Employee & Community Health

Frostnip or bite, cold weather can hurt

11/26/2018 by Dr. Matthew Bernard

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Like it or not, it's that time of year when the temperature drops. During the winter months, while it may be tempting to just hibernate, it's important to stay active for overall health. 

  • If you prefer to stay indoors, use exercise equipment at home, work out at a fitness facility or walk in large stores or malls — all are good ways to keep moving. 
  • If you prefer the outdoors, walking, jogging, skating, snowshoeing, cross-country skiing, sledding, playing in the snow and fat-tire biking are just a few of your options. 

But when you weather the weather, you also run the risk of injury from the cold. Cold injuries are caused by prolonged exposure to low temperatures. They may or may not involve actual freezing of body tissues. The young and the elderly are especially prone to these injuries. Drinking alcohol increases your risk. Two common cold-weather injuries are frostnip (chilblain) and frostbite. 

Common cold-weather injuries

Frostnip (chilblain). While this injury is painful, it causes little or no permanent damage. Frostnip appears as red, swollen skin that's tender and hot to the touch. Your skin also may itch. These symptoms can worsen to an aching, prickling ("pins and needles") sensation, followed by numbness. Frostnip can develop in only a few hours if your skin is exposed to extreme cold. 

Frostbite. This injury is much more serious and can cause serious harm. It typically affects areas of your body, such as fingertips, earlobes, cheeks, chin and the tip of the nose. If they reach 23° F. and stay that cold for an extended period, ice crystals actually form in the tissues. In other words, they start to freeze. 

There are four degrees of frostbite, and it may take three or four days to determine the degree. 

  • First and second degree. Signs and symptoms include blanching (turning white), temporary numbness, redness, and stinging and burning as the skin is warmed. 
  • Third and fourth degree. These symptoms include swelling, blue-gray discoloration, deep burning pain as the area is warmed, blisters, and gangrenous scab formation within two weeks of injury. 

How to treat them

The treatment for cold injuries is to: 

  • Get out of the cold
  • Remove any wet or tight clothing
  • Gently wash and dry the injured area
  • Elevate injured hands or feet
  • Cover the injured area with layers of loose, warm clothes or cloths
  • Slowly rewarm in warm water (105° to 110° F.) for 20 to 30 minutes or until the skin flushes (turns pink)
  • Protect the area from additional injury caused by activity

It's important not to warm an injured area if there's risk of it freezing again. If you suspect frostbite, head to urgent care or the emergency department. 

How to prevent them

Plan to enjoy the winter outdoor exercises and activities. But also make a plan for minimizing cold-weather injuries. Dress in layers and minimize the amount of exposed skin. Look for clothing that wicks dampness away from your skin and also can protect you from the wind. Heed windchill warnings, and head inside if you start to develop symptoms of frostnip. 

Whatever the weather is this winter, stay active, stay healthy, stay warm, stay safe!

Dr. Matthew Bernard is a family physician in Employee and Community Health (ECH). He also serves as chair of Mayo Clinic's Department of Family Medicine.