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You don’t have to live in the Arctic region to be at risk for frostbite or
its less serious cousin, chilblains.
Frostbite. Anyone who is exposed to temperatures below freezing, combined
with strong winds, for an extended period of time can get frostbite. What’s
more, in conditions with extreme wind chill, frostbite can occur more quickly
than most people think.
Cleveland Clinic dermatologist Ursula Stanton-Hicks, M.D., describes the
first symptoms of frostbite as a "pins and needles" sensation followed
by numbness. "Frostbitten skin is hard, waxy, cold and has no
feeling," she says. After it has thawed, frostbitten skin appears red and
may burn. In cases of severe frostbite, the skin may blister, ulcerate and turn
gangrenous, possibly necessitating amputation of the affected body part.
Prevention. If you anticipate being in the cold outdoors for a prolonged
period of time, dress appropriately, don't drink alcohol and don’t smoke.
Wearing mittens (rather than gloves) and a hat that covers your ears helps keep
heat contained. Also, dress in layers, using cotton next to your skin and wool
on the outer layers. Properly fitted clothing that is windproof, water-resistant
or waterproof will offer the best protection.
People who have atherosclerosis, diabetes mellitus and Raynaud’s disease,
as well as those who are taking beta-blockers, which decrease the flow of blood
to the skin, are particularly susceptible to frostbite.
Treatment. Even for a mild case of frostbite, you are urged to seek
medical attention. Immediate treatment includes warming the area with wet heat
(warm water at temperatures between 104 and 108) and keeping the affected area
elevated above the heart. "You can reduce the risk of serious tissue damage
if you can avoid warming an affected area and then returning it to cold again to
freeze. For example, rather than stopping at a temporary shelter to warm a
frostbitten hand, it’s better to continue on until you reach your
destination," advises Dr. Stanton-Hicks.
Chilblains. Unlike frostbite, chilblains occurs when weather is damp and
the temperature is just above freezing. Dr. Stanton-Hicks describes chilblains
as red swellings on the skin, which can sometimes blister and ulcerate.
Generally, symptoms appear 12 to 24 hours after exposure, and the affected areas
may burn and itch upon warming. Barring an infection, chilblains usually heals
within three weeks. Similar to frostbite, chilblains develops on the toes,
heels, legs, fingers, face and earlobes.
Prevention. To prevent chilblains, follow the guidelines for preventing
frostbite. Of particular importance is wearing properly fitted clothing and
keeping as dry as possible, especially the feet. Waterproof boots and insulated
linings that become wet can contribute to chilblains. In addition to children,
people with poor circulation, anemia or a genetic disposition to chilblains are
at higher risk.
Treatment. As with frostbite, you should seek medical attention if you get
chilblains. Immediate treatment includes warming the area, but avoid applying
extreme heat or cold directly to chilblains.
For a free fact sheet on winter skin care, call 800/545-7718.
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