Frostbite can be serious
Red or pale skin, numbness, or a tingling sensation while outside on a cold day can be the first signs of frostbite, a condition that can have serious consequences.
Frostbite is caused by freezing of skin and underlying tissue. Ice crystals can form in the skin, and depending on how deeply tissue freezes, can cause tissue death.
As frostbite progresses, it affects all layers of the skin.
Physician Alisha Schmidt, family practitioner at Hillsboro Community Hospital and Clinic, wants people to be aware of the danger of frostbite during cold weather.
“This is definitely enough to cause frostbite,” Schmidt said of Monday’s temperature in the low teens and wind chill of -4 degrees.
Schmidt said other factors besides temperature come into play with frostbite.
“It has to do with the rest of the elements,” she said.
Wet along with cold is more dangerous, she said. A combination of snow and sleet increases the chance of frostbite.
How prepared someone is to be outside in the cold is a factor. Whether they are dressed appropriately, how long they are exposed, and whether their nose, ears, and fingers are uncovered make a difference, Schmidt said.
“There are a lot of people ice fishing right now,” Schmidt said.
Though an activity many people love, it exposes them to both cold and wet.
“Wet is definitely much colder than dry,” Schmidt said.
Just minutes of exposure to wet and cold can be enough to cause frostbite, she said. People with less reserve, who are very young or old, or who have a chronic disease are more susceptible.
Nurse practitioner Jaynette Miller at St. Luke Hospital and St. Clinic in Marion also encourages people to take precautions to prevent frostbite.
“Make sure you are dressed properly if you are going out in this weather,” Miller said.
Not only are ears, face and fingers at risk, so are toes, Miller said. Toes are the furthest from the core of the body and more likely to be submerged under snow.
“They need to be seen by a practitioner when they’ve passed frostnip — once you get into frostbite,” Schmidt said.
Miller said to see a practitioner for blistering, redness, a lot of pain, or swelling. Blisters can be blood-filled as well as fluid-filled.
“See a doctor within a day or two if you’ve got blisters and a lot of pain, or if there’s numbness and it stays numb,” Miller said.
On the other hand, there are times to go to an emergency room.
“If you’re having a lot of pain or blistering, you also can be seen in the ER,” Miller said. “You can also be seen at ER if there is open draining of blisters.”
The first stage of frostbite is called frostnip. Symptoms of frostnip are pale or reddened skin and a feeling of being very cold. As skin warms, it can be painful or tingly. It does not cause permanent damage.
Schmidt said using warm — not hot — water to rewarm the skin, or gently warming at a distance from a heat source, is a way to treat frostnip.
Reddened skin that turns white or pale is a sign of frostbite. Although frostbitten skin can remain soft, ice crystals may form below the skin. If skin begins to feel warm, that indicates serious skin involvement.
Rewarming frostbitten skin can cause it to turn blue, purple, or mottled, and cause burning, stinging and swelling. Blisters can appear as much as a day and a half later.
One thing a practitioner can do is give a tetanus shot, Schmidt said.
“Tetanus is very preventable with a shot and can be bad when you get it and there is not a lot of treatment,” Schmidt said.
She recommends people wear hats and face protection, such as sunglasses or goggles. Mittens keep hands warmer than gloves. Layers of clothing help protect against the cold, she said.
“Eat enough when you’re out in the cold,” Schmidt said. “Avoid alcohol and smoking. Don’t touch metal or water. Carry some emergency supplies with you.”
Schmidt recommends getting to a warmer place as soon as frostbite appears, and removing wet clothing.
Hands can be gently warmed in the armpits or groin.
“Warm is much better than hot for warming up,” Schmidt said. “Don’t use a fire to warm up. If your hands are numb, you can’t feel how hot it is.”
Another form of frostbite prevention is having warming supplies, including blankets, in a car.
“If you are stranded in a car, having the right supplies can make a difference,” Miller said. “And be aware of the wind chill. It can be 20 degrees, but if the wind is blowing hard, it can be very cold.”
Last modified Jan. 18, 2018