Frostbite: Signs, symptoms and treatment

Joel Graham will never forget the time his son, Finn, got frostbite. The Ottawa dad was cross-country skiing in Gatineau Park, towing his one-year-old behind him on a covered sled. “He would usually fall asleep, and he was bundled and warm inside,” says Graham. “One day, unbeknownst to me, an air vent on the sled popped open, and snow from my skis was being kicked back onto his face.” It wasn’t until Graham finished his trek about an hour later that he noticed what happened, and saw that Finn’s right cheek had turned white. “I brought him into the car right away and put my hand on his cheek to warm up the area,” he says. Thankfully, it only took about five minutes for Finn’s chilly cheek to thaw, and no harm was done.

Frostbite, quite literally, means frozen skin — and there are varying degrees. In the early stages, it looks quite red and kids will describe a tingling feeling. As it progresses, the skin turns pale yellow, but remains soft. “By the time the skin is white, hard and numb, it’s pretty serious,” says Calgary paediatrician Peter Nieman. “The skin tissue freezes and there’s a decrease in blood supply to the area. There can also be inflammation, which causes it to be very painful.”

Kids are more susceptible to frostbite than adults, because they lose heat from their skin faster. Little noses, ears and cheeks are especially vulnerable, since they’re hard to keep covered.

Luckily, most cases of mild frostbite can be treated at home. The first thing to do when you notice the signs is to bring your child inside and remove all cold or wet clothes. Grab a bucket of warm — not hot — water and immerse the affected area for about half an hour, or apply a warm compress to hard-to-soak areas. The thawing process may be a bit painful, so it’s OK to give your child a single dose of acetaminophen or ibuprofen, says Nieman. If you can’t get indoors right away, cover the area with warm hands or place frozen fingers under your armpit. If your child’s skin remains white, “waxy” or hard after a few minutes of treatment, visit your emergency department to have your child assessed for tissue damage and complications, like hypothermia.

Rubbing frostbitten areas — either with your hands or snow — could damage the skin further (but it’s OK to gently place your hands on the injury). Any blisters that form after thawing should also be left to heal on their own. Using dry heat such as stoves, fireplaces, radiators or heating pads to thaw the affected area could aggravate the skin and cause burns.

The best way to prevent the cold from nipping at your little one’s extremities is to be prepared. “Even brief skin exposure in high-wind conditions can cause frostbite,” says Nieman. So bundle your kids up in lots of dry layers that wick moisture away from the skin, and bring them in for regular warm-up breaks, if you can. Applying a thick barrier cream to your child’s cheeks can help protect against wind chill, too. Stay up-to-date on the weather conditions and respect Old Man Winter. “Frostbite is more common in locations where people are not used to the cold. They get blindsided by it,” says Nieman.

A version of this article appeared in our January 2014 issue with the headline “Frostbite,” p. 26.

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