Fingers exposed to the cold

How to Prevent Frostbite and Stay Safe in the Cold

January 19, 2016

Updated December 27, 2017

Note: Communities throughout Cook County open warming centers during cold spells. If you or someone you know is without heat, check the Cook County list of warming centers, including locations, hours of operation and other details.

Arthur P. Sanford, MD, FACS
Burns and Trauma Surgeon

People often underestimate the dangers of cold weather and are unaware what can happen when they don't properly protect themselves. Frostbite is serious and can lead to amputation, so don't kid yourself that you can tough it out during an Arctic blast.

Here's what happens when your body is not properly protected from the cold:

  • Exposure to cold air reduces blood flow to the skin's surface.
  • The body will work to keep your head and internal organs warm.
  • As a result, the body parts farthest from the heart, such as toes, fingers, ears and the tip of the nose, are the most susceptible to reduced blood flow. These same areas also are more likely to be exposed to the cold.
  • The restricted blood flow can lead to freezing and death of skin tissue.

At first, the affected area may pale or turn red and hurt. Next, it may have a prickling feeling. Then the area loses feeling, and its color may fade to white or a bluish or grayish hue. When the area becomes numb, you may not realize you have frostbite until you or someone else sees it. When frostbite does occur, it is critical to know what to do and what not to do:

Don't ignore symptoms! The sooner it's treated, the better.

  • Get out of the cold and into warm shelter. I recommend rapid rewarming using blankets or a heating pad, but only if the temperature can be controlled well and it can shut off automatically.
  • If you need to use water to warm the affected area, use room temperature or slightly warm water to gently revitalize parts of the body that have had prolonged exposure to the cold.
  • Don't use hot water. Have someone else check the temperature before you submerge the frostbitten area. It will not sense heat as well as it normally would, and you can suffer a burn on top of the frostbite injury. Many hot water heaters produce water at a temperature that can cause a third-degree scald in less than 3 seconds.
  • Don't rub with handfuls of snow.
  • Don't vigorously massage any frozen area, because overstimulation can worsen the damage.
  • Seek medical help if the skin develops blisters, is pale and numb or is red and very painful. An emergency physician will assess the tissue and take the proper steps to save the body part.

Respect the cold and know the risks of being outside. How cold you – and your skin – feel is a function of three things. The first two and most simple are environmental temperature and wind speed; how the combination of cold and wind affect exposed skin is called the wind chill factor. A temperature of 0 Fahrenheit with 15 mph winds produces a wind chill of minus 19 F, which causes frostbite in 30 minutes. This and other examples of wind chill and frostbite risk are available in The Old Farmers Almanac. The third factor is water. If skin is wet, it will freeze at warmer temperatures. Here's how to protect yourself:

  • Dress in layers. If a sweater, pair of socks or other article of clothing gets wet, you can quickly remove it and still be protected.
  • Wear warm gloves or mittens. Texting gloves or half-gloves may be handy for using a smartphone or showing off nails, but fingers are one of the first body parts to feel the cold.
  • Wear a snug hat that covers your ears and the top of your head. This will protect your ears and help you to retain body heat.
  • Wear warm socks and boots that will stay dry. Wet socks are especially dangerous and can lead to a condition called trench foot, which results in poor blood circulation, tissue decay, infections and even amputation.

Frostbite is preventable in most cases. So protect yourself and stay safe!

Arthur P. Sanford, MD, FACS, specializes in trauma, burn and surgical critical care.

Loyola’s Burn Center is one of the busiest in the Midwest, treating nearly 600 patients annually in the hospital and another 3,500 patients each year in its outpatient clinic. The Burn Center at Loyola Medicine provides comprehensive care for adults and children suffering from burns, frostbite, complex soft tissue infections and other conditions.