Symptoms

Signs and symptoms of frostbite include:

• At first, cold skin and a prickling feeling
• Numbness
• Skin that looks red, white, bluish-white, grayish-yellow, purplish, brown or ashen, depending on the severity of the condition and usual skin color
• Hard or waxy-looking skin
• Clumsiness due to joint and muscle stiffness
• Blistering after rewarming, in severe cases

Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Because of skin numbness, you may not realize you have frostbite until someone points it out. Changes in the color of the affected area might be difficult to see on brown or Black skin.

Frostbite occurs in several stages:

• Frostnip. Frostnip is a mild form of frostbite. Continued cold exposure leads to numbness in the affected area. As your skin warms, you may feel pain and tingling. Frostnip doesn't cause permanent skin damage.
• Superficial frostbite. Superficial frostbite causes slight changes in skin color. The skin may begin to feel warm — a sign of serious skin involvement. If you treat frostbite with rewarming at this stage, the surface of the skin may appear mottled. And you may notice stinging, burning and swelling. A fluid-filled blister may appear 12 to 36 hours after rewarming the skin.
• Deep (severe) frostbite. As frostbite progresses, it affects all layers of the skin as well as the tissues that lie below. The skin turns white or blue-gray and you lose all sensation of cold, pain or discomfort in the area. Joints or muscles may stop working. Large blisters form 24 to 48 hours after rewarming. The tissue turns black and hard as it dies.

When to see a doctor

Seek medical attention for frostbite if you experience:

• Signs and symptoms of superficial or deep frostbite
• Increased pain, swelling, inflammation or discharge in the area that was frostbitten
• Fever
• New, unexplained symptoms

Seek emergency care for hard, cold, blotchy skin.

Also get emergency medical help if you suspect hypothermia, a condition in which the body loses heat faster than it can be produced. Signs and symptoms of hypothermia include:

• Intense shivering
• Slurred speech
• Drowsiness and loss of coordination

Wrap the person with hypothermia in warm blankets until help arrives.

What you can do in the meantime

While you wait for emergency medical help or a doctor's appointment, take appropriate self-care measures, such as:

• Removing wet clothing
• Protecting the affected area from further cold
• Not walking on frostbitten feet
• Reducing pain with a pain reliever