How to Treat Frostbite

frostbitten hands

Winky from Oxford, UK / Wikimedia Commons / CC BY 2.0

Frostbite occurs when skin and underlying tissue freeze from exposure to extremely cold temperatures. While it's mild form, frostnip, causes redness and numbness that can be self-treated with proper first aid, more advanced stages of frostbite require emergency medical attention. Frostbite treatment includes controlled rewarming, and potential interventions such as IV fluids and medications.

Proper and prompt treatment of frostbite is essential to preventing complications, including permanent damage. Here's what you need to do to handle your a case properly.

Treating Frostnip

Frostnip is the mildest form of cold injury to the skin. Signs of frostnip include redness or paleness of the skin, mild pain, and a tingly or numb sensation in body parts exposed to the cold.

Frostnip doesn’t require a trip to your doctor, but it is an indicator that your skin has already started to become affected and that continued exposure could lead to a more serious form of frostbite.

You can treat frostnip by getting warm. Find a warm shelter, cover up with layers of dry clothing, or blow warm air from your mouth through cupped hands around the affected area. You can also warm the extremity by using body heat, such as putting your fingers in your armpit.

Treating Frostbite

Frostbite can look like a burn injury. Second-degree (superficial) frostbite affects the top layers of the skin. Signs include white, waxy skin; numbness; swelling; and blisters with clear fluid. If second-degree frostbite isn’t treated, it can progress into a more serious stage.

Third-degree (deep-tissue) frostbite can look like second-degree frostbite at first, but often has dark, blood-filled blisters when it thaws. Skin can turn black and tissue loss is likely.

In any suspected case of frostbite, you should get immediate medical attention. If you can’t get to a hospital right away, start providing first-aid treatment for the frostbite. 

At the Hospital

Professional and timely medical evaluation and treatment of frostbite is critical, as it can be difficult to tell how much damage has been done to the surrounding tissues.

At the hospital, the medical team will warm the frostbitten area, bandage it to protect the skin, provide pain medication, and evaluate to determine the extent of the injury.

In third-degree cases, thrombolytic therapy may be used to break up blood clots to help reduce the risk of amputation from severe tissue damage.

The extent of tissue damage may not be evident for weeks, so you may need follow-up appointments to monitor the injured area.

First Aid for Frostbite

You should only work to treat frostbite if getting to a hospital right away is not possible.

Do not attempt to thaw frostbitten skin if there is a possibility it could freeze again. Doing so will result in deeper damage than allowing tissue to remain frozen longer. If feet are affected by frostbite, don’t walk on them unless it’s necessary to get to a safe location. Walking on frostbitten feet can cause more damage to the tissue. 

To start providing first-aid treatment:

  1. Immerse the affected body part in warm water (between 98 and 105 degrees; normal body temperature or a little warmer). If you don’t have a thermometer, feel the water with an uninjured hand to make sure it’s comfortable and won’t cause burns.
  2. Soak the frozen area for 30 minutes. Continue to refresh the water in the container as it cools to keep it at a consistent temperature. If you don’t have access to water, wrap the area gently with clothes or a blanket to help get warm.
  3. Depending on the amount of damage, warming the skin can be very painful as the numbness fades. If available, you can give an over-the-counter non-steroidal anti-inflammatory drug like ibuprofen to help with symptoms until you can get to the hospital. 
  4. During the warming process, the skin may start to blister. To avoid infection, do not rupture any of the blisters. You can apply bulky sterile dressing to the area once dried. Make sure that the bandages are loose, not tight.

Never rub or massage frostbitten tissue. Rubbing frostbitten tissue will result in more severe damage. Don’t use any heating devices, stoves, or fires to treat frostbite. Patients cannot feel the frostbitten tissue and can be burned easily.

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Article Sources

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  1. Laskowski-jones L, Jones LJ. Frostbite: Don't be left out in the cold. Nursing. 2018;48(2):26-33. doi:10.1097/01.NURSE.0000529802.75665.d7

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