Frostbite Requires Medical Attention, Can Result in Permanent Damage

WEST SPRINGFIELD — When temperatures drop below freezing here in Western Mass., the risk goes up for frostbite, a condition that can result in permanent damage to a person’s skin, muscle, tissue, and bone.

“We often pride ourselves on being hardy New Englanders, but that doesn’t mean we are impervious to the elements,” said Dr. Vincent Meoli, regional medical director of American Family Care (AFC), with locations in Springfield and West Springfield. “Everyone needs to take precautions to protect their skin during freezing winter weather or risk long-term damage.”

The first stage of frostbite, called frostnip, generally includes numbness in the affected area, which may feel painful and tingly when the skin is rewarmed. If not addressed, the condition will become superficial frostbite. At this stage, the skin’s color begins to change, and it may look waxy and feel warm despite the cold. If the skin is rewarmed at this stage, it may appear mottled, swell, and feel like its burning or stinging. Fluid-filled blisters will likely develop within the next 36 hours.

Finally, with severe frostbite, which affects all layers of the skin as well as the tissue below, the affected area turns white or bluish gray, hardens, and loses all sensation. Joint and muscle function is affected, and upon rewarming, large, fluid-filled blisters develop, and the tissue turn black and hardens as it dies.

“If you experience frostnip, you should move to a warm place and, if possible, soak the affected area in warm — not hot — water,” Meoli said. “Seek medical attention if you have superficial frostbite and emergency care for severe frostbite. While waiting for care, remove any wet clothing, and gently warm the affected area by soaking it in warm water or by applying a warm cloth. With severe frostbite, hospital staff will rewarm the area and try to restore blood flow. You may receive pain medication for nerve pain, imaging tests to see how deep the damage goes, and procedures to remove the dead skin, which may require surgery.”

In terms of things not to do, Meoli warned against using anything hot to rewarm the skin, as that can result in burns and further damage. Avoid rubbing the affected area, which may cause additional damage, and don’t walk on frostbitten feet or toes.

“The key to preventing frostbite lies in checking the weather forecast in advance and being prepared,” he added. “This means dressing in loose layers that will protect your skin against the cold, wind, and wet. Pay particular attention to the most vulnerable areas: hands, feet, nose, and ears. Limit time spent out in the cold and wind, or take frequent breaks to warm up. Part of the challenge with frostbite is that, because the skin becomes numb early on, you may not realize it’s happening. It can also develop relatively quickly, within minutes in extremely cold temperatures.”

For those who will be out in the cold, Meoli advises wearing three layers: a light first layer that is moisture-wicking, a second insulating layer of wool or fleece, and a top layer that is windproof and waterproof. In addition, wear a hat that covers the head and ears; insulated mittens or gloves; warm, moisture-resistant socks; and a scarf or face mask to cover the nose and face.

The risk of frostbite increases as the temperature drops, and is also related to the wind-chill factor. Wet skin will freeze faster, and children and the elderly are at increased risk because it’s harder for them to regulate body heat. Drinking alcohol also causes the body to lose heat faster.

“The effects of frostbite can be serious and permanent, so, to the extent possible, it’s best to take precautions to avoid it,” Meoli said. “This includes keeping warm blankets and extra clothing in your car during the winter in case you get stuck or break down.”