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We do get frostbite in the UK


December 2012

Walking in the cold, beware of FrostbiteFrostbite isn’t a common problem here in the UK......after all for this serious damage to occur temperatures need to be below freezing (at 0.55C or 31F or less). But even so, every year people experience frostbite and last year there were over 100 admissions to hospital in the UK of people suffering from a serious degree of frostbite.

Some people are more prone to this condition than others; people who work outside of course, especially if their jobs aren’t particularly active. Homeless people are more susceptible to frostbite, and of course with so many people travelling these days to colder climates to see fjords, the northern lights, or snowy mountains, there is a greater risk of people being exposed to really low temperatures.

Frostbite occurs simply because we no longer can keep the area warm enough for a normal flow of blood. In cold, our body’s first reaction is to protect the vital inner organs which it does by reducing the circulation to our extremities first - our hands, feet, ears, nose and lips. This is why these areas can be more quickly affected by cold than other parts.

If the cold continues, this lack of blood supply and therefore oxygen to the skin starts to cause damage to the cells. Eventually ice crystals can form and the cells and blood vessels can become damaged. Blood clots can also form in some of the small vessels and this adds additional problems to getting an adequate supply of blood and oxygen back to the area.

Certain health problems can increase the risk of developing frostbite. A narrowing of the arteries (perhaps in the legs), diabetes and Raynaud’s condition can all present increased risks of frostbite. People who smoke or take drugs which narrow blood vessels, such as beta-blockers and some sleeping tables, can also have increased risk.

Of course the answer is to wrap up warmly with proper insulated clothing and keep moving when you are outside and temperatures drop, but things happen and sadly everyone so often someone will begin to experience the symptoms of frostbite.

The initial symptoms really are just a feeling of cold and possibly pins and needles or numbness but sometimes quite quickly frostbite can develop into a serious problem.

It is usually classified into four stages:

Stage 1 - Early frostnip. Your skin will feel very cold, turn white and begin to numb. When you start warming up, you may suffer from an intense ache in the area, pins and needles or a tingling sensation.

Stage 2 - Intermediate. This is a continuation of the above, with the skin turning harder, whiter and feeling icy to the touch. When you come back in from the cold, the skin will turn red and may blister; there can also be swelling and some irritation. It can be very painful but at this stage only the top layers of the skin and tissue have been affected and underneath the skin and vessels should be intact. However, this stage needs to be professionally assessed to ensure no real damage has occurred.

Stage 3 - Advanced. This is when the cold has penetrated deeply, affecting the epidermis (the outer layer of skin); the dermis (the second layer comprising collagen, elastic tissue and reticular fibres) and the underlying layer of fat. The skin can be white or turn bluish and blotchy. Blisters may develop and the skin feels not only cold but also very hard. When thawed, which can be incredibly painful, damage can remain and after some weeks black thick scabs can form.

Stage 4 - Severe. This affects both layers of skin, the fat and also the underlying tissues such as muscle, tendons and even the bone. The skin is initially deep red and mottled and then turns black.

Certainly the last two stages need medical treatment as frostbite can be extremely serious. If there is deep tissue damage surgery can be required to remove dead tissue. Sometimes amputation is required when tissues are too damaged to recover and the area becomes dead.

Even with superficial frostbite, it can take up to six months to recover as the new pink skin forms underneath and sometimes permanent problems such as pain and stiffness can remain.

The key thing with frostbite is of course prevention and there are a few additional tips along with the obvious aspects of wearing proper clothing and going inside or into a heated area as soon as you feel you are getting over cold. Mittens instead of gloves are more effective in keeping fingers warm; it is important to keep skin dry, or dry skin quickly if you get wet. Wind adds additional cooling. Alcohol may prevent you from being aware of how cold you are getting and it can prevent you from shivering as well which is one way the body helps to keep itself warm.

If the symptoms are severe, then medical attention is urgently needed and most re-warming is really best done by medical professionals. If you are sure it is only minor frostbite, then you can try and warm up the icy areas yourself, but this needs to be done carefully. Forget the old rumours that rubbing an area with snow or massaging the area will help. Both these can cause permanent damage. Instead, get into a warm area, have a warm bath, perhaps a warm drink. Don’t try and thaw out too quickly as it is easy to burn yourself because your skin will be numb.

When you are out in the cold, it makes sense to keep an eye on the people with you as well. There have been cases of people simply trying to be too hardy and ending up with serious problems in hospital.

For more information and important tips you can read about Frostbite on the NHS website

 

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