Deep tissues of the skin are affected (subcutaneous level) and in a more severe way than those of first and second-degree ones.
They are caused by extreme and/or prolonged cold. Humidity, immersion in water, snow and wind aggravate the effect of cold and lesions.
Symptoms include pallor, lack of sensation, hemorrhagic blisters, gray or black skin, pain, and joint stiffness.
Diagnosis is made through clinical history and a complete physical examination.
Treatment is based on warming the body first (central heat) and then the frozen area by immersing it in progressively warmer water, analgesics and anti-inflammatory drugs, antiplatelet and/or anticoagulant drugs, antibiotics if there is suspicion of infection and only if there is no response to this treatment, amputation of the frozen limb will be considered. They should be treated at hospital level.
- Biem J, Koehncke N, Classen D, et al; Out of the cold: management of hypothermia and frostbite. CMAJ. 2003 Feb 4;168(3):305-11.
- Sachs C, Lehnhardt M, Daigeler A, Goertz O. The Triaging and Treatment of Cold-Induced Injuries. Deutsches Ärzteblatt International. 2015;112(44):741-747. doi:10.3238/arztebl.2015.0741.
- Heil K, Thomas R, Robertson G, Porter A, Milner R, Wood A. Br Med Bull. 2016 Mar; 117(1):79-93.
- Ken Zafren, MD, FAAEM, FACEP, FAWM. C Crawford Mechem, MD, FACEP. Frostbite. UPToDate. Apr 20, 2015.
