By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

SON MAY HAVE “FROSTNIP”; SHOULD SEE DOCTOR IF SYMPTOMS PERSIST

Question: We had an early snowstorm this year here in Minnesota where I live, and my high-school aged son played in the snow without proper clothing, like hat and gloves. Thank goodness he had a warm coat on. Now he is complaining that his ear is a little red and slightly tender to touch. Does he have frostbite? Will his ear be permanently damaged?

Answer: Frostbite is caused by exposure of the skin and underlying tissues to extreme cold. Frostbite occurs when the deeper tissues have literally become frozen. Exposed areas like the hands, ears, nose and feet are the most prone to frostbite. Children are more likely to get frostbite than young adults, but it is important for everyone to dress properly when going out in the cold, especially for prolonged periods of time.

Frostnip is an early stage of frostbite that occurs when just the surface layer of the skin is frozen. This is usually treated at home by rewarming the area in slightly warm, not hot, water.

True frostbite is a medical emergency and requires treatment at the nearest hospital emergency department. Frostbitten skin appears white and waxy and feels harder than normal. In the early stages of frostbite, the sufferer feels a prickly sensation in the affected area. As frostbite continues, it becomes numb as well as throbbing and achy. In the later stages of frostbite as all of the deep structures become frozen, you lose all sensation in the affected area.

In some cases of true frostbite, blisters will appear over the damaged area in a couple of days. This is actually a good sign and means that the freezing was not too severe. When blistering does not occur, however, the frostbite may have caused enough damage to require amputation of the injured area.

Prevention is the best treatment for frostbite and frostnip. Dressing in layers and avoiding extended exposure to the cold is where you should start. Avoiding alcohol and tobacco also helps your body retain heat. If you have vascular problems and/or take certain medications like beta-blockers, your chances of getting frostbite are increased.

Also, remember that the wind lowers the effective temperature. It’s what weather forecasters call the “wind chill factor.” That’s why a very windy day can lead to damage of exposed areas even if the temperature didn’t seem that low. Whatever, the temperature, if you are out in the cold and you start getting numb or tingly feeling in an extremity, your face or your ears, get to a warm area as soon as possible.

Without examining your son, I can’t tell for sure what’s wrong with him. Some redness and pain as well as a tingling or burning sensation in the affected area is to be expected after frostnip. This sounds like what you are describing, because in cases of true frostbite, these feelings are usually very intense after the affected area reaches room temperature. If your son’s symptoms don’t improve within a few days, however, you should take him to your family doctor for an evaluation to make sure there’s no permanent damage.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.