Nobody plans to get frostbite

In an “average” year, HCMC’s Burn Center cares for about 25 patients with frostbite requiring hospitalization. In 2014, more than 200 patients were admitted for care.

Dr. Ryan Fey

Dr. Ryan Fey

“It was one of the coldest winters in the past 30 years, so it’s no surprise that we saw an increase in frostbite injuries,” explains burn surgeon and critical care specialist Dr. Ryan Fey. “Obviously, the key is to avoid exposure to extreme cold temperatures. That means staying indoors when it’s cold, and if you have to be outdoors for any length of time, making sure you dress appropriately to stay warm – even if it’s just a run to the mailbox or from your house to your car.”

The human body conserves energy for the most important parts like the heart, brain and other internal organs. When it senses cold, the blood vessels automatically begin to narrow to keep an adequate blood supply to core organs. That puts exposed fingers, toes, feet, hands, noses and ears at risk for frostbite.

“From the heart, these body parts are the last in line for blood supply,” explains Dr. Fey. “So they’re more likely to freeze up quickly – literally forming ice crystals inside the tissues – and cause blood flow to cease. Depending on how long the tissue is without blood, this process can lead to unrecoverable tissue death and amputation.”

That’s why it’s so important to seek immediate medical care if you suspect frostbite injury. Like burns, symptoms of frostbite are staged according to degree.

First Degree Frostbite: A mild form of frostbite in which your skin turns red and feels really cold.

Second Degree Frostbite: In this stage the reddened skin will turn white or very pale. Upon warming, blisters may appear. This results in some tissue and nerve damage.

Third Degree Frostbite: Affecting all layers of the skin, the area will turn black and hard as tissue dies.

If someone with frostbite gets emergent care before there’s permanent damage, there’s a good chance that Dr. Fey and the other specialists at the Burn Center can repair the tissue.

“Rewarming should be done as quickly as possible in a 40 degree water bath. You want to rapidly and definitively rewarm the extremity once – and only once – to avoid the freeze/thaw cycling which magnifies the degree of injury,” says Dr. Fey. “In severe cases, we can use the same clot-busting medications that are used for strokes to open up the blood vessels.”

The jump start on our cold weather season has already brought several frostbite patients to HCMC for care. “Every exposed body part is susceptible to frostbite under the right conditions,” says Dr. Fey. “No one plans to slip and fall on the way to the mailbox, or for their car to stall on the highway. Those circumstances are what lead to trouble.”

Alcohol can also impair judgment and increase frostbite risk. For more information about frostbite prevention and HCMC’s Burn Center, go to