Frostbite in five minutes: Tells, treatment and aggravating factors
By Ilana van der Merwe, January 26 2025—
Although a winter coat, lined toque and fluffy mittens may not always be the most fashionable statements, understanding the dangers of frostbite may rationalize the choice of staying warm over staying stylish.
Freezing cold injuries (FCI) — like frostbite — occur when skin is exposed to sub-zero temperature for prolonged periods of time. When addressing a FCI it is important to understand that the degree of seriousness of the injury is directly caused by the amount of time the tissues have been exposed. Frostbite is, quite literally, the freezing of the skin. As your body is exposed to the cold, blood vessels in the skin constrict to insulate core body temperature, sacrificing heat in parts like hands, feet, nose and ears. Where regular skin blood flow is 250 ml/min, frostbitten skin can drop to as little as 20-50 ml/min, leading to the death of skin, nerve and tissue cells. Frostbite can occur in less than 15 minutes in temperatures below approximately -8 degrees celsius. For this reason, taking frostbite seriously is imperative to staying safe in chilling Canadian winters.
Watching for warning signs of the levels of frostbite is the first step for frostbite prevention. According to the service announcements of the Mayo Clinic, the three stages of frostbite — frostnip, superficial frostbite, and deep frostbite — have telling visual indicators to signify the severity of the burn.
Without any FCI, skin will see no change in colour or in texture. Once frostbite development initiates in early stages, skin can see a slight change in colour, commonly known as blushing. With further development, indicators may seem misleading as it is common for affected skin to feel warm and appear lighter in colour. However, after rewarming a superficial FCI, blisters may form. With a deep frostbite injury, affected skin may appear to be blotchy a white, blue, gray, purple colour. Deeply frozen skin may turn black as skin cells die, resulting in a condition known as gangrene that commonly results in amputation.
Frostbite, like burns, are a thermal injury, and should be taken as serious as their temperature equivalencies. For instance, a more minor injury, known as frostnip, can be treated in two ‘first aid’ approaches: passive warming and active warming. Both can be done from the warmth of your own home, but should be done as soon as possible. Passive warming involves the redistribution of personal body heat by trapping it in a warm blanket. Passive warming can also be performed between individuals as a second effort at reheating. A secondary, more effective approach known as active warming can be performed alongside passive warming. By briefly applying heat to injured areas of skin, individuals will be capable of thawing painfully frozen vessels. It should be noted that one should not rub, massage or shake injured or previously frozen skin as it will harm vessels further.
For serious frostbite, immediate medical attention is required. With many severe frostbite cases leading to amputation, and 90% of cases occurring in the hands, feet and face, the dangers of frost should not be taken lightly. In a call to action, The Canadian Frostbite Collaborative project advocated that a strong defense against frostbite is education. Aside from advising patients to dress warm during the winter and carry extra winter supplies, understanding possible aggravating factors that may put one at risk is key to keeping yourself and your loved ones safe.
Impaired decision making skills are a common aggravate to FCI.
Not only are the effects of frostbite intensified by the consumption of tobacco, alcohol and drugs as they affect the speed of blood flow through the skin, but they also impact the body’s internal ability to gauge and regulate body temperature and impede the mind of analyzing possible frostbite. It is also more common for individuals under the influence to stumble out into frigid temperatures without proper dress or protection against the cold.
Previous cold injuries also factor in when considering if your frostbite makes ground for a trip to the emergency room. Unlike popular belief, skin previously exposed to frostbite is more susceptible to reinjury. Once nerves are damaged due to cold, tracking frostbite signs becomes more difficult, making more severe burns more likely.
Frostbite has become a well known occupational hazard for groups working in agriculture, fishery, trades, construction and machine operations. With long strenuous work hours often spent outside throughout winters, workers are required to execute high physical strain with minimal focus remaining on required acknowledgment of possible frostbite tells.
Individual health factors like diabetes, high blood pressure, and peripheral neuropathy, in their respective ways aggravate frostbite as well. Being aware of your personal risk analysis during cold weather is important to gauge the seriousness of your cold exposure.
Lastly, one of the largest impacts to frostbite is poverty. Poverty can be both the cause and result of frostbite, resulting in a dangerous cycle. With the CBC reporting some of Edmonton’s highest frostbite amputation rates in over a decade, journalist Taylore Lambert argues that these numbers are a result of the city’s homelessness crisis.
“Frostbite amputations disproportionately affect people experiencing homelessness. While Edmonton’s numbers rose 55 per cent from the previous year, the increase among unhoused patients was 87 per cent,” Lambert wrote.
With young families and individuals exposed to poverty often being forced into making cuts concerning warm winter clothing and sufficient winter tools, many are facing higher risks of frostbite. As Alberta’s housing crisis continues to affect individuals, and Canada’s winter temperatures remain cold, fighting frostbite may mean more than just throwing on a scarf.