Jack Frost may paint windows, and nip and fingers and toes. Frostbite isn’t nearly as charming.

Frostbite, an injury caused by freezing temperatures, can cause serious and permanent injuries. It is caused by exposure to extreme cold, either by being in cold weather or direct exposure to a cold object.

Frostbite can be serious for people with disabilities, who may not feel symptoms coming on until it is far too late. Frostbite causes a loss of feeling and color in affected areas, according to the Centers for Disease Control (CDC). It most often affects the ears, nose, cheeks, chin, fingers or toes. Severe cases can lead to amputation.

For people with disabilities, frostbite can be hard to immediately recognize and treat. Reduced blood circulation increases risk of frostbite for people with disability.

People with disabilities should anticipate cold weather and dress in layers. Avoid being out in the weather, if possible. Be equipped for weather extremes and have home and motor vehicle frostbite emergency kits prepared.

Frostbite starts with a milder form of cold injury, known as frostnip. Frostnip is painful but damage can be reversed. Frostnip causes discomfort, blanching and numbness of the skin that is relieved by rewarming.
Superficial frostbite is limited to the skin and tissues just below the skin. Severe frostbite involves the muscles, nerves, and deeper blood vessels and may result in tissue death (necrosis) and decay (gangrene). This could lead to amputation.

At the first signs of redness and pain, frostbite is beginning. Get out of the cold or protect any exposed skin. Signs include a white or grayish-yellow skin area, numbness or skin that feels unusually firm or waxy. The numbness is problematic because an individual is often unaware of frostbite until someone else notices.

Anyone detecting symptoms of frostbite must seek medical care. The CDC notes that because frostbite and hypothermia both result from exposure. Medical personnel must first determine whether the victim also shows signs of hypothermia, when the human body loses heat faster than it can produce heat, causing a dangerously low body temperature. Hypothermia can affect the heart, nervous system and most other organ. Left untreated, hypothermia will eventually lead to heart and respiratory system failure, and death. Hypothermia requires emergency medical assistance.

If there is frostbite but no sign of hypothermia, seek medical attention. If medical care isn’t available immediately, get into a warm room as soon as possible. Unless absolutely necessary, don’t walk on frostbitten feet or toes—this increases the damage. Immerse the affected area in warm—not hot—water. Water temperature should be comfortable to the touch for unaffected parts of the body.

An alternative to water is to warm the affected area using body heat. For example, the heat of an armpit can warm frostbitten fingers. Following warming, the individual often describes tenderness or burning pain.

One myth about frostbite is that it can be treated by rubbing the affected area with snow, or using an ice pack. This can cause more damage. Frostbitten skin should not be rubbed or massaged at all; this can cause more tissue damage. Nor should anyone with frostbite use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for warming. Affected skin easily burns.

After thawing, the skin is reddened with superficial blisters and swelling in mild cases. More severe injuries can result in serious cases. Proper medical care is needed to make sure frostbite doesn’t result in complications.

Lab studies may be ordered by a medical professional, to identify delayed systemic complications such as wound infection or underlying hypothermia. A radioisotope scan may be useful in detecting tissue injury if it is performed within 48 hours after injury. (Sources: Centers for Disease Control, Medical Disability Advisor)