Frostbite and Cold Weather-Related Injuries

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Cold weather-related injuries such as trench foot, frostbite, chilblains, and frostnip don’t always occur when temperatures are below freezing.

There are two categories of cold weather-related injuries.

1. Conditions that occur without the freezing of body tissue, for example,

• chilblains
• trench foot
• frostnip

1. Injuries that occur with the freezing of body tissue, such as frostbite.

Hypothermia is another injury that is caused when the core body temperature is extremely low.

People associate Hypothermia with the bitter cold and below freezing temperatures that are experienced this time of year. The truth be told, more people freeze to death of hypothermia with moderate temperatures above freezing. Example, if you are caught in a rainstorm, are not prepared or do not have the proper gear; wet clothes are deadly when they start dropping your core temperature.

Signs and Symptoms of Frostbite and other cold-related injuries:

The severity and signs and symptoms of frostbite all depend on the amount of tissue damage. Due to that, some may experience some or all of the following signs and symptoms to the affected area.

• Burning
• Tingling
• Changes of the skin such as color and texture
• Clear colored blisters
• Numbness
• pain

With a more severe degree of injury to the tissue structure, your signs and symptoms may progress to:

• Blood filled blisters
• Loss of sensation
• Changes in skin color like pale, yellowish, blue/grey.
• Hard and solid feeling skin and underlying tissue.

With advanced frostbite injuries, the affected area can subsequently appear blackened and gangrene can develop, placing the affected individual at high-risk for infection.

MedicalNet, Author: Steven Doerr, MD 

The appearance of frostbite can change over time, it all depends on the severity of the tissue damage. Figure 1 shows fingers with severe frostbite at the tips of the fingers (dark to black-appearing tissue) that gradually decreases in severity on the digits. Figure 2 is a mild case of frostbite on the toes and figure three shows the progression.

Tips to prevent frostnip and frostbite:

Again, proper planning can prevent cold weather-related injuries. This includes staying home and not traveling when not advised and having a backup plan in case a vehicle breaks down. For example, keeping warm supplies stored in the trunk of your car. When you feel your hands getting cold place them under your armpits if you are not able to get to a warm location and find shelter from the wind.

Frostnip and frostbite, what is the difference?

The differences lie in the severity of the injury. Frostnip (first-degree injury) occurs on the surface of the skin and doesn’t affect the deeper layers of tissue. Frostbite, however, occurs when the body part freezes and there is a lack of blood flow and heat. Ice crystals within the cells then develope, rupture and cause cell death.

Both frostnip and frostbite initially occur on the surface of the skin. Areas such as the cheeks, lips, ears, arms, hands, legs, fingers, and toes.

What is the first aid home treatment for frostbite?

• Moving out of the cold,
• Rewarming the affected area slowly if you won’t be exposing it again to the cold otherwise, it can lead to disastrous results.
• Removing any wet clothes.
• Drink warm liquids.
• Try not to touch the affected area.

What medical treatment should you do for frostbite?

If you have a severe case of Frostbite that requires emergency treatment go to your nearest Emergency or urgent care department or call 911. Do not touch or push on your injured tissue as you could cause more damage.

How do you know if you have frostbite or other cold weather-related injuries?

Frostnip consists of red skin and tingling, frostbite can have discoloration of the skin numbness and pain. Chilblains and trench foot are often self-diagnosed.

Does frostbite heal on its own?

Depending on the severity, the usual recovery period for uncomplicated or level 1 frostbite can be several weeks. Deep frostbite, however, goes beyond the subcutaneous tissue and can affect the nerves, tendons, muscle and even bone leading to amputation.

Other types of injuries that are caused by the cold:

The Winter season can provide a number of opportunities to get you outside and take part in activities such as ice-skating, skiing, sledding, and snowmobiling. When you partake in Winter activities, however, you need to make sure you are well prepared. Cold weather-related injuries can happen even when temperatures are above freezing (32 F, 0 C), when there are high winds, or if your clothes are wet.

Temperature along with the duration in the elements will determine the extent of your injuries. The below information describes what different types of cold weather-related injuries can occur, as well as how you should treat them.

What are chilblains?

Chilblains (also known as pernio) is a common type of cold weather-related injury that can develop in predisposed individuals after exposure to nonfreezing temperatures and humid conditions. Chilblains typically develop because of an abnormal vascular response several hours after the area exposed to cold is re-warmed.

Signs and symptoms

Chilblains are itchy, painful, reddish, or purplish areas of swelling that usually affect the fingers, toes, nose, or ears. In some individuals, blisters or small open sores may form, increasing the risk for developing an infection. Chilblains usually last for several days, and the affected area usually heals after several weeks. Though the affected area may remain sensitive to the cold in the future, there is usually no permanent damage. It is not uncommon for chilblains to recur in susceptible individuals.

MedicalNet, Author: Steven Doerr, MD

Treatment of chilblains:

Chilblains can usually be treated at home though if any signs of infection occur from an open sore, seek medical attention.

What is trench foot?

Immersion or trench foot was named after the condition suffered by many soldiers in the trenches during World War I. Although it is a condition we still see today, it is not very common. Trench foot often comes on when a person is exposed to the wet and cold elements. Temperatures, however, do not have to be freezing. Trench foot can happen with temperatures up to 60 F. Tight-fitting footwear can also aid in worsening the problem.

Signs and symptoms of trench foot:

The symptoms of trench foot may include:

• Pain 
• Itching
• Numbness
• Swelling
• Red or blotchy foot
• Black/bluish discoloration (this is a more advanced injury).
• Blisters
• Open sores

In severe cases, the tissue dies and sloughs off, and the set on of gangrene can occur, sometimes resulting in the amputation of the area(s).

Treatment of trench foot:

Trench foot should be monitored or seen by a professional in case there are any signs of infection.

To prevent these cold weather-related injuries, take the proper steps to plan and stay advised to your local weather reports for your area and the one you will be traveling to. Elderly, children, alcoholics, and the homeless have a higher risk to develop cold weather-related injuries.

– Heather Earles