Brief overview
What is frostbite?: In frostbite, the skin and tissues are poorly perfused and damaged due to severe exposure to cold. There are different types of frostbite, depending on the extent of the damage, doctors distinguish three degrees of severity.
Symptoms: Depending on the severity of frostbite: from mild redness and swelling to skin blisters and pain to tissue death.
Prevention: clothing and shoes adapted to the temperature, hat, gloves, skin protection, exercise, avoidance of alcohol and nicotine, do not place cold packs directly on the skin, be careful when handling dry ice or liquid nitrogen.
Causes: Constriction of blood vessels due to cold, undersupply of blood and oxygen.
Risk factors: Wind, high humidity, clothing that is too thin, light or wet, alcohol consumption, circulatory problems, very young or very old age.
What is frostbite?
Frostbite (congelatio) is localized cold damage to the skin or the underlying tissue. Before localized frostbite occurs, the affected body parts have usually already been exposed to cold, wind and high humidity for some time.
If the body continues to be exposed to extreme cold, ice crystals form in the cells, destroying them. If the ice crystals extend to the entire organism, death by freezing (death from frostbite) is imminent. People who cannot escape the cold, such as after a fall outdoors, are particularly at risk.
What are the different types of frostbite?
Superficial frostbite affects only the uppermost layers of the skin and improves after a few minutes when these are warmed up again. Deep frostbite affects all layers of the skin and the underlying tissue. They may have serious and permanent consequences, such as the death of the affected body parts.
The resulting skin damage is similar to that of a heat burn: Within a few seconds, sharply defined, pale and dry areas with blistering appear – exactly where contact with the damaging substance has occurred. Within this area, all skin layers are dead and stuck together within seconds.
Never place cool packs directly on the skin! Always wrap cool packs in a towel!
What are the symptoms of frostbite?
In the case of local frostbite, the symptoms remain limited to the affected areas; general symptoms such as feeling ill or fever are usually absent. How frostbite manifests itself depends on how far it has progressed. Doctors divide localized frostbite into three degrees of severity based on its extent.
Symptoms of first-degree frostbite
Even if the red spots remain for some time after rewarming, first-degree frostbite heals again without any consequential damage. Sometimes, however, a slight disturbance of sensation remains for years.
Symptoms of second-degree frostbite
Never scratch or prick the blisters yourself, as this can develop into an infection!
Symptoms of third degree frostbite
What to do in case of frostbite?
How to treat frostbite depends on its extent: first-degree frostbite can be treated by yourself and will improve within a few minutes after you warm it up. However, if the affected area of skin remains numb even after warming, you should consult your family doctor. Deeper second- and third-degree frostbite always requires hospital treatment.
First aid measures for frostbite
- Locate in a dry place sheltered from the wind to prevent re-exposure or further exposure to cold.
- Ensure good circulation to the affected area: open tight-fitting clothes or too-tight shoes, or take off rings if hands are affected.
- Remove wet, cold clothing and wrap patient in warm blankets.
- Then loosely cover the affected body parts with a clean, preferably germ-free cloth or bandage, avoiding pressure.
- Warm drinks such as tea or coffee help to warm up the body internally.
What first aid measures you should avoid in case of frostbite
- Do not rub or massage the area, both of which can further damage the skin. Frostbitten areas of the body should also not be rubbed with snow!
- Do not open blisters that have formed!
- Frostbitten parts of the body are numb, so that the affected person does not feel when it gets too hot. Therefore, never warm the frostbite with direct heat (oven, fire, heating lamp)! There is a risk of burns here.
- Stiff frozen body parts should not be moved passively (for example by the first aider). The affected person should also not walk with frostbitten feet or toes. Otherwise there is a risk of further tissue damage.
- The affected person should not smoke under any circumstances! Nicotine constricts the blood vessels. Frozen parts of the body are then even worse supplied with blood.
Treatment of second or third degree frostbite
Frostbite with blistering (grade II and above) should be seen by a doctor as soon as possible after first aid. The same applies to frostbite that remains numb even after warming.
The doctor then treats the local frostbite:
Warming up: First, he slowly warms up the frostbitten skin area. This is done with warm compresses or a body-warm (maximum 35 degrees) bath.
Treatment of blisters: The doctor punctures blisters under sterile conditions and then covers the wound with a wound dressing.
How to prevent frostbite?
You can prevent frostbite with these tips:
Functional underwear: wear functional or thermal underwear directly on your body when it’s cold. It transfers moisture from the body to the next layer and keeps it warm and dry.
Dry clothes: If your clothes do get damp, change them immediately!
Shoes: Make sure that your winter shoes are sufficiently wide and well lined.
Hat, gloves: Always wear a hat and gloves in frost and icy wind! Wear windproof masks in the mountains!
Exercise: Always keep moving in icy outdoor temperatures!
Drink enough: Drink enough. Prefer warm drinks to warm the body from the inside. Refrain from alcohol!
Pre-existing conditions: Ask your doctor for advice if you have circulatory disorders of the fingers and toes (such as Raynaud’s syndrome)!
Causes and risk factors
Causes
The cause of frostbite is exposure to cold. To prevent the body from becoming hypothermic in cold conditions, it tries to keep the internal body temperature (core temperature of about 37 degrees) in balance. This is necessary to keep vital organs supplied with blood.
Risk factors
Frostbite often happens during winter sports and mountain climbing. Infants and young children, as well as adults of advanced age, are particularly at risk because their skin is relatively thin. Death from frostbite often affects people who are unable to get up after falling in the cold. Alcohol consumption does the rest: since alcohol dilates the vessels, body heat can escape all the more quickly.
Other risk factors that can promote or aggravate frostbite are:
- High humidity
- Clothing that is too thin, light or constricting
- Damp or wet clothing
- Physical overexertion
- Blood loss
- Smoking
- Diabetes mellitus
- Circulatory disorders
- Malnutrition
Examination and diagnosis
Go to the doctor if frostbite hurts a lot or blisters form!
Course of the disease and prognosis
The course depends on the intensity and extent of frostbite. Basically, the earlier frostbite is treated, the better the prognosis.
From frostbite grade three, scars form. If the tissue has already died due to the cold, the affected body part must be amputated.
