Educating your patients about the dangers of frostbite

Robert Sheridan, MD, chief of staff of Shriners Children's Boston.
Credit: Shriners Children's.

As winter brings extreme cold and heavy snowfall, Shriners Children’s Boston is reminding parents to take precautions to protect children and teens from frostbite.¹

Frostbite occurs when the skin and deeper tissues freeze due to prolonged exposure to cold temperatures. It can develop after extended time outside or even within minutes in extremely low temperatures.¹

Robert Sheridan, MD, chief of staff at Shriners Children’s Boston, explained that children are more susceptible to frostbite than adults, with babies and children being more suspectable frostbite because their bodies lose heat approximately 4 times faster than adults. Wind can also increase the risk by drawing heat away from the skin more quickly.¹

Children and teenagers may not always recognize when they need to warm up, as cold temperatures can impair judgment. “The tricky thing about cold weather and frostbite is that when the body is exposed to very low temperatures, it tries to prevent heat loss by redirecting the blood away from the extremities such as fingers and toes,” said Sheridan. “At the same time, that change in blood flow may cause people to lose some awareness of how cold their fingers and toes have become. So children and teens may think they’re fine to stay outside in cold temperatures much longer than they should be. If kids are playing outside in extreme cold, then they should be coming inside every 15 minutes or so to take a break and warm up.”¹

Sheridan emphasized the importance of dressing properly for the weather. Frostbite most commonly affects fingers, toes, and parts of the face, so waterproof shoes, gloves, masks, and warm clothing can help prevent it.¹

Early signs of frostbite include the skin changing from red to very pale, loss of feeling, and the skin becoming hard or firm. While mild cases, known as frostnip, can be treated by warming up indoors, frostbite is a medical emergency that requires immediate attention.¹

“Many people don’t realize that frostbite is often treated in burn units and because Shriners Children’s Boston is a nationally accredited burn care facility, this is an area of expertise,” said Sheridan. “And like all burns, the sooner your child receives care, the better their outcome will be.”¹

Tips for your patients on how to treat frostbite and frostnip

Physicians from Nemours Children's Hospital recommend the following steps for treating frostbite and frostnip in addition to the tips above:²

Frostbite treatment

• Call a doctor immediately or take your child to the emergency room.
• If the feet are affected, carry your child instead of letting them walk.
• Move your child into a warm environment and change them into dry clothing.
• If medical help is not immediately available:
  • Give your child a warm drink.
  • Do not thaw the frostbitten area if it could refreeze before getting medical care.
  • Soak the affected area in warm water (around 100°F/38°C). If warm water is unavailable, use warm blankets or body heat.
  • Avoid direct heat sources like fires, heating pads, or radiators, as numb skin can burn easily.
  • Do not rub the skin or apply snow to the affected area.
  • Expect a burning sensation when rewarming. Blisters, swelling, and skin discoloration may occur.
  • If available, apply sterile dressings to the area without wrapping too tightly. Place dressings between fingers and toes if affected.
  • Keep the thawed area warm and as still as possible. If trained in first aid, splinting may help prevent further injury.

Frostnip treatment

• Bring your child indoors immediately.
• Remove all wet clothing, as wet fabrics draw heat away from the body.
• Rewarm affected areas by placing them in warm (not hot) water for 20–30 minutes until sensation returns.
• Do not let your child control the water temperature—numb skin cannot feel heat properly and could burn.
• Use body heat if warm water is unavailable.
• Avoid heating pads, stoves, fireplaces, or radiators, as numb skin can burn easily.
• Call a doctor if sensation does not return or if signs of frostbite appear.

References:

1. Shriners Children's Hospital. Shriners Children’s Boston educates parents about dangers of frostbite. January 23, 2025. Accessed February 7, 2025. https://www.eurekalert.org/news-releases/1071526

2. Durani, Y. Frostbite and Frostnip. Nemours Kids Health. June 2023. Accessed February 7, 2025. https://kidshealth.org/en/parents/frostbite.html