Frostnip and Frostbite: Cold Weather Hazards You Need to Know About

As the outdoor temperature falls, the risk for frostnip and frostbite rises ─ particularly for children.

“Children are more prone to frostbite and frostnip than adults because not only do they lose heat from their skin faster,“ says pediatrician Nicole Zeiner, MD, with Lehigh Valley Reilly Children’s Hospital, “but they also tend to not listen to their bodies when they’re having fun, opting to stay outside and play despite their extremities urging them otherwise.”

A firm believer that there’s no greater prevention than knowledge, Dr. Zeiner strongly urges parents to learn about frostnip and frostbite and their potential for irreversible damage.

Frostnip is reversible, cold-weather damage to the skin that happens when the body is exposed to freezing temperatures (at or below 32°F) for a prolonged period. When frostnip occurs, a child’s skin may appear red and feel numb or tingly. If treated quickly and properly, the effects of this early stage of frostbite are short-lived and do not result in permanent tissue damage.

In many cases, frostnip can be treated right at home. When frostnip occurs:

• Get your child out of the cold as soon as possible.
• Change him or her into warm, dry clothing.
• Warm your child’s skin by using warm compresses or immersing the affected area in warm water (between 100° to 105°F) until feeling returns. Don't use direct heat, such as a heating pad or fire, because this can burn the skin.
• Do not rub or massage the skin.
• Wrap warmed areas of the skin to keep them from freezing again. This will prevent further damage from occurring.
• If warming the skin does not help or symptoms of frostbite occur, call your child's physician immediately.

Without proper treatment, frostnip can progress into frostbite ─ a more severe cold-weather injury.

Frostbite is damage to the skin from freezing and happens when ice crystals form in the skin or in deeper tissue. The most common sites for frostbite are the fingers, hands, toes, feet, ears, chin, nose, and cheeks. Frostbite can cause serious injury, such as long-lasting (permanent) tissue damage.

If frostbite occurs, it is best to seek medical assistance right away. Bring your child to an emergency room (like the Children’s Hospital’s Breidegam Family Children’s ER, which is the region’s only 24/7 emergency room specifically for kids) as soon as possible if his or her skin:

• Is red and then becomes white or turns grayish-yellow.
• Burns, tingles or is numb.
• Feels unusually firm or waxy.
• Feels hard and swollen.
• Has blisters or sores ─ an indication of severe frostbite.
• Turns black and is painful.

Treatment will depend on your child’s symptoms, age, general health, and the severity of the condition. The severity of frostbite depends on several factors, including air temperature, length of time in the cold, wind chill, dampness and type of clothing worn. In severe cases, dead tissue may need to be removed through a procedure called debridement or through surgery.

If your child comes in with cold, hard skin that looks waxy, white, blue or yellow, don’t rub their skin. Have them change into warm, dry clothing and go to the emergency room as soon as possible.

To help protect your child in cold winter weather, Dr. Zeiner shares some helpful tips:

• Dress your child warmly in multiple layers, making sure his or her ears, fingers and toes are well covered.
• If it’s snowing or wet outside, waterproof boots, mittens/gloves and a hat are highly recommended for when your child plays outside.
• If your child gets wet, have them change into dry clothes sooner rather than later.