When Your Fingers (and Toes!) are Freezing Off: How to Prevent and Treat Frostbite

By Niharika Vattikonda

Once the temperatures reach the single digits, and sometimes even the teens, frostbite can begin to occur. Frostbite occurs when the body constricts blood vessels near the skin’s surface to keep internal organs warmer. While blood vessels switch between constricting and widening to keep extremities warm, after the temperature is too cold, the blood vessels near the skin’s surface stop widening. At this temperature, ice crystals can form in the skin tissue and cause cell damage that cannot be repaired without increased blood flow. Although the times for it to occur depend on the wind chill, which is based on the speed of the wind and the temperature. In sub-zero temperatures, as seen below, frostbite can occur due to cell death within even half an hour of exposure, while wet weather reduces the time needed for frostbite yet still occurs drastically.

Frostbite can easily be prevented with some appropriate caution. Wearing warm clothes is a no-brainer, but winter clothes that are too snug can exacerbate the problem, while loose layers will help your body heat be distributed evenly. The first layer (closest to your skin) should be something that keeps you dry, and insulating layers of fleece and wool can be layered on top of this, before a final layer that is both wind- and waterproof. Warm mittens or gloves, which should ideally have textured fingertips to allow you to use your smartphone and other devices, and thick socks along with warm winter boots, are essential to avoid frostbite around your extremities. The key principle of winter clothing is warm and dry, but most importantly, dry. If you’re sweating because your clothes are too hot, you’re increasing your risk from frostbite, and you should take a few minutes to remove a layer so that you stop sweating.
 
However, if you couldn’t follow all the precautions, you need to remain vigilant to prevent severe damage to your skin through frostbite. Frostnip, the first stage of frostbite, causes skin irritation and possible redness as well as a cold feeling in the affected area followed by a numbing sensation. While frostnip doesn’t permanently cause damage to the skin, it is an indicator that you should move to a warm place or put on a layer of warm clothing to prevent further damage. If the frostbite progresses, the earlier stages will consist of the skin turning white and having a “pins and needles” feeling, but eventually the skin will turn hard and cold to the touch, darkening to blue and later to black.
 
If the frostbite has progressed past the earlier stages, it is crucial that you seek immediate medical care. Until then, you should get to a warm place and remove any wet clothing. The frostbitten area should not be massaged and warm water, not hot, should be used to rewarm the skin. However, only attempt to warm the frostbitten skin if you can sustain the warmth for an extended period. Rewarmed skin that is then re-exposed to the cold will sustain greater damage than the frostbitten area did originally. Applying dry bandages to the area can help, as will separating frostbitten fingers and toes with sterile gauze or cotton balls.
 
At the hospital, the doctor will attempt to rewarm the area and treat any other related conditions, such as pain and dehydration. Depending on the severity of the frostbite and secondary dehydration, it is likely that the patient will be hospitalized for a few days. In some cases, the skin is blackened to a point where blood flow cannot be restored; in these situations, the frostbitten area will likely be surgically removed to prevent the damage from affecting the surrounding skin. Some treatments that are being studied to avoid surgical intervention for severe frostbite include aspirin or blood thinners that may restore blood flow if given soon after rewarming the frostbitten area and hyperbaric oxygen therapy, when air pressure is increased in a pure oxygen chamber to stimulate healing. To avoid reaching a stage in which such therapy might be necessary, it is essential that you take all the precautions listed above. Stay warm!
 

About the Author
Niharika Vattikonda is a junior at Thomas Jefferson High School for Science and Technology in Northern Virginia, where she is focusing on computer science. She was first exposed to coding in middle school through HTML/CSS, studied Java in freshman year, and was a student at the Girls Who Code Summer Immersion Program in DC. Niharika enjoys STEM outreach and is the founder and CEO of Teens Transforming Technology, a nonprofit that provides access to computer science through workshops and camps for underserved populations, and she is the Events Director for Inspiring Femgineers, another local nonprofit. When she’s not coding or writing, Niharika enjoys participating in Model United nations and writing for her own blog, Teen Thoughts on Politics.

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