Frostbite occurs when skin is exposed to cold temperatures for a prolonged period of time, especially if there is a low wind-chill factor, or to extreme frigid temperatures for even a short time. Freezing results when blood vessels contract, reducing blood flow and therefore oxygen to the affected body part. Fingers, hands, toes, feet, nose and ears are most often affected. Frostbite may be superficial or deep. If your child has frostbite he may not realize it at first because the area is numb. Most children will recover fully without permanent damage as long as treatment is prompt. If severe frostbite occurs, damage may be permanent depending on the length and depth of exposure.
Skin that is frostbitten may look white or grayish yellow. It may feel hard or numb, or it may blister or become very dark or black. There may be swelling, itching, burning and/or severe pain on rewarming.
If your child has blisters or blackened skin present, he needs to be seen in the office now. If color and sensation do not return to normal after one hour of rewarming, he needs to be seen in the office now.
To rewarm the frostbitten area, place the body part in very warm water. A bath is often the best method. For the face and ears, apply warm, wet washcloths. The water should be very warm but not hot enough to burn. Continue to soak the affected body part until a pink flush returns to the skin. This may take 30 minutes. The last few minutes may feel particularly painful for your child. Warm fluids to drink are also helpful. For acute pain, ibuprofen may be given for pain relief.
Common mistakes: Do NOT apply snow to the frostbitten area. Do NOT massage/rub the affected area. Both of these methods can cause damage to the thawing tissues. Do NOT use dry heat, such as a heat lamp or electric heater, because the frostbitten skin cannot sense the burning.
Of course, prevention is the best way to avoid having to deal with any of the above. Make sure your child is dressed appropriately for the cold weather. Dress him in layers with a waterproof outer layer. Mittens are warmer than gloves. Make sure he is wearing a hat and avoid tight gloves or shoes that might interfere with circulation. Change wet socks and mittens immediately.