Steven Doerr, MD
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Frostbite and cold weather-related injuries facts
- Introduction to frostbite and cold weather-related injuries
- What type of injuries can be caused by cold weather?
- What are the signs and symptoms of frostbite?
- What are cold weather-related injuries without tissue freezing?
- Trench foot
- Frostbite: Cold weather-related injuries with tissue freezing
- What does frostbite look like (frostbite pictures)?
- How should frostbite and other cold weather-related injuries be treated?
- What is the recovery time for a frostbite injury?
- When should a person seek medical care for a cold weather-related injury?
- Who is most likely to get a cold weather-related injury and what can be done to prevent it?
What are the signs and symptoms of frostbite?
The signs and symptoms of frostbite depend on the extent and depth of tissue injury. Individuals with superficial frostbite may experience the following signs and symptoms to the affected area:
- pale colored skin,
- clear-colored skin blisters may develop, and
- firm-feeling skin with soft underlying tissue which can move over bony ridges.
As the degree of injury progresses to involve deeper tissue structures, the signs and symptoms of deep frostbite can develop, which may include the following:
- complete loss of sensation,
- pale, yellowish, bluish, gray, or mottled skin color,
- formation of blood-filled skin blisters, and
- firm-feeling skin and underlying tissue, with the affected area feeling hard and solid.
With advanced frostbite injuries, the affected area can subsequently appear blackened and gangrene can develop, placing the affected individual at high-risk for infection.
What are cold weather-related injuries without tissue freezing?
Cold weather-related injuries that do not involve tissue freezing include:
- chilblains or pernio
- frostnip, and
- trench foot or immersion foot.
Chilblains (also known as pernio) are a common type of cold weather-related injury that can develop in predisposed individuals after exposure to nonfreezing temperatures and humid conditions. Chilblains typically develop because of an abnormal vascular response several hours after the area exposed to cold is re-warmed. Chilblains are itchy, painful, reddish, or purplish areas of swelling that usually affect the fingers, toes, nose, or ears. In some individuals, blisters or small open sores may also form, increasing the risk for developing an infection. Chilblains usually last for several days, and the affected area usually heals after several weeks. Though the affected area may remain sensitive to the cold in the future, there is usually no permanent damage. It is not uncommon for chilblains to recur in susceptible individuals.
Frostnip is a mild cold weather-related injury that typically affects the face, ears, toes, and fingers.
Symptoms of frostnip usually occur after exposure to cold weather. The affected area(s) may:
- appear pale,
- be accompanied by burning, itching or pain;
- feel numb
Simple rewarming restores normal color and sensation, and there is no subsequent permanent tissue damage.
Trench foot also referred to as immersion foot was named after the condition suffered by many soldiers in the trenches during World War I, though it is a condition still encountered today, often in homeless individuals. Trench foot develops after a prolonged exposure to a wet, cold, environment and is typically a more serious condition than chilblains. Tight-fitting, constricting boots and footwear serve to exacerbate the condition. Trench foot does not require freezing temperatures, and can occur with temperatures of up to 60 F (15.5 C).
The symptoms of trench foot may include:
- numbness, and
The affected foot may appear red or blotchy (red and pale areas mixed together) or even bluish-black with advanced injury.
As with chilblains, blisters and open sores can develop. With severe trench foot, the tissue dies and sloughs off, and the development of gangrene can occur, sometimes requiring amputation. The usual recovery period for uncomplicated trench foot can be several weeks.
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