Frostbite is skin damage caused by freezing temperatures below 32 degrees Fahrenheit (0 degrees Celsius). You’re more likely to get frostbite in any situation that leads to prolonged cold exposure:
During the winter.
In windy weather conditions.
At high altitudes.
If you don’t have shelter from the cold weather.
You can get frostbite even under cold-weather clothing.
Frostbite may lead to permanent, irreversible tissue damage (necrosis). A way to prevent frostbite is to limit your time outdoors and warm up your body often if you’re exposed to freezing temperatures.
If you believe you have frostbite, go inside or seek shelter from the cold. Then, call your healthcare provider or visit the emergency room immediately to reduce your risk of tissue damage.
What does frostbite look and feel like?
Symptoms of frostbite vary based on what stage you’re in and the severity of skin damage that the cold caused.
Frostnip: During frostnip or the first stage of frostbite, you may see that your affected skin is red to purple or lighter than your natural skin tone. Your skin may also feel cold, slightly painful and tingly. Frostnip is the warning stage when skin damage is just temporary. If you notice symptoms, get inside immediately and thaw the affected area of skin with warm (never hot) water. Afterward, you may notice small red bumps (chilblains) on your skin. Even if you have mild symptoms, visit a healthcare provider to make sure you don’t have long-term damage from frostnip.
Superficial (surface) frostbite: This is the second stage of frostbite, and it requires medical treatment. Your skin might feel warm, but the water in your skin is slowly freezing into ice crystals. Your skin contains over 60% water. This can cause a “pins and needles” feeling. In addition, your skin may sting or swell up. After rewarming, you might have painful, spotty patches or purple or blue areas of skin like a bruise. Your skin might start to peel and feel just like a sunburn. You may also get fluid-filled blisters in the area after a day or so.
Severe (deep) frostbite: In the third stage of frostbite, your lower layers of skin (subcutaneous tissue) freeze and total numbness sets in. It can be difficult to move the area that’s frostbitten or you may not be able to move it normally. Get medical attention immediately if you experience any of these symptoms. Big blisters will appear on the frostbitten skin a day or two after cold exposure. Your frostbitten skin turns black because your skin cells die after freezing. Your skin might form a hard, black covering (carapace) that falls off on its own. If it doesn’t, a healthcare provider will remove it surgically.
Frostbite is dangerous because it often numbs your skin so you may not feel that anything’s wrong at all. Contact a healthcare provider if you believe you have frostnip or frostbite.
Can you have frostbite and not know it?
Yes. Many people who get frostbite are completely unaware that they have it. This happens because frostbite numbs your nerves and can cause damage deep inside your skin. You might not notice any symptoms after coming in from the cold. It’s important to limit your time outdoors in freezing temperatures to prevent frostbite.
Where are common places to get frostbite?
Frostbite can affect any part of your skin, but you’re more likely to get frostbite on your extremities. These are parts of your body that are the most exposed to cold temperatures, even if they’re bundled up and include your:
Hands and fingers.
Feet and toes.
Face and nose.
Ears.
How do I know if my child has frostbite?
It can be difficult to tell if your child has frostbite. Infants don’t shiver like adults because they don’t have as much energy stored up. Older children are usually too busy having fun outside to notice they’re frostbitten.
If your baby or toddler is outside in the cold for even 10 minutes, it’s time to check on them. If you notice parts of their skin are lighter than their natural skin tone, red, white or gray, contact their healthcare provider.
If your children are older and they’ve been outside for more than half an hour in freezing temperatures, even with cold weather clothing on, ask them to come inside and remove their wet clothing. They should put on dry clothes and warm their body under blankets. A warm bath may also help your child warm up from the cold. Always use lukewarm, never hot, water.
How do you get frostbite?
Freezing temperatures cause frostbite. Cold temperatures (slightly above freezing) for long periods of time can also cause frostbite. You can get frostbite by:
Exposure to freezing temperatures.
Having frozen objects like an ice pack or metal pressed against your skin.
Not wearing sufficient clothing to protect your skin from the cold.
Even if you’re wearing protective clothing like a hat, boots and gloves, you can still get frostbite through your clothing.
When you get frostbite, the water within your skin freezes and crystalizes. Over 60% of your skin contains water. This damages your skin cells and tissues, which prevents blood flow to these areas of your body. Severe frostbite can damage your muscles, nerves and joints.
How long does it take for you to get frostbite?
You can get frostbite in 30 minutes or less when the wind chill is -15 F (-26 C) or lower. If you live or work in cold climates, try to limit your time outdoors to prevent skin damage.
How cold does it have to be to get frostbite?
Freezing temperatures cause frostbite. It needs to be colder than 32 F or 0 C for you to get frostbite. Remember that the temperature may be significantly colder if there’s wind, which can increase your risk of getting frostbite.
How is frostbite treated?
Treatment for frostbite varies based on the stage.
If you show signs of frostnip, go indoors or find shelter to get out of freezing temperatures, if possible. Next, take these steps to warm your affected skin:
Gently remove your cold weather gear, like gloves or boots. You should also remove any jewelry like rings or watches if they’re near an affected area of skin. If your clothing is wet, put on dry clothing.
Place your affected skin in a bath of warm (not hot) water. This will be a slow rewarming process that can take at least 30 minutes.
Place blankets on your affected area of skin. Don’t wrap blankets around your skin because it could cut off circulation and prevent blood flow to your affected tissues.
Avoid applying heat directly to your skin to prevent burns.
If you have signs or symptoms of surface or deep frostbite, which are the second and third stages of frostbite, visit a healthcare provider immediately for treatment. Time is critical with frostbite. You may experience severe pain with frostbite as your skin thaws.
To treat frostbite, a healthcare provider will:
Raise your body temperature in lukewarm water or by applying warm, wet packs to your skin for up to 30 minutes.
Apply wound dressings to your frostbitten skin with sterile bandages, keeping your fingers and toes separated to avoid rubbing.
Test blood flow in the affected area of your body. If you have stage three frostbite, your provider may also connect you to an IV (a needle that enters a vein in your arm to deliver fluids) to improve your circulation.
Give you antibiotics and pain relievers, such as ibuprofen (Advil®, Motrin®).
Rehydrate your body by giving you water (frostbite dehydrates your tissues).
Give you oxygen therapy. For extreme frostbite, your provider may have you breathe pure oxygen inside a pressurized room. This treatment, called hyperbaric oxygen therapy, helps some people heal faster by increasing their blood-oxygen levels.
Do I need surgery for frostbite?
For severe cases of frostbite, your provider may need to perform surgery to remove any dead skin and tissue after you heal. It may take days or even months to determine if you need surgery. Surgeons may need to remove (amputate) the fingers or toes if your tissue died or if you develop gangrene.
Can I treat frostbite at home?
You should seek care from a healthcare professional if you have frostnip or frostbite. If you’re in a remote area or you’re unable to go to the hospital right away, you can take steps to treat frostbite at home to prevent it from damaging your skin and tissues. Your priority is to make sure you stay warm. You should find shelter and prevent warming and refreezing of your body, which can cause more severe skin damage. To warm up, follow these steps:
Remove all wet clothing and put on dry clothing.
Elevate the injured area slightly.
Warm your skin by soaking the frostbitten area in warm water, around 98.6 F to 102.2 F (37 C to 39 C). It can be difficult to determine the temperature of the water, as your skin may be numb. Use a thermometer if you have one available. When your skin feels soft again or after at least 30 minutes, you can stop warming it.
Cover your frostbitten area with a clean cloth. If your fingers or toes are frostbitten, wrap each one individually. Make sure you keep them separated to avoid stress or pressure. Avoid tightly wrapping your fingers and toes to allow blood to circulate easily.
Try not to move the area at all while you’re thawing. Avoid walking on frostbitten toes or feet.
Don’t rub frostbitten areas because rubbing skin that’s hard or numb can cause tissue damage.
You may experience pain during the thawing process. This is normal. You may take over-the-counter pain relievers as directed by your healthcare provider.
How is frostbite diagnosed?
A healthcare provider will diagnose frostbite after a physical exam and possible imaging tests. During your exam, your provider will look for skin discoloration or other skin symptoms like mottling or blisters. Your provider will also ask you questions about your cold exposure. For example, how long were you exposed to freezing temperatures and what was the temperature during exposure?
Depending on the severity of your symptoms, your provider may take an imaging test like an X-ray to look beneath your skin for tissue damage.
What’s a sign of permanent skin damage from frostbite?
Your healthcare provider will let you know whether or not your skin damage is permanent. An indication that you have temporary skin damage is the presence of clear blisters. If you have blood-filled blisters, you may have permanent damage. If your skin turns black or darker than your natural skin tone, that’s a sign of severe tissue damage. In that case, you may need surgery to remove your damaged skin to prevent secondary infections or gangrene.
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