How and why to protect against frostbite as the region plunges below zero

Closeup of red berries covered with frost
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By Wynne Armand, MD

Harvard Gazette

Whether you and your family are embracing the pleasures of the winter season with ice skating and snowball fights, or reluctantly venturing outdoors to walk the dog and shovel snow, be aware of the health hazards of this cold snap… like frostbite.

Here’s why you don’t want to mess with frostbite

Frostbite can occur even after minutes of exposure to sub-freezing temperatures and wind chill. It develops after exposure to severe cold leads to freezing and injury of tissue with destruction of cells. The inflammation that follows frostbite can cause further tissue damage. The more commonly affected areas are the ears, face, fingers, and toes.

So how do you recognize trouble?

A precursor to frostbite is frostnip, when the cold hasn’t caused any permanent tissue damage. The skin might be red or pale and painful. As early-stage frostbite sets in, the affected areas might feel numb. The skin may feel cold and harder, and become paler or grayish-yellow, and later develop blisters.

Some conditions and situations can increase the risk for frostbite, like dehydration, circulation problems, nicotine and alcohol use, or inadequate shelter and clothing. Also, always be mindful that infants and young children are more vulnerable, and may not be able to recognize these early symptoms and take steps to protect themselves.

What to do if you think someone has frostbite

If you think you are dealing with frostbite, try to get to warmth as soon as possible. However, don’t try to rewarm the frostbitten areas if there is a chance of refreezing, since that can lead to even more tissue damage. Similarly, avoid walking on frostbitten feet, but if that’s not possible and you must walk to get to a warm environment, do not try to rewarm your feet until out of the cold. Once you are out of the cold, safer ways to rewarm the frostbitten areas are with body heat (e.g., fingers into the armpits) and warm (not hot!) water. Don’t try to warm frostbitten tissue by rubbing or using a heating pad, stove, or the heat of a fire. If symptoms don’t improve, go to the hospital promptly for further medical care.

Keeping frostbite at bay

Though it is important to recognize early signs of frostbite and know how to begin safe home care, here’s where taking steps for prevention for you and your family goes a long way toward a healthier and more delightful winter season.
•Pay attention to the weather forecast.
•Dress appropriately, with layers, moisture-wicking clothing, and other winter wear like hats, mittens (better than gloves), ski masks, and sunglasses or goggles.
•Make sure everyone is hydrated and nourished.
•Skip the alcohol and cigarettes.
•Ditch the ointments, which actually might not protect exposed skin but can increase the risk, contrary to popular thought.
•When outside, avoid direct contact with metal and water.
•Get out of wet clothes as soon as possible.

Closeup of red berries covered with frost

(Published with permission from Harvard Gazette.)



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