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Symptoms

By Mayo Clinic staff

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Picture of frostnip 
Frostnip
Picture of frostbite 
Frostbite

Signs and symptoms of frostbite include:

  • A slightly painful, prickly or itching sensation
  • Red, white, pale or grayish-yellow skin
  • Hard or waxy-looking skin
  • A cold or burning feeling
  • Numbness
  • Clumsiness due to joint and muscle stiffness
  • Blistering, in severe cases

Frostbite typically affects smaller, more exposed areas of the body, such as your fingers, toes, nose, ears, cheeks and chin. Because of area numbness, you may not realize you have frostbite until someone else points it out.

Frostbite occurs in several stages:

  • Frostnip. The first stage of frostbite is frostnip — a mild form of frostbite in which your skin turns red and feels very cold. Continued exposure leads to prickling and numbness in the affected area. As your skin warms, you may feel pain and tingling. Frostnip doesn't permanently damage the skin.
  • Superficial frostbite. The second stage of frostbite appears as reddened skin that turns white or very pale. The skin may remain soft, but some ice crystals may form in the tissue. Your skin may begin to feel deceptively warm — a sign of serious skin involvement. If you treat frostbite at this stage, the surface of your skin may appear mottled, blue or purple as it's warmed or thawed. With warming, you may notice stinging, burning and swelling. A fluid-filled blister may appear 24 to 36 hours after rewarming the skin.
  • Severe or deep frostbite. As frostbite progresses, it affects all layers of the skin, including the tissues that lie below. You may experience deceptive numbness in which you lose all sensation of cold, pain or discomfort. Joints or muscles may no longer work. Large blisters form 24 to 48 hours after rewarming. Afterward, the area turns black and hard as the tissue dies.

When to see a doctor
Seek medical attention for frostbite if you experience:

  • Signs and symptoms of superficial or severe frostbite — such as white or pale skin, loss of all sensation in the affected area, or blisters
  • Increased pain, swelling, redness or discharge in the area that was frostbitten
  • Fever of more than 100.4 degrees Fahrenheit (38 degrees Celsius)
  • Dizziness, aching or feeling generally ill
  • New, unexplained symptoms

References
  1. Pierard GE, et al. Cold injuries. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=2953356. Accessed Aug. 1, 2011.
  2. Mechem CC. Frostbite. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
  3. Winter weather: Frostbite. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/disasters/winter/staysafe/frostbite.asp. Accessed Aug. 1, 2011.
  4. Frostbite. In: McPhee SJ, et al. Quick Answers to Medical Diagnosis and Therapy. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aid=3264952. Accessed Aug. 1, 2011.
  5. Winter weather FAQs. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/disasters/winter/faq.asp#frostbite. Accessed Aug. 1, 2011.
  6. Hallam M, et al. Managing frostbite. British Medical Journal. 2010;341:1151.
  7. Imray C, et al. Cold damage to the extremities: Frostbite and nonfreezing cold injuries. Postgraduate Medicine Journal. 2009;85:481.
DS01164 Oct. 7, 2011

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