Early Stages of Frostbite

Frostbite is a serious condition that may permanently damage tissues, potentially leading to loss of fingers, toes or portions of the skin. It occurs when temperatures are low enough to freeze body tissues. Ice crystal formation damages the affected tissues and blood vessels. Frostbite develops in stages, which are marked by specific signs and symptoms. Recognizing the early stages of frostbite and seeking medical care can prevent permanent damage.

Frostnip

• Superficial frostbite, commonly known as frostnip, is the earliest stage of the condition. The outermost layers of your skin freeze with frostnip, causing a pale appearance. Partial numbness and tingling or a "pins and needles" sensation typically accompany frostnip. At the superficial stage, frostbite is reversible and does not cause permanent tissue damage. However, frostnip can rapidly progress to more severe stages of frostbite if you are unable to quickly rewarm the affected areas.

Pain

• Differing levels of pain are a good indicator of the progression of frostbite. With early frostbite, numbness and tingling predominate. Upon rewarming, pain and burning develop but typically resolve within hours. More advanced frostbite, involving freezing of the deeper layers of skin, leads to a complete loss of sensation in the affected areas. This is a dangerous characteristic of advanced frostbite because the condition may go unrecognized due to the absence of pain.

Skin Texture

• The texture of your skin changes as frostbite progresses. With frostnip, the skin is likely to feel stiffer than usual but compresses and bounces back when you press on it. As freezing progresses deeper into the tissue, it becomes increasingly firm and has no give. At this stage, the potential for recovery of the frozen tissue is uncertain. Rewarming the affected areas and monitoring them over several days reveals the extent of tissue damage sustained.

Rewarming Effects

• What happens to your skin upon rewarming is another indicator of the severity of frostbite. With frostnip, the affected skin typically becomes bright red and swells but appears otherwise normal. These effects characteristically persist for a few hours. With more advanced frostbite, swelling is accompanied by the formation of blisters as the skin warms. The blisters may be filled with clear or milky fluid, or blood. Blood-filled blisters indicate deep tissue freezing and severe tissue damage.

Prevention

• Be on alert for the early signs and symptoms of frostbite if you are exposed to temperatures or wind chill below freezing. Wear warm clothing and footwear. Protect your skin from exposure to the cold by wearing a hat that covers your ears; mittens or gloves; and a scarf to cover your nose, chin and cheeks. Go inside and seek warmth immediately if you notice skin discoloration or begin to lose sensation in your fingers, toes, ears or face.