Keeping Your Family Safe from Frostbite

Little Girl At Snow ParkThis year we had an extended break over the holidays in order to visit the Canadian grandparents and ski the Canadian Rockies in Alberta. It’s a very beautiful part of the world and I do love visiting there….but in the winter, it is COLD! Which is why I couldn’t help but laugh while we were packing for the trip – in our Midwest American winter – when my husband asked if I was packing the sunscreen. Seriously?! Whatever for? You see, however much sunlight might reflect off snow while skiing, creating a risk for sunburn – in the Canadian Rockies – EVERYTHING needs to be covered up, even your face.

Our 12-year old son learned this the hard way, when he began getting frostbite on his cheeks after extensive time out on the slopes on one of the colder days. We took care of it in fairly short order, but when I returned back to the U.S. and discovered it was actually COLDER in the Midwest than it had been in Canada, the idea of a frostbite post seemed like a good idea.

Windchill and Frostbite

When considering frostbite risk, a good place to start is with windchill, which is the term used for the rate of heat loss from the human body resulting from the combined effect of low temperature and wind. As winds increase, heat is carried away from the body at a faster rate, driving down both the skin temperature and, eventually, the internal body temperature.

It’s important to note that the only effect that windchill has on objects (or people) is that it shortens the time that it takes the object to cool to the actual air temperature (it cannot cool the object down below that temperature). Windchill matters because, for any given temperature, with increasing winds, it increases the risk of – and reduces the time for – frostbite of exposed skin to occur.

A Frostbite Primer

Girl with frostbite on cheek

A case of frostnip

At or below freezing (32 °F or 0 °C), blood vessels close to the skin start to constrict, and blood is shunted away from the extremities, like fingers, toes, ears and nose. The same response may also be a result of exposure to high winds. This constriction is helpful as it preserves core body temperature. However, in extreme cold – or when the body is exposed to cold for long periods – this protective strategy can reduce blood flow in some areas of the body to dangerously low levels. This lack of blood leads to the eventual freezing and death of skin tissue in the affected areas.

The level of severity of frostbite is characterized in degrees – similar to burns – with the least severe level known as first degree, or the quaint, “frostnip”. Below is an outline of the degrees of frostbite severity:

First degree (aka Frostnip)

  • Superficial cooling of the surface of the skin, without destruction of the skin cells.
  • At onset, there is itching and pain, then the skin develops white, red, and yellow patches and becomes numb.
  • Affected area usually does not become permanently damaged as only the skin’s top layers are affected – though long-term insensitivity to both heat and cold can sometimes happen after suffering from frostnip.

Second degree

  • If freezing continues, the skin may freeze and harden (destroying skin cells), but the deep tissues are not affected and remain soft and normal.
  • Injury usually blisters 1–2 days after becoming frozen. The blisters may become hard and blackened, but usually appear worse than they are.
  • Most of the injuries heal in one month, but the area may become permanently insensitive to both heat and cold.

Third and fourth degrees

  • If the area freezes further, deep frostbite occurs. The muscles, tendons, blood vessels, and nerves all freeze and can be destroyed.
  • The skin is hard, feels waxy, and use of the area is lost temporarily, and in severe cases, permanently. The deep frostbite results in areas of purplish blisters which turn black and which are generally blood-filled. Nerve damage in the area can result in a loss of feeling.
  • May result in fingers and toes being amputated if the area becomes infected with gangrene. If the frostbite goes untreated, they may fall off.

Frostbite Prevention

In order to avoid frostbite in the first place, it’s helpful to keep track of both the actual temperature – and the windchill or apparent temperature – and plan your time outdoors accordingly. For example, at an actual temperature of -10 °F, a light wind of 5 mph will make it feel like -22 °F and could cause frostbite after 30 minutes of exposure. But if the wind increases to 25 mph, it will feel like -37 °F and frostbite could occur in just 10 minutes – which might explain all the recent school delays and closures! The National Weather Service has a helpful windchill chart with estimated times for frostbite to occur.

When you and your family are outdoors in cold weather it’s also important to consider the following:

  • Dress in layers of loose, warm clothing – and check for gaps in the coverings (such as between gloves and sleeves)
  • Wear a hat or covering on your head – and make sure your ears are covered
  • Wear mittens rather than gloves – so your fingers can share warmth
  • Wear socks and sock liners that fit well, wick moisture and provide insulation
  • Consider using hand or foot warmers – we got a lot of benefit from these skiing in Canada
  • Try to keep moving outside to get blood flowing

Most of all, be aware of and check for signs of frostnip and frostbite, such as red or pale skin, and prickling feelings or numbness in the skin.

Frostbite Treatment

Frostnip – or mild frostbite – can be treated at home. It’s important to get out of the cold soon after the signs appear and change into dry clothing if needed. Warm the area gradually using warm (not hot!) water – about 100 to 150 degrees Fahrenheit (no hotter!) – or body heat such as a warm hand pressed on the cold skin. A couple of watch-outs:

  • Do NOT rub or massage the area – this can further damage the skin
  • Do NOT use direct heat from a heating pad, lamp, fire or radiator – as your skin will be numb and you will not be able to detect when it is burning

More serious frostbite needs medical attention immediately. Again, warm the area gradually, but do not start warming if the area may become exposed to cold again – this can make the situation worse. Remove any tight or wet clothing, and rest affected areas (e.g. do not walk on frostbitten feet). Also, leave any injured tissue intact for a physician to address – and follow the restrictions above for frostnip.

Thanks to my husband for the inspiration and much of the research for this post!

About the Author

Audra is an experienced pharmaceutical marketing professional, aspiring writer, and mother of Elliott, a high-spirited twenty-year old. Frequently tired but never bored, she has a strong interest in public health fostered by numerous years implementing global oncology education programs as well as by her twenty-year crazy (wild? amazing?) adventure in parenting. She recently earned a Masters in Public Health to augment her expertise in health policy and health promotion. Audra is a founding member of the PedSafe Team


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