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December 1st, 2018


Avoiding Frostbite

The cold weather is here and so is the danger of frostbite.

 

What Is It?

Frostbite is tissue injury resulting from the freezing and crystallization of the body fluids within and between the cells.  The ice crystals then damage the cell membranes.  Further damage results from obstruction within the smallest blood vessels and inflammation when blood flow is reestablished.

 

How Will I Know It?

Frostbite can develop insidiously.  It may begin with coldness that progresses to burning or throbbing.  This can eventuate in numbness and then loss of sensation.  The skin may subsequently become pale or bluish. Finally, frostbite causes finger clumsiness, difficulty walking, and severe joint pain.

 

The areas most often affected are fingers, toes, ears, and nose.

 

What Are the Consequences?

A case of frostbite can leave permanent reminders of the event.  Some consequences are minor, such as cold sensitivity.  Others are substantial, such as squamous cell carcinoma, arthritis, limb growth deformities in children, and gangrene.  Frostbite can result in limb amputations or require nose and ear reconstruction surgery. 

 

Who Is at Risk?

Both the very young and very old are at greater risk for frostbite.  They have greater difficulty producing and regulating heat as well as a proportionately greater body surface area from which to lose heat.

 

Groups especially at risk for frostbite are those of African, Middle Eastern, and Pacific Island descent. 

 

Women are usually more sensitive to frostbite than men.

 

People whose hands tend to become white in the cold are especially at risk for frostbite.

 

What to Avoid?

  • Avoid tight clothing.  It restricts circulation thus promoting cold injury.
  • Avoid smoking.  It also restricts circulation.
  • Avoid prolonged inactivity.
  • Avoid getting clothing wet.  The air trapped between the clothing fibers is an insulator that keeps heat from leaving the body.  Water is a conductor that facilitates passage of heat away from the body.

 

What To Do?

  • Seek shelter from wind as well as cold.  A small envelope of warm air surrounds the body and reduces the dissipation of heat.  Wind continuously blows away this envelope, thus accelerating dissipation of heat from the body.
  • Wear several layers of light, loose clothing.  The air trapped between the layers insulates against heat loss.  It is especially important to wear at least two pair of socks.
  • Wear mittens in place of gloves or on top of the gloves.  The reduced surface area of the mitten compared to the glove reduces the dissipation of heart. 
  • Cover the face and head and use a hat that covers the ears.  The face and head have a large blood supply that can rapidly dissipate heat.  Additionally, the ears and nose can easily have their blood flow compromised, predisposing them to frostbite.
  • Wear fabrics that are especially good insulators, such as fleece, polypropylene, and wool.

So be sure to protect yourself from frostbite and enjoy the many pleasant outdoor activities of winter.

 

Thomas Falasca, DO

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