Damage to the deeper (subcutaneous) layers of the skin, more severe than first- or second-degree burns.
They are caused by extreme and/or prolonged cold. Humidity, immersion in water, snow and wind aggravate the effects of cold and the lesions.
Symptoms include pallor, numbness, haemorrhagic blisters, grey or black skin, pain and stiffness in the joints.
The diagnosis is made by taking the patient's full medical history and performing a full physical examination.
Treatment is based on warming the body (central heating) and then the frozen area by immersing it in progressively hotter water, analgesics, anti-inflammatories, antiplatelet and anticoagulant drugs, antibiotics if infection is suspected and, only if this treatment is not effective, amputation of the frozen limb is considered. It must be treated in the hospital.
- 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.
