Q. I was outside for longer than expected in the cold weather and am concerned about frostbite. What can you tell me about it?
A. We do experience wintry weather in Grey-Bruce with many snow days for the kids and sometimes the adults get snow days too. With the kids (and kids at heart) wanting to go and play in the snow for hours on end as well as the many people traveling in treacherous driving conditions and getting stuck, you may find yourself or a loved one at risk of frostbite.
Frostbite is an injury that is caused by freezing the skin and the tissues beneath it. When body tissues are exposed to very cold temperatures, ice crystals begin to form inside the cells which cause damage and restrict blood flow. This can ultimately result in tissue death if not dealt with promptly. One thing to note is that frostbite can develop in mere minutes during extreme cold and high wind conditions. Also, children and older adults as well as anyone with poor circulation are particularly vulnerable to frostbite. Certain medical conditions (such as diabetes, peripheral vascular disease and Raynaud’s phenomenon) and certain medications (such as beta blockers and some psychiatric medications) can reduce blood flow to your extremities thus increase your risk of frostbite. Some other contributing factors that may also play a role and amplify your risk of frostbite are alcohol use, dehydration, and fatigue.
You might imagine that the formation of ice crystals on our skin might cause some discomfort and you are right. Some symptoms to be wary of if you are out in the cold temperatures are;
– Cold, tingling or stinging sensations
– Pale, red, or greyish-yellow skin
– Hard or waxy skin
– Numbness or loss of sensation
– White or bluish skin
There are three stages of frostbite which describe the severity of the frostbite and the symptoms associated with them.
1. Frostnip where the skin is cold, sore and painful and the skin looks red/purple. In this stage, the damage is temporary.
2. Surface frostbite when you begin to experience pins and needles. You may notice your skin beginning to peel. Blisters may form in the affected area.
3. Deep frostbite when numbness sets in and the skin begins to turn hard and black.
Most typically frostbite affects areas of exposed skin that are farthest from the heart (fingers, nose, ears, cheeks, chin). However, frostbite can also develop under gloves or boots if they are wet or ill fitting so don’t think your toes are fully protected if you are wearing footwear.
If you suspect frostbite, find a warm, sheltered environment and get out of the cold immediately. Remove wet or tight clothing and jewelry which might restrict your circulation. As much as we think we need to rub the skin to promote heat, rubbing can cause further tissue damage, especially if ice crystals have already formed in the skin. Rather, immerse the area in warm (not hot) water. This rewarming can take 15-30 minutes. Refrain from applying a direct source of heat like a heating pad or hot water bottles as the frostbitten skin is now fragile and it at risk of burns and thus further skin damage.
If you suspect stage 2 or 3, look for medical treatment as soon as possible to avoid long-term damage to your skin.
During the rewarming process, when the circulation begins to improve, you may experience pain, tingling or burning. This can be quite severe in some cases. Analgesics like acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) might be required to ease the pain. It is also important to drink water to rehydrate your body. It may sound odd but frostbite takes water away from our tissues.
Once the skin has thawed, the area should be kept clean and dry and loosely covered with a clean cloth or towel. Closely monitor the skin over the next several hours and days. Seek medical attention if;
– The skin remains numb after rewarming
– Blisters are severe
– Skin turns black or dark blue
– Increasing pain, swelling or signs of infection
As with many ailments we discuss, prevention is the best approach. When going out in the cold, wearing multiple loose-fitting layers are better at trapping warm air around your body than one single thick layer. Tight clothes may restrict circulation and should be avoided.
Wearing scarves helps to cover exposed skin on your head and neck that are hard to keep covered with clothing. Wearing mittens and insulated boots can help keep those fingers and toes safe. By the way, mittens are better than gloves when it comes to preventing frostbite as they allow our fingers to share the heat with each other.
If you find yourself with wet clothes, make sure you change out of them (socks, mitts, etc) and into dry ones as soon as possible.
As mentioned above, alcohol and dehydration can increase your risk of frostbite. Alcohol increases heat loss and impairs your judgement leading to poor decision making. Proper nutrition and hydration will also help you maintain your body heat.
Like many conditions, the young and the old tend to be more susceptible as they may not recognize the early signs or symptoms of frostbite or their reduced circulation or sensation does not allow them to notice it.
In rural areas like ours, many people are driving distances to get to activities, jobs, or appointments. For those of you that have lived here through a winter, you know that the road conditions can change quickly. Make sure you bring an emergency bag filled with layers of outdoor clothing, scarves, blankets as well as food and water. This can help keep you safe and warm. If you have a cell phone, try to ensure you have a good amount of battery left before you leave the home. That would be a shame if you needed to call for assistance only to find out your cell phone won’t work.
For more information on this or any other health related topic, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination.
