Frostbite is, literally, frozen body tissue — usually the skin, but sometimes deeper tissue — and must be handled carefully to prevent permanent tissue damage.

The varying degrees of frostbite are based on the depth of the tissue injury, ranging from a superficial area of the skin all the way down to the muscle and bone in the most severe cases.

Frostbite requires medical attention by a health care provider. Kids are at greater risk for frostbite than adults, both because they lose heat from their skin more rapidly and because they may be reluctant to leave their winter fun to go inside and warm up.

The areas most prone to frostbite are the head, face, ears, hands, and feet. Frostbite also can be associated with hypothermia, a serious medical condition that requires emergency medical care.

Frostnip

Frostnip is a milder form of injury. It usually affects areas that are exposed to the cold, such as the cheeks, nose, ears, fingers, and toes, leaving them red and numb or tingly.

Frostnip can be treated at home and gets better with rewarming.

What to Do:

• Bring your child indoors immediately.
• Remove all wet clothing. Wet clothes draw heat away from the body.
• Immerse chilled body parts in warm (not hot) water for 20 to 30 minutes until all sensation returns. Don't let your child control the water temperature during rewarming. Numb hands won't feel the heat and can be severely burned by water that is too hot. Body heat can also be used to rewarm.
• Don't use heating pads, stoves, fireplaces, or radiators to rewarm because the affected skin can be numb and easily burn.
• Call your doctor if sensation does not return or there are signs of frostbite and/or hypothermia.

Frostbite

Frostbite is characterized by white, waxy skin that feels numb and hard. It requires immediate emergency medical attention. It can be associated with hypothermia, which is a serious medical emergency.

What to Do:

• Call the doctor immediately or take your child to a hospital emergency room.
• If feet are affected, carry your child. Do not let the child walk on frostbitten feet.
• Get your child into dry clothing in a warm environment.
• If you cannot get to a hospital right away or must wait for an ambulance, give your child a warm drink and begin first-aid treatment:
  
  • Immerse frozen areas in warm water (around 100° F [38° C]). If warm water is not available, wrap your child gently in warm blankets or use body heat on the affected area.
  • Do not use direct heat such as a fire or heating pad. The skin may be numb and can burn easily.
  • Do not thaw the frostbitten area if it's at risk for refreezing before you get to a health care provider. Skin that is thawed then refrozen again can cause severe tissue damage.
  • Do not rub frostbitten skin or rub snow on it.
  • Rewarming will be accompanied by a burning sensation. Skin may blister and swell and may turn red, blue, or purple. When skin is pink and no longer numb, the area is thawed.
  • Apply sterile dressing to the area (be sure it's not too tight), placing it between fingers and toes if they are affected. Try not to disturb any blisters and keep the wound areas clean to prevent infection.
  • Wrap rewarmed areas to prevent refreezing, and have your child keep thawed areas as still as possible. If you have the first-aid training, splinting the affected area can help reduce the risk of injuring the area further.

Preventing Frostbite

To help prevent frostbite in cold weather:

• Stay updated on weather forecasts. If it's extremely cold, even brief exposure to cold can cause frostbite.
• Dress kids in layered warm clothes and use hats, gloves, scarves, thick socks, and well-insulated boots to cover body parts that are most prone to frostbite. Inner clothing layers that absorb moisture and outermost layers that are windproof and waterproof are helpful.
• Make sure kids come indoors at regular intervals.
• Change kids out of wet clothing or shoes as soon as possible.
• Watch for frostnip, frostbite's early warning sign.
• If you are planning travel to a remote area, make sure you have proper supplies in case of emergencies and let family or friends know your travel plans.
• Take a first-aid and CPR class to help learn what to do in emergency situations.

Reviewed by: Yamini Durani, MD
Date reviewed: April 2011