Frostbite and Cold Weather Injuries


With winter here bringing colder temperatures and wet weather in our area; cold related injuries become more of a concern. The most severe cold weather injury, frostbite, is the catch-phrase many attribute to any cold related injury to the skin. Chilblains and Trench Foot are some lesser known and less severe forms of injury worth noting. Education and prevention can go a long way in ensuring you are able to enjoy your outdoor activities (or just necessary activities) during the colder months safely.


This condition refers to painful inflammation of small blood vessels in your skin that occur in response to repeated exposure to cold but not freezing air. Also known as pernio, chilblains can cause itching, red patches, swelling and blistering on your hands and feet.
Chilblains usually clear up within one to three weeks, especially if the weather gets warmer. You may have recurrences seasonally for years. Treatment involves protecting yourself from the cold and using lotions to ease the symptoms. Chilblains don't usually result in permanent injury, but the condition can lead to infection, which may cause complications if left untreated. Seek medical care if the pain is unusually severe, if you suspect an infection, or if your symptoms aren't improving after one to two weeks. See a doctor to rule out other potential conditions if the symptoms extend into the warmer seasons.

Trench Foot
Trench Foot, also known as immersion foot, is an injury of the feet resulting from prolonged exposure to wet and cold conditions. Trench foot can occur at temperatures as high as 60 degrees F if the feet are constantly wet. Injury occurs as wet feet lose heat 25 times faster than dry feet. In order to prevent heat loss, the body constricts blood vessels to shut down circulation in the feet. Skin tissue begins to die because of lack of oxygen and nutrients, leading to the buildup of toxic products. Damage to nerves may make any painful symptoms less noticeable.

Just like water turns to ice when the temperature drops, your fingers, hands, toes, feet - even your nose and ears -- can freeze. In severely frigid weather, frostbite can happen in as little as five minutes. Symptoms include changes in skin color from white to red to blue, numbness, burning, blisters, swelling, or a rubbery, waxy appearance. Frostbite can be classified into different stages depending on the extent of tissue damage, which is similar to classifying burns. First degree is considered mild frostbite and is associated with the skin becoming red and irritated. Second degree is characterized by blisters and swelling, but there is no major tissue damage. Third degree, the most severe, involves all skin layers and may lead to permanent damage through the skin and underlying tissue layers.

To help prevent Frostbite, wear insulated clothing and dress in layers. Recommended combinations begin with a moisture wicking base layer followed by an insulating layer and finally a windproof/waterproof outer layer. Wool still remains one of the best materials in regards to insulation. Properties include moisture wicking to keep the skin as dry as possible and the ability to retain heat when wet. Shoes or boots should be waterproof and insulated. Cover all areas of exposed skin at all times. Clothes should not be tight or constricting to allow for adequate circulation, and should be loose enough to allow for mobility. Avoid smoking, alcohol, or caffeine as all of these can affect blood flow.
If you think you may have frostbite, it is important to seek medical help. First make sure that you are not experiencing hypothermia which is life threatening and requires immediate attention. In order to keep swelling down, try to keep your hands or feet elevated. Stay in a warm area to keep heat loss minimal and avoid walking on frostbitten toes or feet. Remove anything wet or constrictive that may prevent blood flow to the area. Apply a sterile bandage to the involved areas to prevent rubbing or irritation. Never rewarm the frostbitten area if there is a chance it could freeze again as this will accelerate tissue damage. If there is no chance of re-freezing, warm the affected area in not too hot water. Warming as soon as possible is important to stop progressive cellular damage.

Your skin should respond quickly to gentle warming. As it thaws, it may appear reddened. You may also experience stinging or prickling sensations.
Medical emergencies with cold injuries include skin becoming hard, persistent numbness in the affected area, severe pain with thawing, blistering with signs of infection / fever, darkened skin or foul odor.
The best approach to preventing cold weather injury is by limiting your exposure to cold, dressing warmly and covering exposed skin.
If you have diabetes or poor circulation, healing may be impaired in all of these conditions. Be cautious and seek care if needed.

Enjoy a safe winter!



Photos courtesy of Marjorie Vorhaben