Frostbite and your feet

The effects of a single episode of frostbite can last many years, so please take steps to protect your feet.

By Amie Scantlin, DPM, MS, FACFAS

Brrrrrrrrr!  Old Man Winter has arrived!  Along with the snow and wind, the recent bout of freezing temperatures puts all of our feet at risk.  Whenever you are outside at this time of year – to sing carols, ride a snowmobile, or go ice fishing, your feet are susceptible to the extreme temperatures.

Frostbite is a condition that many of us are aware of, but did you know that the effects of a single episode can last many years?  What should you be doing to protect your feet?  And who is at increased risk of developing frostbite?

The mildest form of cold injury to the skin is a condition called chilblains. This occurs on areas of commonly exposed skin such as the tops of the hands, feet and on the face.  This occurs with exposure to cold, wet and windy conditions.  The skin becomes itchy, red, dry and rough.  Many times the area will be swollen as well.  Once this occurs, it will often last the duration of the cold weather season.  The skin will return to normal without long term effects at the return of warm weather.

Frostbite is a term used for more severe injury to the skin.  Frostbite is typically described in degrees, similar to burns:

  • First degree:  Initial increased blood flow causes the skin to become red and swollen.  After the skin rewarms, hard, white plaques will form.  The area of affected skin will often times itch and burn. There is no blister formation in this stage.
  • Second degree:  Blister formation occurs along with the redness and swelling.  After rewarming, the skin will be red and feel hot and dry.
  • Third degree:  Black or gray discoloration of the skin occurs with formation of blood blisters.  The skin is numb at first, but gives way to throbbing and aching.  The areas will break open and peel as they heal.
  • Fourth degree:  The entire area becomes black and bone tissue is destroyed in this stage.  Gangrene and mummification of the skin is evident quickly.  It can take up to 3 months to determine if tissue in this stage will survive.

People who smoke and those who have poor nutrition, diabetes, poor circulation and/or kidney disease are at greater risk of developing frostbite in less time.  You should take extra care in protecting your feet and hands if you have any of these health conditions. Here’s how:

To protect your feet against the extreme cold, wear two pairs of socks or wool socks to insulate the skin.  Do not wear shoes that are too tight or socks that cut off circulation to the feet.  Avoid prolonged exposure to severely cold temperatures.  Wind chill does decrease the time it takes to progress to third- or fourth-degree frostbite.  Do not allow skin to be exposed to the air, as this allows for rapid loss of body heat and increases risk of frostbite.

Long-term effects of frostbite can include increased sweating in the affected area, arthritis, scarring, numbness or burning sensations, and permanent cold sensitivity.  These symptoms can last for a lifetime after the injury occurs, causing pain that is hard to manage.  Take the extra time now to protect your feet and keep them warm and healthy all year long.


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