Preventing frostbite: How to cope with the extreme cold of Chicago's winters

Icy Chicago skyline

Most people, especially those who have been to a late-season Bears game, have experienced the discomfort of really cold fingers and toes. When your skin actually freezes, it hurts even more. But the real ache — a throbbing, stinging or burning pain — often comes when tissue thaws. That’s when the body recognizes how much damage has been done.

People should be aware of the risk of frostbite and take precautions when the temperature drops. The body parts most susceptible to frostbite, such as fingers, toes, exposed skin on the face, ears and even the corneas of your eyes, are at highest risk. Be especially cautious when temps fall below zero and particularly when there’s a strong wind: If the temperature is below zero, you can sustain a cold injury in less than 15 minutes.

Tips for going out in the cold:

  • Dress in multiple layers and don’t forget to wear a knit hat, scarf, insulated and waterproof boots and a warm, wind-resistant coat; remember that mittens are warmer than gloves.
  • Keep in mind that the more you move, the better your blood circulates to keep your body warm.
  • If you’re driving a long way, especially at night, make sure you have extra clothes and blankets to cover up effectively if you get stuck somewhere. Have enough gas in the car.
  • If you have frostbite (see below for its signs and symptoms), insulate the affected body part to prevent additional heat loss and damage.
  • Immobilize and protect frostbitten tissues from further injury.
  • Prevent thaw-and-refreeze cycles of the frostbitten body part. Do not begin to rewarm until there’s no longer a risk of further exposure.
  • Once in the hospital, physicians recommend rapid rewarming in a water bath at 104°-107.6°F (40°- 42°C) for 15-30 minutes until thawing is complete.
  • Go to a city warming center if you don’t have access to a warm space.

The body’s tissues go through several stages of injury when exposed to extreme cold. The early phase of frostbite is called frostnip. Although frostnip can cause fluid-filled blisters, it can usually be treated outside of the hospital.

Superficial frostbite, which is characterized by swelling, redness, loss of sensation and skin appearing paler than in other places, means the tissue beyond your superficial layer of skin has been injured. This damage can require hospital care.

In the most extreme case, severe frostbite involves full-thickness freezing damage of deeper tissue including fat, muscle, blood vessels and even bone or cartilage. This can cause tissue to die and require amputation of body parts.

Severe cases of frostbite should be treated in a timely manner in a burn center like the Burn and Complex Wound Center at the University of Chicago Medicine. (In addition to burns, these highly specialized centers treat patients with frostbite, necrotizing soft tissue infections, complex wounds and other conditions.) In cases of severe frostbite, burn center physicians can use specialized techniques to salvage as much tissue as possible and ideally minimize the need for amputation.

Lawrence J. Gottlieb, MD, is a reconstructive plastic surgeon and director of the Burn and Complex Wound Center at the University of Chicago Medicine.

Lawrence J. Gottlieb, MD

Lawrence J. Gottlieb, MD

Lawrence J. Gottlieb, MD, is an internationally known reconstructive plastic surgeon. He has clinical and research interests in reconstructive microsurgery, and the care of patients with burn injuries, difficult wounds, or complex reconstructive needs. Dr. Gottlieb works on many multidisciplinary teams to provide comprehensive, state-of-art treatment for a wide variety of adult and pediatric patients.

Learn more about Dr. Gottlieb