As the weather quickly continues to get colder, a condition known as frostbite is commonly seen in podiatry. Frostbite injuries are classified by depth of tissue injury. Let’s talk about what symptoms to look for and how to treat these injuries!
Frostbite Classification
1st Degree – Frostnip / Superficial Frostbite
- Skin appears red, then pale or white.
- Numbness, tingling, or burning.
- No blisters.
- Full recovery expected with rewarming.
2nd Degree – Superficial Frostbite
- Skin may feel hard/frozen, but deeper tissues still soft.
- After rewarming: clear blisters form within 24 hours.
- Tissue remains painful and swollen.
- Typically heals but may leave long-term sensitivity or nail changes.
3rd Degree – Deep Frostbite
- Involves deeper tissues (dermis and subcutaneous layers).
- After rewarming: bloody (hemorrhagic) blisters.
- Skin turns blue-gray, eventually forming a black eschar (dead tissue).
- Can lead to tissue loss and permanent damage.
4th Degree – Full-Thickness Frostbite
- Extends into muscle, tendon, and bone.
- Area is insensate, cold, and hard.
- Skin becomes black, dry, and mummified.
- Often results in amputation.
How do you properly treat Frostbite?
1. Get out of the cold immediately
- Move to a warm, dry environment.
- Remove wet clothing, socks, boots, gloves.
2. Rewarm the area safely. This is the most important step!
How to rewarm:
- Use warm water at 37–39°C (98–102°F).
- Soak the affected area for 15–30 minutes until:
- Skin becomes soft again
- Color returns (red or pink)
- Tingling begins
Do NOT:
- Use hot water, stoves, fires, heating pads
- Rub or massage the frostbitten area
- Rewarm if it may refreeze again (this causes worse damage)
3. Protect the area
After rewarming:
- Pat dry gently.
- Cover with sterile, loose gauze.
- Place clean gauze between toes/fingers if affected.
- Keep the area elevated to reduce swelling.
4. Manage pain
- Frostbite rewarming is painful.
- Over-the-counter pain relievers like ibuprofen can be used.
5. Hydrate
- Drink warm fluids to help improve circulation
Go to an ER or urgent care immediately if:
- Skin is hard, white, gray, blue, purple, or black
- Blisters form
- The area stays numb after warming
- You cannot feel part of the skin
- There is severe swelling or dark discoloration
- You suspect deep frostbite
