Frostbite

Frostbite is an injury that occurs when the skin and tissues are exposed to extreme cold, causing the affected area to become swollen, red, numb, and pale. It often occurs when the body is exposed to temperatures below freezing and in strong winds for an extended period of time, and can sometimes occur even when the body is covered with clothing.

Cold skin damage

Frostbite typically causes pain, swelling, numbness, redness, paleness, purpleness, blistering, or burning of the skin. It most commonly affects the fingers, toes, nose, chin, and ears, and symptoms vary depending on the extent of tissue damage, including:

• Mild symptomsinclude skin turning pale or red. There may also be numbness in the area of ​​frostbite, as well as a feeling of extreme cold on the skin. The pain and numbness feel like needles are being pricked when the area of ​​skin is warmed. In the early stages, there is no harm to the skin or any damage to the cells.
• Moderately severe symptoms:Tissues continue to function normally, but the red skin begins to pale and turn white, pale, or ice crystals form in the tissues. Burning, blistering, and swelling may occur.
• Severe frostbite symptomsinclude severe skin damage, numbness, loss of sensation, and difficulty moving joints and muscles. Blisters may develop 24 to 48 hours after frostbite, and the affected area may begin to turn black due to tissue death.

If you have a fever, pale skin, numbness, blisters, or may have swelling and pain in the area where frostbite occurs, have severe chills, or if you are not sure whether you are at risk of frostbite, you should see a doctor immediately for proper examination and treatment.

Causes of skin damage from extreme cold

Frostbite is caused by skin cells and tissues being cold and lacking blood and oxygen. When the body is exposed to cold temperatures, the process of protecting important organs in the body begins to work by reducing blood flow to certain areas of the body to bring blood to important organs of the body such as the heart, brain, liver, kidneys, etc. This causes the arms and legs to suffer from lack of blood and oxygen. At the same time, the area that is exposed to cold may have ice crystals inside the cells, causing cell damage and blood clots to form, reducing blood flow to various organs.

The main cause of frostbite is being in very cold and possibly windy conditions for a long time, especially when the temperature drops below -15 degrees Celsius, and wearing clothing that is not suitable for cold weather. Other causes can be caused by contact with liquids or objects that are very cold.

In addition, some people have risk factors that may increase their risk of frostbite, such as:

• People who are chronic alcoholics, smokers or drink alcohol
• Infants and the elderly, as they are not very good at maintaining body temperature.
• People with mental illnesses, such as those who may not have the ability to properly handle cold environments, have poor responses to cold, or have poor judgment, may be more likely to suffer from frostbite than the general population.
• People with diabetes, fatigue, and poor circulation may lose their ability to respond to cold weather.
• People who work in cold climates for long periods of time or are homeless
• People who play sports in cold weather, such as skiing, mountain climbing, etc.
• People who live in areas above sea level because the amount of oxygen at high altitudes is less, causing less oxygen to enter the body.

Diagnosis of cryotrophic skin disease

Doctors usually make an initial diagnosis by looking at the symptoms on the skin, asking about medical history and activities related to cold weather, and taking temperature, pulse, blood pressure, breathing rate, and checking the function of various body systems to diagnose and promptly provide treatment if the patient is hypothermic or has a severe infection that may be life-threatening.

In addition, the doctor may perform additional examinations with X-rays, bone scans, or MRI scans, especially in cases where the patient is hypothermic, to assess the severity of the muscle and bone damage. The doctor may re-evaluate the symptoms periodically to consider possible damage to tissues in various parts of the body.

Treatment of skin damage caused by cold

Frostbite is a condition that should be treated immediately. Patients should avoid exposure to cold weather and should not allow the injured area to become colder. Treatment will depend on the severity of the symptoms and will focus on helping the patient’s body warm up. If the patient has mild symptoms, they may be able to relieve symptoms on their own. In severe cases, patients may need to see a doctor for appropriate treatment.

Self-help relief

• Avoid being in cold environments. If your clothes are wet, change them to prevent further frostbite injuries. When you have to go outside in cold weather, keep your skin and body parts warm at all times.
• In case of hand or foot injuries, soak the affected area in warm water for 10-30 minutes. The water temperature should be appropriate and not too hot as this can burn the skin.
• If a foot injury occurs, do not walk barefoot as this can damage the tissue.
• Use a cloth to cover the skin in the affected area to reduce swelling and prevent further injury.
• Do not rub the injured area and do not use devices to directly heat the skin in that area, such as heating pads, lamps, or fireplaces, as this may cause more tissue damage.

In general, initial care may help the skin in the affected area gradually warm up. The skin may become slightly red as blood flow returns to the area. However, if symptoms do not improve, there is numbness, swelling, or a wound in the area, you should see a doctor for treatment.

Medical treatment

When you get to the hospital, the doctor will try to warm the injured area by soaking it in warm water for about 15-30 minutes because it may not be possible to diagnose the level of frostbite. They will also take care to protect the area from further injury, treat the wound if it is injured, and in cases where muscles or bones are injured, they may need to put a splint or cast on the bone.

The doctor may consider treatment with the following methods:

• Medication: Painkillersmay be used to relieve the pain and inflammation in the frostbite area.
• Use of antibioticsIf the skin wound becomes infected, your doctor may consider using antibiotics and may also give you a tetanus shot if the wound is at risk of infection.
• Excision of dead tissue:The doctor may need to cut away damaged, infected, or dead tissue to allow the skin in that area to heal normally. It may be necessary to wait about 1-3 months after the initial treatment before beginning to assess and treat by excision of dead tissue.
• Wound care:If there is a wound, the wound should be treated strictly according to the doctor’s instructions. If the wound is severe or complicated, Vacuum Assisted Closure Therapy may be used to help the wound heal faster.
• Surgery:Doctors usually perform surgery only in severe cases to remove dead tissue. In some cases, doctors may have to surgically remove the affected organ.
• Whirlpool physiotherapyis a water therapy that uses water as a tool. Patients are immersed in warm water with a whirlpool to help remove dead skin cells.

Complications of skin damage from freezing

Those with severe symptoms are at risk for complications at the injured site, such as increased skin sensitivity to cold, chronic numbness, arthritis, risk of recurrent frostbite, tetanus, infection , gangrene.

In addition, if the infection occurs in children, it can affect bone growth. Some patients with severe symptoms may be at risk of hypothermia or organ malfunction, especially the heart and respiratory system. If such conditions do not receive timely treatment, it can also cause death.

Preventing skin damage from cold

• Avoid staying outside in cold, windy weather for long periods of time, as the cold can cause frostbite.
• If you are going to a place with cold weather, you should prepare clothes to protect yourself from the cold weather, such as socks, gloves, hats, etc. Wear multiple layers of clothing to keep your body warm, and the clothing should be waterproof and windproof.
• Wear a hat that covers your ears for effective protection from the cold.
• Hands and feet should be kept warm at all times.
• You should not drink alcohol when you are going outside in cold weather.
• Eat healthy foods and drink warm water frequently to keep your body warm.
• Exercise to improve blood circulation in the body and help warm the body, but do not do it when you feel tired.
• Observe any unusual symptoms that may occur to you, such as cold, hard skin, pain, or numbness. If you find that you have symptoms similar to Frostbite, you should see a doctor for treatment immediately.