Useful Tips For Dealing With and Treating Frostbite

frostbitten hands

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

Frostbite occurs when the body's skin and internal tissues freeze from exposure to extremely cold temperatures. Ice crystals form in the tissues as a result of continued exposure to cold temperature, and these ice crystals cause damage to the body’s cells. As ice crystals form and thaw, they move and grind against one another. The grinding action causes damage to surrounding tissues.

Because of potential damage both from freezing and thawing, it is extremely important not to try to rewarm or treat the frostbitten area until absolutely certain that the tissues will not refreeze after being thawed. Find a safe, warm place to treat frostbite and stay warm. On the other hand, don't wait too long. It is typically best to thaw frostbitten tissue no later than 24 hours after the initial injury as long as you don't expect to refreeze the tissues.

Frostbite is most likely to occur in body parts that are located far away from (also known as distal to) the heart, such as the hands or the feet. It takes the longest for the heart to circulate blood throughout these body parts. Soft tissues that are exposed to the elements are also susceptible to frostbite. The nose and the ears are examples of exposed soft tissues.


Frostbitten tissue, such as skin, can be a variety of colors. It may look blue, red, white or even very pale. It often looks just like a burn from a fire. To the touch, frostbitten skin may feel waxy or especially hard. Patients with frostbite might not be able to feel the frostbitten tissue or properly move affected areas.

The damage to skin layers from frostbite is extremely similar to the damage done by burns. Unlike burns, there is usually no significant fluid loss from frostbite—mostly because it's frozen and can't leak out.

Many times, patients will not recognize the symptoms of frostbite until it is too late. Frostbite can result in the loss of limbs, ears, noses, and other body parts, and in some extreme situations, even death.

First Aid for Patients with Frostbite

Below are several steps to dealing with and helping a patient with frostbite. It is important not to subject yourself to potential frostbite while helping another individual.

  1. Most importantly, stay safe! It's important to make sure that no one else is injured by the cold. Only help a patient with frostbite if you can do so safely. Follow universal precautions and wear personal protective ​​equipment if you have it.
  2. Remove the patient from the cold as soon as possible. DO NOT attempt to thaw frostbitten tissues if there is a possibility they could freeze again. This is important. Thawing frostbitten tissues only to have them refreeze will result in deeper damage than allowing the tissues to remain frozen longer.
  3. To thaw frostbitten tissues, fill a shallow container with enough water to cover the frostbitten body part and soak the frozen tissues in the tepid water. The water should be about 98 to 105 degrees (normal body temperature or a little warmer).
  4. Maintaining the water tissue is paramount. Continue to refresh the water in the container as it cools. Keep the water at the same temperature as consistently as possible, as it must remain warm. It should take about half an hour to thaw the frostbitten tissue this way.
  5. As soon as feasible, get the patient to medical assistance, even after thawing frostbite.


  1. DO NOT allow thawed tissue to freeze again. The more often tissue freezes and thaws, the deeper the damage. If the patient will soon be exposed to freezing temperatures again, wait to treat frostbite.
  2. NEVER rub or massage frostbitten tissue. Rubbing frostbitten tissue will result in more severe damage.
  3. DO NOT use any heating devices, stoves, or fires to treat frostbite. Patients cannot feel the frostbitten tissue and can thus be burned easily.
  4. In a pinch, body heat can be used to thaw mild frostbite or frostnip (tissues that are not quite frozen yet). For example, you can place mildly frostbitten fingers under the arm to keep warm.
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Article Sources

  • Markenson D, Ferguson JD, Chameides L, Cassan P, Chung K-L, Epstein J, Gonzales L, Herrington RA, Pellegrino JL, Ratcliff N, Singer A. "Part 17: First Aid: 2010 American Heart Association and American Red Cross Guidelines for First Aid."Circulation. 2010;122(suppl3):S934–S946.