Frostbite: Symptoms, Prevention and Treatment

How to recognize frostbite and prevent it from worsening.

Close-up shot of left eye with blue lashes.

Everyone knows winter weather is uncomfortably chilly, but it can also be damaging to your skin.

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Chicago is not known for pleasant, temperate winters, and December of 1983 was no exception. It was 30 below zero on Christmas Eve, when Jordan Pritikin got a flat tire while running what was supposed to be a quick errand. Rather than wait for a tow truck, the 20-year-old decided to change the tire himself. (This is "when I was young and stupid," he says.) Within 15 minutes of being outside, Pritikin had suffered frostbite and wound up losing the top part of his ear.

Flat tires, breakdowns, accidents and road closures may be mere inconveniences most months of the year, but in winter weather, they can leave folks stranded and ill-prepared for the cold and wind that can blister fingers, deaden toes and, in Pritikin's case, halve ears. Pritikin, who is now a otolaryngologist (an ears, nose and throat doctor) at the Chicago Nasal & Sinus Center, thinks we'll see more of these situations.

[Read: U.S. News Best Hospitals.]

"We're seeing people stranded in Atlanta – Atlanta! – because it was cold and snowy," he says. "People don't think it can happen to them, but it obviously does." Whether you're on on the road in Atlanta, plan to be outside for a while in Chicago or on a brisk jog in Cleveland, you should be prepared to defeat frostbite. The first step? Study your enemy.

What is frostbite?

When exposed to the cold, our body tries to preserve heat by sending blood away from the extremities and toward the core. "Small blood vessels in the ears, cheeks, fingers, toes and tip of the nose will clamp down to prevent blood from flowing to those areas," Pritikin says. "But in doing so, those tissues become cool, cold and robbed of oxygen." The water in those tissues actually starts to freeze, and depending on how cold it is and how long you're exposed, those tissues will become damaged. (Here's a chart showing the amount of time before frostbite occurs, depending on wind chill.) Sometimes, the damage is beyond repair, "in which case, things might fall off or need to get cut off," Pritikin says.


Signs of frostbite

There are a few clues to look out for before you need to say goodbye to frozen fingers and toes. The first sign is simply the cooling of tissues, and you've got nothing to worry about at that point if they warm up with heat or friction, like rubbing your cold hands together. If at all possible, try to warm up and stay warm by going indoors and removing cold or wet clothes.

From this point, be on the lookout for the frostbite symptoms, such as tingling followed by numbness, swelling, aching or burn-like blisters. Get inside and stay inside, as thawing and refreezing tissues can cause further damage. Remove cold or wet clothes and jewelry that touch the affected area, and soak it in warm water – making sure to circulate the water and avoid rubbing – until skin softens and sensation returns. The National Institutes of Health Medline Plus medical encyclopedia advises wrapping the area in sterile bandages and, if it's someone else with frostbite, checking him or her for symptoms of hypothermia.If you have frostbite symptoms and notice the area is discolored or has hardened or lost sensation (when you push on the area, and there's no give or feeling), head to the emergency room, Pritikin says.

[Read: How to Prepare Your Car for Winter.]

How to prevent frostbite
To prevent frostbite should you become stranded, keep a warm blanket and hand warmers in your car. When outside in the cold, wear several loose layers of clothes, which create pockets of air in between them to trap body heat. This route is typically preferred to a single warm layer.
And remember those extremities that are so vulnerable to the cold as blood flows toward the core? Keep them cozy. Don't be shy with hats and earmuffs, scarves that cover the nose and cheeks and thick (or doubled) socks and mittens, which allow fingers to share their heat better than gloves. Bonus points for anything wind and waterproof. "There's the whole vanity aspect of, 'I don't want to wear a hat and ruin my hair,' or 'I don't want to bundle up,'" Pritikin says. "But there are some things that just transcend vanity – there are some things that just become more important."