“Bitter, bitter cold” is one of the best ways I’ve heard a patient describe the Upper Midwest weather conditions that left him hospitalized with frostbite. Living here, we get pretty used to these bitter temps that head our way each winter. But unfortunately, this familiarity can also be our downfall.

When we don’t properly prepare for or respect the mighty winter elements, serious injuries like frostbite can and do happen – fast.

What is frostbite? How does it affect your skin and body?

What’s the first thing that comes to mind when you think of a skin burn? It’s likely not “extreme cold” or “frostbite.” Despite this, frostbite is actually considered a type of burn that happens when the skin and tissues below it begin to freeze. It’s usually the result of skin being exposed to temperatures below the freezing mark.

Depending on how serious frostbite is, there can be some long-term effects. For less serious cases, body parts affected by frostbite may be more sensitive to the cold. But sometimes, patients experience life-long numbness in these areas. And in severe cases, amputation is needed if blood flow to the skin is permanently blocked.

How long does it take for frostbite to set in?

The colder it gets, the faster you get frostbite. And when you add wind and water, the process speeds up even more. Every person and every situation is different, but here are a few guidelines to know:

  • Once sub-zero temps hit, it takes about 30 minutes for exposed skin to get frostbite.
  • At 15 below with a little bit of wind, frostbite is possible within 15 minutes.

Wind Chill Temperature and Frostbite Chart

The chart below from the National Weather Service shows how long it might take to develop frostbite at varying temperatures and wind speeds.

Windchill chart

What are the symptoms of frostbite?

Your fingers, toes, nose, ears, cheeks, and chin are the most common places for frostbite. Here’s what the first signs of it look and feel like:

  • Your skin starts to become cold with a pins and needles sensation.
  • You have an increasing loss of feeling and numbness.
  • Your skin turns pale blue or grayish.
  • Your skin feels stiff or rubbery to the touch.

Knowing these early symptoms can help you treat frostbite fast and have the best outcome.

In severe cases of frostbite, blisters can develop after re-warming the skin and affected areas. In addition, your muscles and joints may stop working, and your skin can become dark purple or black.

Frostbite prevention: preparation is key

Every winter, our Regions Hospital Burn Center sees up to 60 patients come in with frostbite injuries. Many times, the frostbite happened when these patients were out doing ordinary tasks that just didn’t go as planned. Getting stranded in the cold in a stalled or wrecked vehicle tends to be a common situation. There are also quite a few people who get locked out of their house, or that slip outside and can’t get up after the fall.

With that said, do your best to limit trips outdoors when the temperature is below zero. But if you do have to leave, remember to be prepared by expecting the unexpected. Here are my top four tips:

  1. Dress (or pack) for success. Whether you’re planning to spend the whole day outdoors or are just heading to the grocery store, make sure you’re wearing (and/or bringing along) the right clothes. The best choices are clothes made of wool, down or Thinsulate – all which prevent the loss of body heat. And don’t forget a warm hat, mittens and pair of boots. Think you have enough layers? Add one or two more!
  2. Carry your cell phone with you. Most of us do this anyway, but it’s still a good reminder in case of an emergency situation. Don’t assume you’ll be able to reach someone if don’t have a phone with you.
  3. Remain calm if you find yourself exposed to extreme cold. Fear can cause sweating, which cools the body and can make you feel chilled. To get your blood moving and make body heat, whirl your arms around like a windmill. But be careful not to be so active that you sweat.
  4. Know what to do if you get frostbite. Mild frostbite can be treated at home. Do not rub or massage frozen skin – but rather soak the affected area in warm water (99-108 degrees) for 15 to 30 minutes. If this doesn’t seem to be working (and/or your skin starts to blister and pain increases), go to the Emergency Department.