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Frostbite Hypothermia Winter Risk Stages Safe Steps to Prevent

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Last updated 11/30/23

Yes, ol Jack Frost is back again to nip at your nose. Temps drop during the winter making it downright chilly outside. So, when going outside to shovel snow, walk the dog or get the kids to school everybody bundle up. Frostbite hypothermia is a risk.

There are dangers to all weather conditions and winter has no exceptions. Windchill can contribute to frostbite and hypothermia leading to damaged underlying tissue. But these situations can be prevented.

It can be impossible to avoid going outside altogether. However, you can prepare yourself before facing the elements. Along with storing warm, dry clothes in your car.

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What is Frostbite?

Frostbite is damage to skin and tissue exposed to freezing temps. As your body contains water this expands when it freezes. Thus, ice crystals can form in your cells.

Often skin facing the harsh elements are vulnerable to frostbite. This means going out in the cold without wearing the appropriate clothing. So, your hands may not be covered and protected.

Affected areas:

  • Nose
  • Cheeks
  • Ears
  • Chin
  • Fingers
  • Toes

Frostbite symptoms:

  • Cold skin with prickling feeling
  • Numbness
  • Color red, white, bluish-white, grayish-yellow, purplish, brown or ashen
  • Hard or waxy appearance
  • Clumsiness from joint and muscle stiffness
  • Blistering once rewarmed (severe)

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What Causes Frostbite?

Mainly it is caused by being outdoors during cold (winter) weather conditions.

These winter conditions contribute to frostbite:


There is a dangerous risk to your skin when temperatures outside fall below freezing. This is even with low wind speeds. Frostbite takes less than 30 minutes on exposed skin when the windchill is harsh.

Your Garments

Well, you have to be out in the cold temperatures for sure. But think about what you’re wearing. Does the fabric protect against cold, wind or wet weather or is it too tight?

Touching Frozen Objects

If you touch or have skin contact with ice, cold liquids or frozen metal frostbite can occur. So don’t touch that steel pole with bare hands.

Frostbite Hypothermia Affects Your Skin How?

Your tissues freeze because you exposed them to temps below the freezing point. Hypothermia develops when your body temperature drops extremely below 98.6F. To clarify, your body is primarily programed to survive and function second.

Thus, blood vessels of your arms and legs are told to constrict (narrow) making them colder. As it slows blood flow to the skin the body can provide more blood to vital organs. This gives them essential nutrients. In addition, this prevents the reduction of the body’s temperature by not exposing blood to the outside cold.

As the blood is redirected fluid in these farther tissues can freeze into ice crystals. Ice crystals can cause severe cell and tissue damage here. With low blood flow the tissues are also deprived of oxygen. Above all, if the blood flow can’t be restored, eventually the tissue will die.

But when your brain receives a message that you are in danger of hypothermia it permanently constricts the blood vessels. Further, this keeps vessels from returning cold blood back to your internal organs. Frostbite has begun when this happens.

The Two Different Ways

This freezing occurs in two different ways.

Number 1, ice crystals develop in the area outside of the cell. There is water loss from the cells inside and this dehydration causes the cell to destruct.

The second is blood vessels with damaged lining. As the blood flow returns to the extremities during rewarming, it finds injured blood vessels from the cold. In short, blood is leaking from the vessel walls into the tissues.

Blood flow causes small clots to develop in the smallest vessels of the limbs. Complications occur due to these blood flow problems leading to inflammation. As a result, more tissue damage.

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The Three Stages of Frostbite


Frostnip is a mild form and can lead to frostbite. Numbness can develop in the affected area with continued exposure to the cold. Certainly, there may be a pins and needles feeling.

The area could turn white or ashen on darker skin. When your skin warms you may experience pain and tingling. In conclusion, this stage doesn’t cause permanent skin damage.

Superficial Frostbite

Superficial frostbite causes slight color changes from red to white or pale on the skin’s surface. Your skin may begin to feel warm. Furthermore, indicating serious skin involvement.

If you treat it with rewarming at this stage the surface of the skin could turn mottled. And you could feel stinging, burning and swelling. In addition, a fluid-filled blister could develop 12-36 hours after rewarming the skin.

Deep (Severe) Frostbite

As the frostbite becomes severe it affects all the skin layers including the tissues beneath the skin. The color turns white or bluish gray. Likewise, this area no longer has sensation of cold, pain or discomfort.

Therefore, joints and muscles could cease working. Large blisters develop 24-48 hours after rewarming. In conclusion, the tissue will turn black and hard as it dies.

Permanent damage could affect:

  • Blood vessels
  • Muscles
  • Nerves
  • Tendons
  • Bones

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People at Risk for Frostbite

These groups are most at risk for frostbite.

  • People active in winter and high-altitude sports like, skier and mountain climbers
  • Being stranded during extreme cold weather conditions
  • Anyone working outdoors in harsh weather for extended periods: rescue workers and postal workers
  • Homeless people
  • Infants and the elderly
  • People with blood vessel damage or circulation conditions: diabetes, atherosclerosis, Raynaud’s
  • Smokers
  • Those on medications that constrict blood vessels, beta blockers
  • Medical conditions affecting how you feel or respond to cold like, dehydration, excessive sweating or exhaustion
  • Alcohol or drug abuse
  • Phobias of fear, panic or mental illness where good judgment is altered or affects your dealing with cold
  • You had frostbite or an injury due to cold
  • Being in high altitude will reduce oxygen to your skin

When to See Your Doctor for Frostbite

Visit your physician if your frostbite:

  • Signs and symptoms are superficial or deep
  • Rise in pain, swelling, or inflammation
  • Discharge from frostbitten skin
  • Fever
  • New concerning symptoms

Most importantly, emergency care is required for hard, cold, blotchy skin. It is a medical emergency if you suspect hypothermia. This condition causes someone to lose heat faster than it is made.

Signs and Symptoms of Hypothermia:

  • Intense shivering
  • Slurred speech
  • Drowsiness and loss of coordination
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Frostbite Hypothermia Prevention

Limit Time Outdoors

Keep track of time outdoors in cold, wet or windy weather. Watch your weather forecasts and know the windchill readings.

Dress for Elements

Windproof and waterproof outer clothing should be worn as protection from the wind, snow and rain. Wear a couple more layers than you usually would for extra protection. Further, air trapped between clothing layers acts like insulation from the cold.

Dry Garments

Choose clothing underneath that wicks moisture away from your skin. Cotton is not recommended because it holds moisture against the skin making you wet and uncomfortable. Most importantly, change quickly out of wet clothing, especially gloves, hats and socks.

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Wear Something on Your Head

Wear a hat or headband to cover your ears. Heavy wool or windproof fabrics are the ideal headwear for protection from the cold. To sum up it’s best to have a hat that covers most of your face.

Mittens Yes

Opt for mittens versus gloves. Mittens are better than gloves in this weather because our fingers are close together to keep warm. Having hand warmers in your mittens while standing on a bus stop or working outside during winter will feel good.

Warm Socks

Wear socks and sock liners. These need to fit well, wick moisture away and insulate your feet. You can also use foot warmers. But make sure the foot warmers aren’t affecting your winter boots causing a restriction of blood flow.

Wearing an extra pair of wool socks (draws moisture away from sweating feet) will help keep toes from frostbite. Having diabetes is a risk factor so you want to be extra careful with your feet.

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Be Prepared

You never want to think about it but anyone can run off the road or get stranded with car problems. My dad would be after us to have things in the car for this reason. So have emergency supplies and warm clothing available. For example, I have a throw on my back seat and extra hats and mittens in my console.

Above all, this is just in case you should ever have to wait for help to arrive. If you are traveling to a remote area let others know your route and when you’ll be back.

Skip Alcohol

Don’t drink if you plan to go outdoors during cold weather. Alcohol causes your body to lose heat quicker.

Eat Healthy and Stay Hydrated

This helps you stay warm. Do this even before you head out in the cold. Have a water bottle along.

Keep moving

Yes, little movements keep your blood flowing. But don’t do this to the point you’re exhausted.

Wrapping it up

Avoiding extreme winter weather conditions by staying indoors is the best prevention against frostbite. If you must go out wear appropriate layers of clothes. Further, limit your time outside, if possible.

Know the signs and symptoms of frostbite. There are three stages. In addition, hypothermia is another serious condition. Most importantly, seek medical attention if you suspect freezing skin tissue.

Have you known anyone who has had frostbite? If you have learned anything new, let me know in the comments.


Mary is the founder of All About Our Skin. Former esthetician and CPC. Enjoys researching skincare and has been studying our skin for the past fifteen years.

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