The Frostbite Face-Off

Frostbite can be a serious threat to your health, but it usually happens in only the most extreme conditions, when skin has been exposed to cold temperatures for long periods of time. Generally, recreational skiers get a condition called frostnip much more frequently, and because many aren’t as familiar with it, it has a tendency to sneak up and catch them off guard.

Frostnip attacks exposed skin, causing blood vessels to constrict. It can happen at 32 degrees (or higher with a strong windchill) and often strikes on the chairlift, where your body has to work extra hard to stay warm. Since the body wants to first protect the vital organs, it restricts blood flow to the fingers, toes, nose and ears. Watch out for skin that becomes numb and pale. This means that blood vessels are going into spasm, stopping blood flow and causing a loss of oxygen to the tissues. Because frostnip is a superficial freezing, the basic warning signal is an intense, cold tingly feeling¿the signal that it’s time to get to the lodge. Frostnipped skin may remain tender, pink and a bit shiny for the rest of the day, but it most likely won’t blister or sustain long-term damage. True frostbite, on the other hand, is much more serious. It occurs in two grades¿superficial and deep¿and requires temperatures of 24.8 degrees and below, the point at which the skin actually freezes. With superficial frostbite only the skin freezes, but deep frostbite means that underlying muscles, tendons and bone are freezing as well. “You know you have frostbite when your cold skin is no longer pliable and suddenly you feel no pain,” says Warren Bowman, director of the National Ski Patrol and author of Outdoor Emergency Care. Similar to frostnip, frostbite also causes skin to turn white and/or yellow as ice crystals form in the fluid surrounding the affected tissues. If the damage becomes severe enough, frozen tissues can die.

You may not know what degree of frostbite you have suffered until blisters appear the next day. If blisters are large and filled with clear or yellow fluid, you have superficial frostbite. Deep frostbite blisters will be smaller and filled with red or purple fluid. In the worst cases of deep frostbite, skin won’t blister at all because vessels have clotted, making skin puffy and dark.

Regardless of the rainbow of colors you may see tomorrow, today is the time to get help. In the case of frostnip, treatment is simple: putting the affected area next to a warm body part, such as your armpit, is most effective. With frostbite, the key is to rapidly rewarm the area to its original temperature. “The best treatment is to immediately submerge the affected body part in a whirlpool or any water of approximately 105 degrees Fahrenheit,” says Dr. Jerome Litt, a dermatologist in Cleveland, Ohio. (Make sure the water is not too hot since this can cause further injury.) If the area has blistered, however, warm compresses are the best option. There are two rules to obey¿never use dry heat in treating frostbite and never rub the affected area. Only the most severe frostbite cases will have notable long-term damage. In mild cases, redness and numbness will disappear within a few weeks.

With both frostnip and frostbite, says Bowman, you should also “realize where you went wrong. It’s likely you were underdressed for the conditions.” Experts advise skiers to wear one layer of polypropylene to wick away moisture, and to avoid cotton at all costs. While dressing in warm layers is a crucial preventative measure, what you put into your body is equally key. Avoid alcohol and tobacco, eat plenty of high-energy carbohydrate foods and drink lots of water. Also get plenty of rest. When the body is fatigued, its heat-conserving methods (such as shivering) are not as effective, and it may be harder for you to realize how cold you are.

If you really want to be safe, consider skipping a day on the slopes if the temperature is below 10 degrees or if theree’s a high windchill factor. Of course, the speed at which you ski also plays a role¿the faster you move, the higher the windchill, and therefore the greater the risk.

You’ve probably heard that once you have had a cold-induced injury, you’re more susceptible to re-injury. It’s true. So whether it’s frostbite or frostnip, experts agree that prevention is a must. And the basics are easier and more fun than you think. Take more breaks, drink more hot cocoa and relax by the fire more often¿all of which, on a cold day, are nearly as satisfying as the skiing itself.

Health Hit
If you suffer any degree of frostbite, applying aloe vera to the area, along with taking aspirin and vitamin C, can reduce tissue damage.

Check out Healthy Skier: Preventing Pint-Sized Frostbite