Frostbite and Frostnip

Frostbite is damage to the skin from freezing and is due to prolonged exposure to cold temperatures, usually below 32 degrees F. It occurs when ice crystals form in the skin or deeper tissue. The most common sites for frostbite are the fingers, hands, toes, feet, ears, nose, and cheeks.

The severity of frostbite depends on several factors, including temperature, length of exposure, wind-chill factor, dampness, and type of clothing worn. Children are more prone to frostbite than adults because they lose heat from their skin faster and do not want to come inside when they're having fun playing outdoors.

Frostnip is less severe and affects the tips of the cheeks, ears, nose, fingers, and toes. It can usually be treated at home.

When frostnip occurs, a child's skin may be reddened and feel numb or tingly. If this happens, bring your child inside and warm his skin by using warm compresses or immersing the area in warm water (100 to 105 degrees F) until sensation returns. Do not rub or massage your child's skin. If symptoms of frostbite occur or warming the skin does not help, call your child's physician immediately.

Each child may experience symptoms differently, but the most common signs of frostbite are:

• Skin that reddens before becoming white, hard, and swollen
• Skin that burns, tingles, or becomes numb

Severe frostbite can result in blisters or ulcers forming and may involve deeper tissues.

To help prevent frostbite and frostnip, consider the following:

• Dress your child warmly in layers. Make sure the ears, fingers, and toes are well covered.
• Change clothing if it becomes wet, especially socks and mittens.
• Bring your child indoors often to warm up and provide a warm snack, soup, or drink.
• Be alert for early signs of frostnip and frostbite, and teach your child what signs he or she should watch for.

Specific treatment for frostbite will be determined by your child's physician based on the extent and severity of the injury. But in general:

• Remain calm and reassure your child that you can help. If feet are affected, carry your child; do not allow him or her to walk.
• Move your child inside to a warm area and put him or her in dry clothes. Call your child's physician or take your child to the emergency room immediately. Frostbite can cause serious injury and needs immediate medical attention.
• While waiting for medical assistance:
  • Give your child something warm to drink and wrap a blanket around him or her.
  • Warm the skin by using warm compresses or immersing the area in warm water (100 to 105 degrees F) until sensation returns.
  • Do not rub or massage the skin.
  • Do not use direct heat such as heating pads or fires.
  • Do not place the frostbitten skin in snow to "warm" it.
  • Apply clean cotton or gauze between fingers and toes if they are affected.
  • Do not disturb any blisters.
  • Wrap warmed areas of the skin to prevent further damage.

Further treatment will depend on the extent and severity of injury and may include treatment of skin damage with debridement or surgery.