Frostbite is damage to the skin and underlying tissues caused by extreme cold.
Cold exposure - arms or legs
A person with frostbite on the arms or legs may also have hypothermia (lowered body temperature). Check for hypothermia and treat those symptoms first.
Frostbite occurs when the skin and body tissues are exposed to cold temperature for a prolonged period of time.
You are more likely to develop frostbite if you:
Symptoms of frostbite include:
Very severe frostbite may cause:
Frostbite may affect any part of the body. The hands, feet, nose, and ears are the most vulnerable.
1. Shelter the person from the cold and move him or her to a warmer place. Remove any constricting jewelry and wet clothing. Look for signs of hypothermia (lowered body temperature) and treat accordingly.
2. If immediate medical help is available, it is usually best to wrap the affected areas in sterile dressings (remember to separate affected fingers and toes) and transport the person to an emergency department for further care.
3. If immediate care is not available, rewarming first aid may be given. Soak the affected areas in warm (never hot) water -- or repeatedly apply warm cloths to affected ears, nose, or cheeks -- for 20 to 30 minutes. The recommended water temperature is 104 to 108 degrees Fahrenheit. Keep circulating the water to aid the warming process. Severe burning pain, swelling, and color changes may occur during warming. Warming is complete when the skin is soft and sensation returns.
4. Apply dry, sterile dressings to the frostbitten areas. Put dressings between frostbitten fingers or toes to keep them separated.
5. Move thawed areas as little as possible.
6. Refreezing of thawed extremities can cause more severe damage. Prevent refreezing by wrapping the thawed areas and keeping the person warm. If protection from refreezing cannot be guaranteed, it may be better to delay the initial rewarming process until a warm, safe location is reached.
7. If the frostbite is extensive, give warm drinks to the person in order to replace lost fluids.
When to Contact a Medical Professional
Call your doctor or nurse if:
Be aware of factors that can contribute to frostbite, such as extreme cold, wet clothes, high winds, and poor circulation. Poor circulation can be caused by tight clothing or boots, cramped positions, fatigue, certain medications, smoking, alcohol use, or diseases that affect the blood vessels, such as diabetes.
Wear suitable clothing in cold temperatures and protect exposed areas. In cold weather, wear mittens (not gloves); wind-proof, water-resistant, layered clothing; two pairs of socks; and a hat or scarf that covers the ears (to avoid substantial heat loss through the scalp).
If you expect to be exposed to the cold for a long period of time, don't drink alcohol or smoke, and get adequate food and rest.
If caught in a severe snowstorm, find shelter early or increase physical activity to maintain body warmth.
Danzl DF. Hypothermia and frostbite. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 137.
Danzl DF. Hypothermia and frostbite. In: Fauci AS, Harrison TR, eds. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw Hill; 2008:chap 20.
Review Date: 1/8/2012
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.