Frostbite

Diagnosis

Frostbite is diagnosed based on your symptoms and a review of your recent exposure to cold temperatures. A healthcare professional will assess the affected skin for color, texture, and sensation changes. They may also ask about how long you were exposed to the cold and whether you noticed numbness or pain before the injury.

To evaluate the severity of tissue damage, imaging tests may be used, including:

• X-rays to check for bone or joint damage

• MRI scans to assess muscle and tissue injury

• Bone scans in some cases to detect deep tissue involvement

It may take 2 to 4 days after the skin has been rewarmed to determine the full extent of tissue damage.

Treatment

Frostbite requires prompt first aid followed by medical treatment. The main goal is to rewarm the affected area, relieve pain, prevent infection, and reduce the risk of long-term complications such as tissue loss.

First Aid for Frostbite

• If hypothermia is suspected, seek emergency medical help immediately

• Protect the affected area from further exposure

• Avoid rewarming the skin if there’s a chance it may freeze again

• Move to a warm environment and remove any wet clothing

• Warm the affected skin using body heat or a warm-water bath for about 30 minutes

• Avoid walking on frostbitten feet or toes

• Remove rings or tight clothing before swelling starts

• Do not rub or apply direct heat to the affected skin

• Take a mild pain reliever if needed and drink a warm, nonalcoholic beverage

Medical Treatment

Once in medical care, frostbite treatment may include:

• Rewarming: A warm-water bath (15–30 minutes) is used to gently thaw frozen skin. You may be asked to move the area during rewarming.

• Pain relief: Because rewarming can be painful, you may be given pain medication.

• Protecting the injury: The affected area may be loosely wrapped in sterile dressings and elevated to reduce swelling.

• Whirlpool therapy: Soaking the injured area in a whirlpool bath helps clean the skin and remove dead tissue naturally.

• Antibiotics: If infection is suspected, you may be prescribed antibiotics.

• Blood flow medications: In severe frostbite, thrombolytic medicines such as tissue plasminogen activator (TPA) or iloprost (Aurlumyn) may be used to improve blood flow and reduce the risk of amputation. These medicines are typically used within 24 hours of exposure.

• Debridement: Dead or damaged tissue may need to be removed to promote healing.

• Blister and wound care: Depending on the blister type, healthcare professionals may either drain or leave them intact for natural healing.

• Surgery: In cases of severe frostbite, surgical removal or amputation of dead tissue may be necessary over time.

Early diagnosis and prompt medical care can help prevent complications, preserve tissue, and improve recovery outcomes after frostbite.