Frostbite: symptoms, first aid and treatment

The NHS says frostbite happens when your skin freezes after being in very cold temperatures, and that you can get it if your skin is exposed to temperatures of 0C (32F) or below. The parts of the body most often affected are the fingers, toes, nose and ears.

It gets worse the colder it is and the longer you are exposed to the cold. Frostbite is different from the milder, itchy skin patches called chilblains and from hypothermia, which is a drop in whole-body temperature.

At first, the NHS says your skin may be cold and firm, numb or with a stinging or burning sensation, painful, throbbing or aching, and red or pale (redness may be harder to see on black or brown skin). If frostbite gets worse, symptoms can include hard, frozen skin that can be white, blue or blotchy, swelling and loss of feeling in the affected area, blisters filled with blood or clear or milky fluid, and skin that turns black and hard as it starts to die, which may be harder to see on black or brown skin.

The NHS says to call 999 or go to A&E if you have been exposed to very cold temperatures and have hard, frozen skin, swelling and loss of feeling in the affected area, blisters filled with blood or a clear or milky fluid, or you are constantly shivering, have slurred speech, slow breathing and are tired and confused. While waiting for medical help:

• Go indoors or somewhere sheltered as quickly as possible.

• Remove clothing and jewellery, such as gloves, rings and boots, from the affected area.

• Wrap yourself in something warm like a blanket, sleeping bag or dry towel.

• Put your hands in your armpits if they are affected. If you are with someone who has frostbite, place the affected body part in your lap and gently warm it with your hands.

• Place the affected part in warm (not hot) water, dry it and put on a light dressing such as a gauze bandage if you have one.

• Raise the body part to reduce swelling.

• Take paracetamol to ease any pain (do not give aspirin to children under 16), and have a warm drink or water.

• Do not rub the affected area, use a fire, radiator, hot water bottle or heat lamp, have a hot bath, or drink alcohol.

The NHS says frostbite is treated in hospital. Treatments include warming the affected body part, removing dead skin, medicines to treat swelling and infection, and surgery if frostbite is severe. You may have follow-up appointments to check how your wounds are healing and to help with any lasting problems, such as problems with movement.

If the person is shivering a lot or struggling to stay awake, the NHS says they may have hypothermia (very low body temperature). Make sure they are warm and keep them awake by talking to them until you can get medical help.

The NHS says frostbite can cause serious problems, especially if it is severe. It can cause skin and tissue to die (gangrene), which may mean the affected body part needs to be removed (amputated). Some people have lasting problems after frostbite, such as pain and stiffness in the affected areas, and you are more likely to get frostbite again if the body part is exposed to cold temperatures.

These cold-related problems are easily confused, but they need very different responses.

The NHS says to get medical help if you think you or someone else has frostbite, and to call 999 or go to A&E for the signs listed in the first aid section. For hypothermia, the NHS says it is a medical emergency that needs treatment in hospital, and to go to A&E or call 999 if you think you or your child have it. Signs include shivering, pale, cold and dry skin that may turn blue or grey, slurred speech, slow breathing, and tiredness or confusion. In a baby it may mean being cold to the touch, floppy, unusually quiet and sleepy, and refusing to feed.

Do not drive to A&E yourself. Ask someone to drive you or call 999 and ask for an ambulance, and bring any medicines you take with you.

To help avoid frostbite, the NHS says it is important to wear warm clothing in very cold temperatures, for example several loose layers of clothing with a waterproof outer layer, a hat and scarf to protect your head, neck and face, gloves or mittens to protect your hands and fingers, and thick socks and boots to protect your feet and toes. It is also important to eat and drink regularly if you are in cold conditions for long periods.

Suspected frostbite is an emergency NHS pathway: 999 or A&E, with hospital treatment and follow-up appointments. The NHS says frostbite is treated in hospital, so this is not a condition to manage through a routine GP or private appointment.

The NHS says you may have follow-up appointments to check how your wounds are healing and to help with any lasting problems, such as problems with movement.