Q&A: Dermatologist talks frostbite as Groundhog Day predicts 6 more weeks of winter
Key takeaways:
- Patients that present with frostbite should first be assessed for hypothermia.
- In addition to standard therapies, dermatologists can use systemic treatments such as tissue plasminogen activator with heparin.
Between Groundhog Day’s prediction for 6 more weeks of winter and the recent cold fronts rushing into both northern and southern states, wintery weather may linger this year – and with it, the chance for frostbite could stick around, too.
Healio Dermatology spoke with Anthony Rossi, MD, FAAD, FACMS, assistant attending of dermatologic, Mohs, cosmetic and laser surgery at Memorial Sloan Kettering Cancer Center and founder of Dr. Rossi Derm MD Skincare, about the risks of frostbite and dermatologists’ role in treating affected patients.
Healio: What is frostbite and how do patients get it?
Rossi: Frostbite happens when skin and underlying tissues freeze due to prolonged exposure to cold temperatures. This condition can lead to severe, and sometimes permanent, tissue damage.
Frostbite typically develops in cold, windy weather when the skin is exposed to temperatures below freezing (32°F or 0°C). The risk increases with lower temperatures and longer exposure times. It’s important to note that wet skin or clothing can elevate the risk.
When exposed to these extreme cold temperatures, the body’s protective mechanisms prioritize core temperature. This causes constriction of blood vessels in the extremities.
Healio: What are the health risks of frostbite?
Rossi: Frostbite can result in permanent nerve damage, tissue death and, in severe cases, amputation. It can also increase susceptibility to infections and long-term sensory deficits.
Healio: What are signs to look out for in patients that indicate frostbite?
Rossi: The early signs of frostbite include redness as well as stinging, burning and throbbing, which can be followed by numbness. As the condition progresses, the skin may become hard, pale and cold, and blisters may form. In severe cases, the skin turns black due to tissue death.
Healio: What should dermatologists do if a patient comes in the office with frostbite? How can they treat it?
Rossi: If a patient presents with frostbite, dermatologists should first assess for hypothermia, ensuring the patient’s core temperature is above 35°C (95°F) before treating the frostbite.
Next, if there’s no risk for refreezing, rewarm the affected area using warm water (37° to 39°C or 98.6° to 102.2°F) for 15 minutes to an hour. Avoid dry heat sources and refrain from rubbing the area, as this can cause further damage.
If needed and if there are no contraindications, dermatologists can give nonsteroidal anti-inflammatory drugs for pain. Additionally, it’s important to focus on wounds and blistering with topical wound care.
There are also more systemic treatment options that can be used such as tissue plasminogen activator with heparin.