Frostbite (cont.)

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Frostnip

Frostnip is a mild cold weather-related injury that typically affects the face, ears, toes, and fingers. After exposure to cold weather, the affected area may appear pale, and may be accompanied by burning, itching or pain. Tingling or numbness are frequently present. Simple re-warming restores normal color and sensation, and there is no subsequent permanent tissue damage.

Cold weather-related injuries with tissue freezing

Frostbite

Frostbite occurs when there is freezing of body tissue, and it is the most serious of the cold weather-related injuries. Frostbite usually affects the hands, feet, nose, ears, and cheeks, though other areas of the body may also be affected. This type of injury results from decreased blood flow and heat delivery to body tissues resulting in damaging ice crystal formation, which ultimately leads to cell death. Upon re-warming of the affected tissue, vascular damage and complex cellular metabolic abnormalities lead to tissue death. Damage to tissue is most pronounced when there is prolonged cold weather exposure, the affected area slowly freezes, and the subsequent re-warming process is slow. Repeated thawing and refreezing of the affected tissue is particularly damaging, and should be avoided.

Frostbite injuries can be classified as either superficial or deep, depending on the tissue depth of injury. Superficial frostbite injuries involve the skin and subcutaneous tissues, while deep frostbite injuries extend beyond the subcutaneous tissues and involve the tendons, muscles, nerves, and even bone. Superficial frostbite injuries have a better prognosis than deep frostbite injuries.

What are the signs and symptoms of frostbite?

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The signs and symptoms of frostbite depend on the extent and depth of tissue injury. Individuals with superficial frostbite may experience the following signs and symptoms to the affected area:

  • pain,
  • burning,
  • tingling,
  • numbness,
  • pale colored skin,
  • clear-colored skin blisters may develop, and
  • firm-feeling skin with soft underlying tissue which can move over bony ridges.

As the degree of injury progresses (1st to 3rd) to involve deeper tissue structures, the signs and symptoms of deep frostbite can develop, which may include the following:

  • complete loss of sensation,
  • pale, yellowish, bluish, gray, or mottled skin color,
  • formation of blood-filled skin blisters, and
  • firm-feeling skin and underlying tissue, with the affected area feeling hard and solid.

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

What does frostbite look like (frostbite pictures)?

The appearance of frostbite may gradually change over time; the extent of the change depends on how severely the tissue is damaged. Figure 1 shows a hand with severe frostbite changes at the tips of the fingers and thumb (dark to black-appearing tissue) that gradually decreases in severity on the digits.

Figure 1. Frostbite on digits and thumb

Picture of the Stages of Frostbite
Picture of the Stages of Frostbite
Medically Reviewed by a Doctor on 1/4/2014

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