Frostbite

Overview

Frostbite is an injury caused by the freezing of skin and the tissues beneath it. It happens when your body is exposed to extreme cold, and the cold damages your skin and sometimes deeper structures like muscles and nerves.

Frostbite is not common in the general population, but it occurs in people who spend time in extremely cold conditions, such as mountaineers, outdoor workers, and people who are homeless.

It can affect anyone exposed to freezing temperatures, but people with poor circulation, those who use alcohol or tobacco, and those with certain medical conditions (like diabetes or Raynaud's disease) are at higher risk.

Symptoms

Common symptoms

• Numbness or loss of feeling in the affected area
• Cold, hard, or waxy-looking skin
• Skin that is pale, white, grayish-yellow, or bluish in color
• Stinging, burning, or throbbing pain when the area is warmed

Symptoms in children

• Children may not complain of symptoms, so look for changes in skin color or if they seem unusually quiet or in pain.
• They might resist having the affected area touched.

Symptoms in older adults

• Older adults may have reduced sensation and slower circulation, which can delay noticing symptoms.
• They are more likely to have underlying health conditions that increase risk.

Causes

Main causes

• Prolonged exposure to freezing temperatures, especially with wind chill
• Direct contact with cold surfaces like metal or ice
• Wet or damp clothing in cold conditions

Risk factors

• Being in cold weather without proper clothing
• Alcohol or drug use, which can impair judgment and reduce body heat
• Smoking, which restricts blood flow to the extremities
• Poor circulation from conditions like diabetes or peripheral artery disease
• Certain medications that affect blood flow
• Homelessness or inadequate shelter
• Previous frostbite injury

When to see a doctor

See a doctor urgently if:

• If you have hard, cold, blackened skin or large blisters
• If the area has no feeling at all
• If you have signs of infection like redness, pus, or fever

Book a routine appointment if:

• If you have mild numbness or color changes that don't go away after a day of gentle warming
• If you have small blisters and are unsure how to care for them

Diagnosis

A healthcare provider will examine your skin and ask about your exposure to cold. They will check for signs of tissue damage, like hardness, color changes, and loss of sensation.

Tests that may be done

• Usually no special tests are needed for mild frostbite.
• If deeper damage is suspected, the doctor may use an imaging test like an X-ray, MRI, or a special scan to check blood flow and tissue health.

What to expect at your appointment

You will have a physical exam. The doctor may gently warm the area or do rewarming in the clinic. They will assess how deep the injury is and plan treatment accordingly.

Treatment

Treatment focuses on safely rewarming the frozen tissue and restoring blood flow. It is important not to rewarm too fast or with direct heat, as that can cause more damage.

Self-care at home

• Get out of the cold and into a warm place immediately.
• Remove any wet or tight clothing and jewelry from the area.
• Warm the affected area using body heat (for example, tucking fingers in your armpit) or by placing it in warm — not hot — water (about 37-39°C or 98-102°F).
• Do not rub the skin or use direct heat like a heating pad, fire, or hot water, as this can increase injury.
• Wrap the area loosely in sterile gauze or a clean cloth after rewarming.

Medical treatments

In hospital, doctors may rewarm the area with warm water baths, give pain relief, and clean the skin. They may use medicines to improve blood flow or prevent infection. In some cases, they may remove dead tissue safely.

When is surgery considered?

Severe frostbite that causes deep tissue death (gangrene) may require surgery to remove dead tissue (debridement) or amputation if the tissue cannot be saved. This is only done after giving the body time to heal enough to see what can be saved.

Living with this condition

After frostbite, the affected area may be more sensitive to cold, and you may have permanent numbness or tingling. Protect the area from cold and injury for the rest of your life.

Lifestyle tips

• Always dress warmly in layers when in cold weather, especially protecting hands, feet, ears, and nose.
• Avoid smoking and limit alcohol, as they reduce blood flow.
• Manage any health conditions like diabetes or high blood pressure that affect circulation.

Diet and exercise

Eating a healthy diet rich in vitamins and minerals helps your body heal. Gentle exercise can improve circulation, but avoid activities that might expose you to extreme cold again until fully healed.

Mental health and emotional wellbeing

Frostbite can be emotionally distressing, especially if it leads to scarring, loss of function, or amputation. You may feel anxious, depressed, or worried about your appearance. It is normal to need support.

Prevention

Yes, frostbite can often be prevented. Dress in warm, windproof layers, including a hat, gloves, scarf, and insulated boots. Keep your skin dry and avoid staying in cold weather for long periods. Stay active to maintain blood flow, but do not push through numbness.

Vaccines

There is no vaccine for frostbite.

Screening programmes

There is no routine screening for frostbite, but if you have a medical condition that affects circulation, talk to your doctor about cold exposure risks.

Complications

If left untreated

• Gangrene (death of tissue), which can lead to infection and the need for amputation
• Long-term numbness, tingling, or pain
• Increased sensitivity to cold in the affected area
• Joint stiffness or arthritis in fingers or toes
• Scarring or changes in skin color

Long-term outlook

With early and proper care, many people recover fully from frostbite and have no lasting problems. Even if the injury is severe, medical advances in wound care and surgery often save more tissue than in the past. Your outlook depends on how quickly you get treatment and the depth of the injury.

Find support

International organisations

• NHS (National Health Service) ↗
• Centers for Disease Control and Prevention (CDC) – Cold Stress ↗

Local organisations

• NHS 111 ↗ · United Kingdom

Helplines

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