By Dr. Michal Kalisiak
It’s a painful winter affliction that carries the risk of permanent scarring. Yet frostbite, and its most severe effects, can be avoided by arming yourself with essential information.
Frostbite is a condition where the skin and the underlying tissue freeze due to prolonged exposure to sub-zero temperatures. Risk factors include outdoor work or sports, but also accidents, homelessness, mental impairment and pre-existing problems with circulation.
Symptoms of frostbite range from coldness, firmness, stinging, burning, numbness, pain, throbbing, pallor or blue skin discolouration and blisters to gangrene (tissue death).
If medical attention isn’t available right away, move out of the cold, replace wet or damp clothing to minimize further heat loss and use a blanket to warm the entire body.
If there is a risk of re-freezing, do not rub frostbitten skin with warm hands, or apply direct heat or thaw frostbitten skin as doing so can cause further damage.
Once you have access to medical attention, rewarming should be rapid. A common warming technique is the use of a whirlpool or bath at 37 to 39 degrees Celsius, or applying warm wet packs of the same temperature.
Rewarming usually takes 25 to 40 minutes and is complete when the tips of the affected area flush, the skin turns soft and sensation returns. Dead tissue around clear blisters can be cleaned, but leave blood-filled blisters intact to reduce the risk of infection. Apply dry sterile bandages (especially between fingers and toes) and try to restrict movement as much as possible.
Within days of rewarming, further blisters may form, but these should settle after about a week and may leave behind dead blackened tissue that forms scabs. If the frostbite is superficial, pink new skin will appear beneath the scab.
Additional therapeutic interventions, including radiologic studies, surgery or medications may be recommended depending on the severity of injury. To learn more about frostbite, please see dermatology.ca.
Dr. Michal Kalisiak is a dermatologist whose Alberta practice is devoted to skin cancer prevention, early detection and treatment. He also speaks on dermatology topics at physician education events.
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