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Frostbite and hypothermia are two cold weather concerns

By: James Rogers, M.D.

This is the time of year when the weather can be headline news. As temperatures dip down into the negatives and wind chill factors make the air even colder, there are a number of things you can do to protect yourself from two of the most common weather-related medical conditions: frostbite and hypothermia.

Frostbite
Frostbite is freezing of the skin and tissues below the skin. The most common sites for frostbite are the feet, hands, ears, nose, and face. Frostbite occurs after prolonged exposure to temperatures of 32 degrees Fahrenheit or lower, and can vary in severity.

First-degree frostbite involves partial freezing of the outer layers of the skin. The frostbitten area can tingle, sting, or have burning pain. The skin may be swollen and appear red, white, yellow, or mottled.

Second-degree frostbite occurs when all the layers of the skin freeze. The outer layer of skin feels hard. The affected area is initially numb, changing to aching and throbbing pain as the skin warms. Within six to 24 hours, blistering with clear or white fluid -- occurs. The skin around the blisters is red and swollen.

Third-degree frostbite includes freezing of the skin and the tissues below the skin. As with second-degree frostbite, the skin feels hard, and numbness is followed by burning, or shooting, pain. Skin appears white, blotchy, or bluish gray, and blisters resemble blood blisters.

Fourth-degree frostbite is the most serious type of frostbite and involves freezing of the muscles, tendons, and bones. It causes deep, aching joint pain. Skin appears mottled red or blue and changes to black. There is little or no swelling, and the area feels rubbery.

First-degree frostbite can usually be treated effectively at home. This involves warming the affected areas by blowing warm air on them, putting them in warm (not hot) water, covering them with a heating pad, or tucking them into your clothing or under a blanket. Do not rub frostbitten skin. This can make the injury worse.

After an initial frostbite, skin may be more sensitive to injury. Protect skin with sunscreen and clothing to prevent further skin damage.

If the frostbitten area is numb, it's likely that your frostbite is more serious and requires medical treatment. Your health care professional will work to rewarm the frostbitten area, provide pain relief, and prevent complications such as infection.

Hypothermia
Hypothermia occurs when a person's body temperature drops from its normal 98.6 degrees to below 95 degrees. While hypothermia is more likely to happen when you are exposed to outdoor elements of cold air, water, wind, or rain, it can occur indoors, especially in babies and older adults. Hypothermia can develop quickly (over a few hours) or gradually (over the span of a days or weeks) depending on environmental conditions and a person's overall health.

Hypothermia can vary in severity from mild (with a body temperature ranging from 90 to 95 degrees Fahrenheit) to severe (with body temperatures below 82 degrees). Early symptoms include: shivering, pale skin, apathy, poor judgment, balance problems, slurred speech, and numb fingers. As hypothermia progresses, other symptoms develop. These are: stiff muscles, slowed pulse, shallow breathing, weakness, sleepiness, confusion, and loss of consciousness. During later stages of hypothermia, the trunk of the body will feel cold to the touch and shivering may stop.

It is important to treat hypothermia quickly. During the initial stages, hypothermia can usually be treated at home. This involves moving the affected person to a warm, dry environment. Use hot water bottles, warm blankets, and heaters, and offer warm non-alcoholic fluids to help restore the body temperature.

Moderate and severe hypothermia generally requires treatment in a hospital, where health professionals can provide specific treatments to warm the core body temperature.

Prevention
Frostbite and hypothermia are two potentially serious cold weather ailments. Both can be prevented in similar ways.

Wearing the right type of clothing is an important first step. Multiple layers are most effective in keeping the body warm. A thin layer of synthetic fabric next to the skin will help pull perspiration away and allow it to evaporate. Follow this with one or more layers of wool, fleece, or down, ending with an outer layer that is waterproof or water resistant. Use layers on as much of your body as possible. Don't forget your lower torso. A pair of jeans is not enough to ward off the cold when the wind chill is in negative digits. Feet, too, benefit from layers. Moisture wicking socks, followed by a thick wool layer, and warm waterproof boots will work together to keep you warm.

Hats and mittens are a must. Up to 80 percent of your total body heat loss can occur through exposed head and neck areas. For body parts that you just can't cover-- like the nose and around the eyes you can gain some protection by covering the area with petroleum jelly. Lip balm with sunscreen works well to keep the lips protected from the cold, dry air.

Use common sense when the weather is extremely cold. Don't stay outside for more than a few minutes at time. Tell the kids it's too cold outside, and they'll have to find something to do indoors.

When you are out in the cold, your body's caloric needs increase. Make sure you are eating plenty of healthy foods. The same goes for beverages, drink plenty of fluids to stay hydrated. Just make sure they are of the non-alcoholic variety. Alcohol causes the body to lose heat more rapidly.

Winter weather is a part of life in Minnesota, however with it comes the possibility of frostbite and hypothermia. You can ward off these two conditions with layers of clothing and some common sense. If you or someone you know shows signs of frostbite or hypothermia, use blankets, heaters, and warm fluids to treat them at home. If a person shows more advanced symptoms of hypothermia or frostbite, it is likely that medical attention is needed quickly. Help them get to a hospital or medical clinic so that treatment can begin.

Dr. Rogers is a board certified family practice physician at Raiter Clinic.