Frostbite Symptoms and Signs

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Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: Dennis Lee, MD

Frostbite is an injury resulting from freezing of the tissues in the body. The hands and feet are most commonly affected by frostbite, but the nose, cheeks, shins, ears, and even the corneas of the eyes may be affected by frostbite.

Frostbite typically occurs in soldiers or others who work outdoors, or in outdoor winter sports enthusiasts. People who become stranded outdoors can also become victims of frostbite. Nicotine and other drugs that reduce blood circulation to the extremities (called vasoconstrictive drugs) can increase a person's chances of developing frostbite. There is no official reporting system for frostbite cases in the U.S., but it is known to affect predominantly residents of the northern states, including Alaska. Research has shown that African American men and women are slightly more prone to develop frostbite than Caucasians. Other people who may be more predisposed to frostbite are those of Arabic descent and those who reside in warm climates. Men develop frostbite more often than women, but this may reflect a greater participation in sports and outdoor activities.

The areas of the body affected by frostbite feel cold and firm. Burning, tingling, stinging, or numbing sensations may be present. Clumsiness can result from impaired motor control. When the affected body part is rewarmed, a throbbing or burning pain may result. Frostbite, like burns, is classified according to the degree of tissue injury. Minor injuries result in swelling, redness, loss of sensation, and white plaques on the skin. More severe lesions have blisters that may become filled with blood. In the most extreme cases, full-thickness freezing damages bones and muscles, resulting in tissue death and loss of the affected area.

If you believe you may be experiencing frostbite, it is important to get to shelter as soon as possible and seek medical attention. If you are somewhere (for example camping), and you come in from a hike and have frostbite, don't try to warm up the frostbitten area in the tent or at a campfire if you still have to stay out in the woods, or have to hike further. In other words, never start warming the frostbitten area until you know for sure that you are out of the cold for good. If there is a chance that your body part could re-freeze (get frostbite again) don't try to warm it until you have reached shelter as this can result in worse damage to the area. Rubbing the affected area should also be avoided.

Once you are indoors, the best way to warm a frozen part is to put it into a tub of moderately hot water (104-108 degrees F (40-42 degrees C)). Always test the temperature of the water with a thermometer or a hand that is not frozen to avoid burning the injured area (which may lack feeling).