What Are the Basics of Frostbite?

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What is frostbite?

Frostbite is a treatable but potentially serious condition caused by freezing of the skin and underlying tissues. Being exposed to cold temperatures and windy weather increases the risk of developing frostbite. It is a common condition in winter. Cold weather can cause repeated skin erythema, swelling damage, and in severe cases, it can even trigger blisters, ulcers. Frostbite may be self-healing in warm climate, but it is easy to relapse. There are three stages of frostbite: frostnip, superficial frostbite and deep frostbite. Frostnip is a milder form of cold injury that doesn't cause permanent skin damage, and you can treat it with first-aid measures, like rewarming the affected skin.  

What causes frostbite?

Cold temperature is the most common cause of frostbite. When suffering from cold (0 ~ 10 °C), wet or rapid changes in temperature, local small arteries of patients with frostbite contract, then arterial vasospasm and expansion, venous congestion, poor local blood circulation happen subsequently, thus causing the condition. In addition, patient's own skin moisture, peripheral microvascular malformations, autonomic dysfunction, malnutrition, endocrine disorders can also be involved in the onset of frostbite. Other factors may also include the lack of exercises, sweating of hands and feet, over-tightening of footwear, and long-term outdoor working under low temperatures.  

What are the symptoms of frostbite?

Symptoms of frostbite depend on how deep it goes into the body. Early frostbite affects the top layers of the skin, more advanced cases can go all the way through to the muscles and bones. <!--nextpage--> Early signs and symptoms:
  • Itchy, stinging, burning skin, feeling like "pins and needles."
  • Skin turns a pale yellow or white.
  • Skin looks shiny or waxy.
  • Blisters with fluid or blood form.
Advanced signs and symptoms:
  • Extremely hard and cold skin.
  • Skin darkens quickly, and looks like blue and later turns black.
There also exists a special type of frostbite that is more common in women's thighs. Clinically, there are characteristic blue-red infiltrative plaques distributed symmetrically on the lateral side of the obese femur. Occasionally, there may be secondary ulcers.  

How to treat frostbite?

Systemic treatment
  • Take nicotinamide, nifedipine or other vasodilators orally.
  • Add salvia miltiorrhiza (20ml) into 500ml of low molecular dextran, which has the functions of dilating blood vessels, improving microcirculation, increasing blood flow and dissolving thrombus.
  • Hyperbaric oxygen therapy: Breath pure oxygen in a pressurized room.
Topical treatment
  • Defocusing radiation of the parts of the frostbite after He-Ne laser, infrared irradiation, or laser irradiation in acupoints (zusanli(st26), fuliu, etc.).
  • Heparin ointment, polysulfonic acid mucopolysaccharide cream, vitamin E ointment, etc. can be used externally for patients without blisters and ulcers.
  • Surgery: People who have experienced severe frostbite may in time need surgery or amputation to remove dead or decaying tissue.

How to prevent frostbite?

Besides the medical treatments listed above, you can also prevent frostbite in daily lives:
  • Strengthen exercises, thus promoting blood circulation, and improving the body's ability to adapt to cold weather.
  • Pay attention to anti-freezing, keep warm and prevent moisture, and do not wear tight shoes and socks.
  • You should avoid soaking in hot water or fire baking immediately after being frozen.
  • Active treatments for other related diseases.
  • For patients with repeated episodes of frostbite, easily affected parts of skin may be irradiated with ultraviolet rays or infrared rays before winter to promote local blood circulation.
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