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Frostbite

What is Frostbite?

  • Frostbite occurs when tissues freeze. This condition happens when you are exposed to temperatures below the freezing point of skin. Hypothermia is the condition of developing an abnormally low body temperature. Frostbite and hypothermia are both cold-related medical emergencies.
  • The condition has long been recognized. A 5000-year-old pre-Columbian mummy discovered in the Chilean mountains offers the earliest documented evidence of frostbite. More recently, Napoleon's surgeon general, Baron Dominique Larrey, provided the first description of the mechanisms of frostbite in 1812, during his army's retreat from Moscow. He also noted the harmful effects of the freeze-thaw-freeze cycle endured by soldiers who would warm their frozen hands and feet over the campfire at night only to refreeze those same parts by the next morning.
  • Although frostbite used to be a military problem, it is now a civilian one as well. The nose, cheeks, ears, fingers, and toes are most commonly affected. Everyone is susceptible, even people who have been living in cold climates for most of their lives. Some groups of people at greatest risk for frostbite and hypothermia include those:
    • who spend a lot of time outside, such as the homeless, hikers, hunters, etc.;
    • under the influence of alcohol;
    • who are elderly without adequate heating, food, and shelter;
    • who are exhausted or excessively dehydrated;
    • who are mentally ill.

Frostbite Causes

Your body works to stay alive first, and to stay functioning second.

  • In conditions of prolonged cold exposure, the body sends signals to the blood vessels in the arms and legs telling them to constrict (narrow). By slowing blood flow to the skin, the body is able to send more blood to the vital organs, supplying them with critical nutrients, while also preventing a further decrease in internal body temperature by exposing less blood to the outside cold.
  • As this process continues and the extremities (the parts farthest from the heart) become colder and colder, a condition called the hunter's response is initiated. The body's blood vessels are dilated (widened) for a period of time and then constricted again. Periods of dilatation are cycled with times of constriction in order to preserve as much function in the extremities as possible. However, when the brain senses that the person is in danger of hypothermia (when the body temperature drops significantly below 98.6 F [37 C]), it permanently constricts these blood vessels in order to prevent them from returning cold blood to the internal organs. When this happens, frostbite has begun.
  • Frostbite is caused by two different means: cell death at the time of exposure and further cell deterioration and death because of a lack of oxygen.
    • In the first, ice crystals form in the space outside of the cells. Water is lost from the cell's interior, and dehydration promotes the destruction of the cell.
    • In the second, the damaged lining of the blood vessels is the main culprit. As blood flow returns to the extremities upon rewarming, it finds that the blood vessels themselves are injured, also by the cold. The vessel walls become permeable and blood leaks out into the tissues. Blood flow is impeded and turbulent and small clots form in the smallest vessels of the extremities. Because of these blood flow problems, complicated interactions occur, leading to inflammation that causes further tissue damage. This injury is the primary determinant of the amount of tissue damage that occurs in the end.
    • It is rare for the inside of the cells themselves to be frozen. This phenomenon is only seen in very rapid freezing injuries, such as those produced by frozen metals.

Frostbite Stages: Pictures

Three frostbite stages are:

  1. The first degree - irritates the skin
  2. The second degree - blisters but has no major damage
  3. The third degree - involves all layers of the skin and causes permanent tissue damage

Picture of the Stages of Frostbite

Picture of the stages of frostbite

Medically Reviewed by a Doctor on 3/2/2016

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Patient Comments & Reviews

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Frostbite Symptoms

Frostbite and Hypothermia Symptoms and Stages

Frostbite and hypothermia are the consequences of cold exposure and both can have long lasting effects.

Frostbite and hypothermia are the consequences of cold exposure and both can have long lasting effects. Not all organs in the body are created equal. While the body tries to maintain a constant temperature where heat production is balanced by heat loss, it is quite willing to sacrifice expendable parts like fingers and toes to protect vital organs like the heart and brain. When exposed to a cold environment, the body tries to keep blood circulating away from the skin where it can be cooled by the outside weather. Shivering starts to generate heat and can compensate well if the cold exposure is short-lived. If, however, the body remains in the cold, bad things can happen very quickly.


Read What Your Physician is Reading on Medscape

Frostbite »

Frostbite is a cold-related injury characterized by freezing of tissue.

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