Frostbite first aid

The signs of—and treatment for—frostbite.

Frostbite is when your skin literally freezes. It is most common on the bits that stick out and chill faster: fingers, toes, nose, ears, chin, and also cheeks (thin walls of flesh).

The rampant cell necrosis can cause these areas—and the underlying flesh—to die completely, and you can lose those parts of your body.

There is first aid for frostbite (and its milder, early-stage cousin, frostnip), but either way you need to get to the hospital as soon as possible for further treatment.

But first: check for hypothermia.

If you are cold enough to get frostbite, you might also be entering hypothermia, which is of far greater concern because it can kill you. The first rule of first aid triage is to treat the most life-threatening injury first. Better to lose a few fingers than your life.

How to avoid frostbite

  • Protect susceptible, exposed areas of skin when outdoors in the cold. Wear mittens or gloves, a hat, and some kind of face protection.
  • Wear warm, dry socks and carry several spares. Swap out as needed.
  • Layer in warm, dry clothing.
  • Bring spare mittens or gloves so you can swap out wet ones.
  • Stay out of the wind.
  • Try to avoid situations that restrict blood circulation: sitting in tight, cramped positions; wearing overly tight boots or clothing; drinking alcohol.

Signs of frostbite

  • Skin of an odd color (pale, bright red, or yellowish-gray) and very cold, hard, and waxy.
  • Prickly pins and needles followed by numbness.
  • Pain and blisters (when severe).
  • Blackened or gangrenous skin (when very severe).

How to treat frostbite

  • Protect the skin from any more exposure. Put on gloves and a face mask or balaclava if you have them. Tuck hands into armpits. Cover an exposed face with (dry) gloved hands.
  • Do not rub or massage the skin. Rubbing skin that is merely cold can warm it up, but with frostbitten skin the friction will only cause more damage.
  • Do not rub it with snow. This is an old (utterly false) remedy you may have heard of or seen in some survival movie.
  • Do not pop or disturb any blisters.
  • Try not to walk on frostbitten feet if you can.
  • Get out of the cold.
  • Remove wet clothes once you are safely out of the cold and in a warm, dry place.
  • If you are sure you do not run the risk of refreezing the affected areas, go ahead and thaw them. If the affected areas are likely to be refrozen—if you have to hike in a blizzard—do not attempt to thaw, because refreezing after a thaw will only make things worse.
  • Warm the skin slowly with warm—not hot—water. The ideal temperature used in hospitals is 104–108°F, but you are unlikely to be carrying an accurate thermometer, so test it by dipping in an unaffected body part (ideally, of another person). Soak for 15–30 minutes, circulating the water and rewarming it as necessary.
  • Do not use any direct heat. Do not use a stove, fireplace, heating pad, or anything else. The skin is so numb it has no feeling, and the person can easily be burned.
  • Wrap the affected area(s) in dry, sterile bandages (separating any fingers or toes).
  • Give pain medication as appropriate.
  • Seek emergency help.

As the skin thaws it will turn red, tingle, and burn. This is uncomfortable, but a good sign: it means the underlying blood vessels were, at least largely, undamaged, which means you may recover. If, however, a great deal of numbness or pain remains or blisters develop, get moving on emergency medical attention.

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