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All about Frostbite

What is Frostbite?

Frostbite damages your skin if your skin gets into contact with freezing temperatures below 32 degrees Fahrenheit (0 degrees Celsius). Getting out during a cold windy winter can also cause frostbite. Frostbite can affect any part of your body but your fingers, toes, nose, and ears are more prone to it. Though it gets well by itself in a few days, in some instances it can cause permanent and irreversible tissue damage, a condition known as necrosis. To prevent frostbite, you need to limit your time outdoors and often warm up your body if you’re exposed to freezing temperatures. If it’s important to go outside during very cold temperature then take precautionary measures such as wearing warm clothes, beanies, and hand gloves.

What are the Types of Frostbite?

There are no types of frostbite but there are three stages of it that occur gradually including:

– Frostnip: It’s the starting and mild form of frostbite that causes numbness in the affected areas. When your skin warms, the feeling of pain and tingling will be there for some hours but it doesn’t cause permanent skin damage.

– Superficial frostbite: Superficial frostbite causes some small changes in your skin colour. A feeling of warmth is a sign of serious skin involvement. Rewarming  the frostbite at this stage, can make the surface of the skin appear spotty. You might experience feelings of stinging, burning, and swelling. A fluid-filled blister might develop after 12 to 36 hours of rewarming the skin.

– Deep (severe) frostbite: When the frostbite progresses, it starts to affect all the layers of the skin and tissues beneath the skin. The colour of your skin may become white or blue-grey and you might feel no sensation of cold, pain, or discomfort in the area. The functioning of joints or muscles might stop working. Huge blisters will form 1 to 2 days after rewarming and the tissue turns black and hard when they die.

What are the Symptoms of Frostbite?

The symptoms of frostbite include:

– Feeling of cold skin and prickling

– Numbness in the affected areas

– Skin may turn red, white, greyish-yellow, bluish-white, brown, ashen, or purplish based on the severity of the condition and your skin colour.

– Hard or waxy-looking Skin may become hard and waxy-looking.

– Joint and muscle stiffness can lead to clumsiness.

– Blistering

What Causes Frostbite?

Frostbite happens when you get exposed to extreme cold weather which makes your skin and tissues freeze. Having direct contact with ice, freezing metals, or very cold liquids can also result in frostbite. A few causes of frostbite include:

– Being exposed to extreme cold and freezing temperatures.

– Touching things such as an ice pack or metal pressed against your skin may also be a cause of frostbite.

– If you are not wearing sufficient clothing to safeguard your skin from the cold.

– If you stay outside in the cold and wind for a long period, and the air temperature is below 5 F (minus 15 C).

– Staying outside when the willow wind speeds with a temperature of minus 16.6 F (minus 27 C), can cause frostbite on exposed skin within 30 minutes.

What are the Risk Factors of Frostbite?

The risk factors of frostbite may include:

– Medical issues that affect your capability to feel or respond to cold, like dehydration, exhaustion, diabetes, and poor blood circulation in the limbs.

– Drinking alcohol, smoking or drug use increases the risk of frostbite

– Anxiety, fear, panic, or mental condition that might weaken your ability to judge.

– If you earlier suffered frostbite or cold injury, then the chances of getting it again increases

–  Infants and older adults are more prone to frostbite because them having a tough time producing and retaining body heat

–  Visiting places with high altitudes, where there’s less oxygen can cause frostbite.

What are the Complications of Frostbite?

The complications of frostbite include:

– You might become abnormally sensitive to cold

-If you had frostbite once, then it may appear again

– The affected areas become numb

– Sweating excessively

– Changes in the colour of your skin

– Changes or loss of nails

– Stiffness in the joints of the body, a condition known as frostbite arthritis

– Growth-related issues in children, if a bone’s growth plate is damaged because of frostbite

– Infection

– Tetanus if you don’t take tetanus injection within 24 hours

– Decay and death of tissue because of  interrupted blood flow in the affected area — which can lead to amputation in severe cases


How Frostbite is Diagnosed?

Doctors can diagnose frostbite just by looking at the appearance of the affected area further a physical exam and possible imaging tests might be taken to make sure that it’s frostbite and not some other skin condition. During the physical exam, your doctor will examine the discoloration of the skin or symptoms such as mottling or blisters. You may be asked questions such as how long you have been exposed to cold weather. Some tests  may be prescribed to check the severity of the frostbite, and damage to the bones or muscles.

– Bone scan: It is done by using nuclear imaging to check the damage in the bones that might occur because of frostbite.

– MRI: Magnetic fields are created along with computer-generated radio waves to create detailed images of the affected area which can be helpful to diagnose frostbite.

– X-Ray: An X-ray is a rapid, and painless test that produces images of the structures inside your body — particularly your bones and helps to diagnose frostbite.

What are the Treatment Options Available for Frostbite?

The mild form of frostbite can be treated in the home as it mostly gets better by itself or by using some first aid care. If frostbite is more than just mild then there are various treatments available including:

– Rewarming the skin: If your skin is not rewarmed already, your doctor will rewarm the affected area with a bath for 15 to 30 minutes with warm water which makes the skin soft. You will be asked to move the affected area gently as it rewarms.

– Oral pain medicine: The process of rewarming can be painful, and a painkiller may be given to you orally to reduce the pain.

– Safeguarding the injury: After warming and cleaning the affected area, it might be wrapped with sterile sheets, towels, or dressings to save the skin. Also, your fingers or toes can be protected by gently separating them from each other. You may be required to take proper care of the affected area to decrease swelling.

– Removal of damaged tissue: To heal the frostbite properly, the frostbitten skin needs to be removed.  To distinguish between healthy and dead tissue, a doctor might wait 1 to 3 months before getting rid of damaged tissue.

– Whirlpool therapy or physical therapy: Here the frostbitten area is soaked in a whirlpool bath as it can heal the affected area by keeping skin clean and naturally eliminating the dead tissue.

– Infection-fighting medicines: Frostbite can cause various types of infections like blisters and oral antibiotics given to fight the infections.

– Clot-busting medicines: An intravenous (IV) injection of a drug may be injected into your body as it is helpful to restore blood flow.  TPA reduces the risk of amputation but these might have some side-effects about which your doctor will tell you in advance.

– Wound care: It’s very important to take care of the wound based on the extent of the injury.

– Surgery: Surgery is done when the other treatment procedures are not working and the frostbite is quite severe. Surgery or amputation is mostly done to get rid of dead or decaying tissue.

Living with Frostbite

Mild frostbite usually goes away within a few days but if it’s severe then there can be various complications that may affect your daily activities and performance at your job or studies. The amount of period to treat your frostbite skin may vary according to the stage of frostbite you were in and the time you have it. If you have very mild frostbite, you might be healed within a few days to a few weeks but in the second stage it takes nearly six months to get healed and in the third and most severe stage there may be permanent skin damage. Surgery may be needed to repair this type of frostbite.

Whom to Consult?

You should immediately visit a doctor if you have been outside in cold weather and are experiencing the symptoms of frostbite. There may be pain, swelling, inflammation, or discharge in the area along with fever it may be frostbite. Also seek emergency medical assistance if you think that you have hypothermia, a condition where the body loses heat quicker than it can be produced, and can be quite serious.

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