What is Frostbite?
Frostbite is the result of extreme cold damaging skin and other body tissues. Usually the damage is localized and happens most often in those body parts furthest away from the core of the torso.
Causes of Frostbite
There are several different circumstances that contribute to frostbite. The primary cause is getting caught in the cold with inadequate protection. Extreme wind chill and wet clothing can also increase the chances of getting frostbite. Exposing skin to cryogenic substances such as liquid nitrogen can also cause frostbite.
Medications for Frostbite
There are some medications that are used while recovering from frostbite. These medications include narcotic analgesics for the pain. Typical narcotics that are used include the hydrocodon/acetaminophen combinations of Vicodin, Lorcet and Norco. Codeine may be prescribed along with hydrocodone/homatropines like Hycodan and Tussicgon. For inflammation NSAIDs are usually prescribed including aspirin and ibuprofen. Acetaminophen is not used because it tells the body to lower its temperature. Antibiotics are also prescribed to prevent infection and include Doxycycline, Amoxicillin, Gentamicin and Keflex to name a few.
Prevention of Frostbite
To prevent frostbite it is imperative to take steps to keep warm.
- Wear many layers of clothing for protection.
- Make sure to wear warm gloves and socks and replace any wet clothes as quickly as possible.
- Be sure to wear a hat that covers the ears as 30% of heat is lost through the head.
- Be sure to stay hydrated and well nourished.
- Do not smoke, drink alcohol or drink caffeine while out in the cold.
- Keep an eye out for a white rash or patches on the face and ears. This is a first sign of frostbite.
Risk Factors of Frostbite
Individuals who have problems with blood circulation are more sensitive to the cold and prone to frostbite. Individuals who use beta blockers and suffer from conditions like peripheral neuropathy and diabetes are also at greater risk to develop frostbite in cold temperatures. Individuals who live in cold climates and are forced to spend a lot of time outside in the cold are also at higher risk to develop frostbite. The homeless, the very young and very old, and smokers are also at high risk for frostbite.
Symptoms of Frostbite
Symptoms of first degree frostbite begin with some pain and itching in the affected area and then the skin develops yellow, red and white spots. Numbness follows the discoloration. With second degree frostbite the skin actually feels hard. Blisters will develop that become black and hard. The final state of frostbite results in a waxy feel to the skin. The blisters begin as purple and then turn black. There is usually nerve damage and loss of sensation. In many situations the affected tissues die and need to be removed.
Treatment of Frostbite
Begin treatment of frostbite by keeping the injured area warm. Once safely indoors seek out medical attention. The doctor will begin thawing out the frozen tissues. Frostbitten hands and feet will be wrapped to prevent movement. Movement can cause ice crystals to further damage tissue. The frozen tissue can either be passively or actively rewarmed. Passively warming the frostbite involves exposing the area to warm air and simply covering with a blanket. Active re-warming warms the damaged area as quickly as possible to reduce the amount of tissue damage. To actively re-warm the frozen tissue it is immersed in a water bath between 104-108 degrees F. As the tissue warms it increases blood flow to the affected areas. This flow of blood to a cool area of the body and back to the heart can lower the body's temperature and may cause heart dysrhythmias so this process is carefully monitored. In extreme situations the tissue will die and have to be removed surgically. This can lead to amputation of fingers and toes and in very extreme cases a limb.
Types of Frostbite
Frostbite is typified in terms of degrees.
- First degree frostbite is actually called frostnip. In this situation only the outer skin is frozen. Usually there is no permanent damage.
- Second degree frostbite also has frozen skin but it actually hardens and will form blisters. While the area will heal it may develop an insensitivity to temperature.
- Third and Fourth degree frostbite dives deep into the body. In this case nerves, tendons, muscles, and blood vessels actually freeze. Nerve damage can occur and in very extreme cases amputation may be required.