Do we really know about frostbite?

We all love the cold. But what if that cold gets a little too much? Imagine you are in a place like Nuwara Eliya on a very cold day, or you are abroad for study or work and there is heavy snowfall. Have you ever thought about the damage that can be done to our skin at times like this? That is what we call "Frostbite" in medicine. Simply put, due to extreme cold, our skin cells and tissues freeze, like water freezing, and they are damaged. This is like the skin being burned by the cold. So today, let's learn everything about Frostbite in a very simple and conversational way.

What exactly is frostbite?

Frostbite is damage that occurs when our skin is exposed to temperatures below 0 degrees Celsius (32 degrees Fahrenheit), which is below the freezing point of water. Our skin is made up of more than 60% water. So when it gets too cold, this water starts to turn into ice cubes. These ice cubes damage skin cells and cut off blood flow to those areas. This can even cause tissue death. In medicine, we also call this tissue death (necrosis) .

There are several situations where this situation is more likely to occur:

• In winter.
• When there is strong windy weather.
• In high places like mountain peaks.
• When there is no shelter to protect yourself from the cold.

Remember, even if you are wearing warm clothing, frostbite can still occur under your clothes. If you suspect you have frostbite, get out of the cold and go indoors immediately . Then see your doctor as soon as possible. Or go to the Emergency Department (ETU) . Early treatment can prevent serious damage.

Who is at higher risk of developing frostbite?

Anyone exposed to extreme cold can develop this condition. However, some people are at a higher risk. This is especially true for the fingers, toes, nose, and ears, which are the parts of our body most exposed to the cold.

The groups at highest risk are:

• People under 18 and over 65: Young children and the elderly have a reduced ability to regulate their body temperature.
• People who live and work in countries with cold climates: Because they are constantly exposed to the cold.
• Those who are homeless or do not have proper shelter.
• People with certain underlying medical conditions: For example, conditions such as peripheral vascular disease, malnutrition, Raynaud's syndrome, hypothyroidism, arthritis, or diabetes.
• People who use tobacco products: Smoking causes blood vessels to constrict, reducing the amount of blood flowing to the limbs.

What are the stages of frostbite?

Frostbite doesn't get worse all at once. It develops gradually in three stages. It's important to be aware of these three stages because if you recognize them early, you can avoid major damage.

Is it possible that I don't know if I have frostbite?

Yes, it definitely is. The worst thing about frostbite is that it numbs your skin, so you can go without feeling anything. You may not even notice any difference after you come home from the cold. That's why it's advised to limit your time outside during extreme cold.

How do you know if young children have frostbite?

It's a little harder to tell if a young child has this condition. Babies don't shiver like adults. Older children are so excited about playing that they don't even realize they're cold. That's why we, as parents, need to be very careful.

If you take your baby out in the cold for even a short time, like 10 minutes, check him carefully when you get him back. Look for any changes in his skin color, such as redness, paleness, or graying. If there are any changes, call a doctor immediately. If older children have been playing in the cold for more than half an hour, change their wet clothes, put them in dry clothes, and wrap them tightly in a blanket. It's also good to bathe them in lukewarm water . But never use hot water .

What to do if you get frostbite? First aid and treatment.

The treatment for frostbite varies depending on the stage it is in.

If you have stage 1 (Frostnip):

You can manage this at home.

1. Get out of the cold immediately: Get indoors or to a warm place as soon as possible.

2. Remove cold clothing: Gently remove items like gloves, shoes, and socks. Remove any rings or watches, if any. If you have wet clothing, put on dry clothes.

3. Warm up slowly: Place the damaged skin in a bowl of lukewarm (not hot) water for about 30 minutes. This should be done slowly.

4. Avoid direct heat: Do not touch anything directly to heaters, flames, etc. Your skin is numb and you cannot feel the heat, which can cause burns.

5. Don't rub: Never rub damaged skin. Doing so can further damage the tissue.

If there are symptoms of the second or third stage:

At the hospital, doctors provide treatments like:

• Warming the body: Warm the skin with lukewarm water or warm, damp cloths for about 30 minutes.
• Wound care: The damaged skin is cleaned, an antiseptic is applied, and the fingers are bandaged separately so that they do not stick together.
• Checking blood circulation: If necessary, fluids are given through an IV (saline) line to improve blood circulation.
• Administering medications: Antibiotics are given to prevent infection and painkillers like Ibuprofen for pain.
• Oxygen therapy: In some severe cases, you may be given pure oxygen under high pressure. This is called `Hyperbaric Oxygen Therapy`. This helps the tissues heal faster.
• Surgery: In some of the most severe cases, surgical removal of dead tissue may be necessary, sometimes even requiring amputation of parts such as fingers.

How to protect yourself from frostbite?

"Prevention is better than cure," they say. So keep these things in mind to stay safe from frostbite.

• Avoid the cold: Check the weather reports and stay indoors as much as possible on extremely cold days.
• Limit your travel: If you absolutely must go out, come to a warm place every 15-20 minutes, stay for a while, and then go again.
• Dress properly: Wear layers of clothing. Wearing loose, loose-fitting clothing allows air to circulate between the layers, helping to keep you warm. Cover your ears, nose, and mouth with warm socks, a hat, gloves (mittens are better than gloves), and a muffler.
• Change out of wet clothes immediately: If your clothes get wet, whether from sweat or snow, change into dry clothes immediately.
• Keep your blood circulation good: Don't wear tight clothes or shoes. Don't stay in one position, keep moving and walking around.
• Avoid alcohol and smoking: Although drinking alcohol may make you feel hot, it actually causes your body to lose heat more quickly. Smoking constricts blood vessels.

What is the difference between Frostbite, Chilblains and Hypothermia?

Although all three of these conditions are caused by cold, they are different from each other.

• Frostbite: As we mentioned, exposure to freezing temperatures (below 0°C) causes damage to skin tissue.
• Chilblains: This occurs when you are exposed to temperatures above freezing, but cooler . They cause red, itchy, swollen patches of skin. These are usually not serious and heal on their own.
• Hypothermia: This is the most dangerous of the three. This is when the temperature of the entire body, not just the skin, drops abnormally low (below 95°F or 35°C). This is a medical emergency that can be life-threatening.

It is possible for a person to have both Frostbite and Hypothermia at the same time.

Frostbite, Skin damage, Extreme cold, First aid, Cold burns, Skin protection