Control (CDC)
Mayo Clinic