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Treatments and drugs
By Mayo Clinic staffTreatment for frostbite includes first-aid care and medical treatment, depending on the severity of the frostbite.
First-aid care
Gradually warming the affected skin is key to treating frostbite. To do so:
- Protect your skin from further exposure. If you're outside, warm frostbitten hands by tucking them into your armpits. Protect your face, nose or ears by covering the area with dry, gloved hands. Don't rub the affected area and never rub snow on frostbitten skin.
- Get out of the cold. Once you're indoors, remove wet clothes.
- Gradually warm frostbitten areas. Put frostbitten hands or feet in warm water — 104 to 107.6 F (40 to 42 C). Wrap or cover other areas in a warm blanket. Don't use direct heat, such as a stove, heat lamp, fireplace or heating pad, because these can cause burns.
- Don't walk on frostbitten feet or toes if possible. This further damages the tissue.
- If there's any chance the affected areas will freeze again, don't thaw them. If they're already thawed, wrap them up so that they don't become frozen again.
- Know what to expect as skin thaws. If the skin turns red and there's a tingling and burning sensation as it warms, circulation is returning. But if numbness or sustained pain remains during warming or if blisters develop, seek medical attention.
Medical treatment
- Rewarm the skin. If it hasn't been done already, your doctor rewarms the area using a warm-water bath with the affected area immersed for 15 to 30 minutes. The skin may turn soft and look red or purple. Because the rewarming process can be painful, your doctor will likely give you pain medication.
- Dressings. Once your skin thaws, your doctor wraps the area with thick dressings or bandages to protect the skin. A brace or splint may be necessary if the bone or muscle is involved. The limb is elevated to reduce swelling.
- Removal of damaged tissue (debridement). To heal properly, frostbitten skin needs to be free of damaged, dead or infected tissue. To better distinguish between healthy and dead tissue, your doctor may wait one to three months before removing damaged tissue.
- Hydrotherapy. Whirlpool baths can aid healing by keeping skin clean and naturally removing dead tissue.
- Oral antibiotics. If your skin or blisters appear infected, your doctor may prescribe oral antibiotics.
- Thrombolytics. These drugs, such as tissue plasminogen activator (TPA), are given through an intravenous (IV) line to try to lower the necessity of amputation. These drugs can cause serious bleeding and are typically used only in the most serious situations and within 24 hours of exposure.
- Surgery. In severe cases, surgery or amputation may be necessary to remove the dead or decaying tissue.
- Hyperbaric oxygen therapy. Hyperbaric oxygen involves breathing pure oxygen in a pressurized room. Although older studies showed no benefit of this treatment, some newer ones indicate a possible improvement in symptoms. More study is needed.
References
- 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.
- Mechem CC. Frostbite. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
- Winter weather: Frostbite. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/disasters/winter/staysafe/frostbite.asp. Accessed Aug. 1, 2011.
- 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.
- Winter weather FAQs. Centers for Disease Control and Prevention. http://www.bt.cdc.gov/disasters/winter/faq.asp#frostbite. Accessed Aug. 1, 2011.
- Hallam M, et al. Managing frostbite. British Medical Journal. 2010;341:1151.
- Imray C, et al. Cold damage to the extremities: Frostbite and nonfreezing cold injuries. Postgraduate Medicine Journal. 2009;85:481.
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