How do I know if I have frostbite?

Q: I was out in the cold in tennis shoes for a long time. When I came inside my toes were blue and hurt really bad for a few hours. Did I get frostbite?

A: Frostbite occurs when tissue freezes.  The condition mainly affects the fingers, toes, ears, cheeks and nose, but any body part can freeze – even your eyeballs!  When exposed to prolonged cold temperatures, blood flow is decreased to the extremities and diverted to more vital organs, like your heart, lungs and brain.  Unfortunately, this leaves the vulnerable areas even more at risk.

There is a spectrum of severity in frostbite.  Superficial frostbite occurs when the areas of the skin close to the surface freeze. There is often a burning sensation, numbness, or tingling.  Affected tissue becomes cold and white, but maintains some of the elasticity of normal skin.  This type of frostbite can be serious, but is potentially reversible with no loss of tissue or function.

The deeper the freeze, the more serious the disease.  When there is more extensive damage the tissue becomes white and hard, sometimes with superficial blood blisters. Sensation in the tissue is either absent or profoundly decreased. There probably will be loss of tissue, and sometimes surgery is required.

Frostnip is a cold injury to the tissues that is different from frostbite.  In frostnip, superficial tissue becomes cooled, but is not cold enough to freeze.  Skin is usually pale and numb, but recovers fully with gradual warming.

People with frostbite should be seen by a physician as soon as possible.  The area involved should be elevated and gradually warmed.  No rubbing! Clapping, rubbing, or slapping those cold frozen fingers together is only going to cause more damage to already stressed tissue.

Of course, the best way to avoid frostbite is to listen to your mother (and Dr. Vicki) and wear your hat and gloves. Minimize your exposure during severe weather. Be extra careful if you’re sick, have diabetes, vascular disease, or you smoke. Be wary of cold weather and alcohol. Stay warm out there, Buckeyes!

Victoria Rentel, MD (OSU SHS)

Reviewed by Tina Comston, M.Ed.

5 thoughts on “How do I know if I have frostbite?

  1. I work in a popsicle factory and I’m in the freezer 8 hours a day except for our for lunch and two 15 minute breaks I noticed my toes in my Hill is becoming numb and it get cold faster than any part of my body I was wondering if I have been bitten or what do I do about it

    • OK – so you are the very person I have ever heard say they work in a popsicle factory! Very, very cool – yes pun intended. 🙂

      According to WebMD, there are 3 stages to frostbite:
      1. Frostnip – this usually causes symptoms of pins & needles, tingling, aching, or numbness. You may also see patches of white skin.

      2. Intermediate – skin may feel hard and frozen which turns red and blisters after it warms up.

      3. Advanced – this type requires immediate medical attend. The affected skin may look blotchy, white, or blue. After it thaws out, blisters and black scabs may appear.

      Some long term effects could be an increased sensitivity to old.

      If you recognize any of the three stages outlined above in your situation then it could be that the sensitivity to cold you are experiencing is a result. Some suggestions to reduce your risk of frostbite are:
      Dress appropriately – perhaps looking for some sock specifically designed for cold weather, such as those worn by skiers.
      Avoid drinking alcohol as it may keep you from realizing that you are getting cold.
      Avoid smoking cigarettes as they can decrease your circulation

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