Nepal: Frostbite is often linked to freezing polar regions, but it can happen even in places with moderate winters, like Kathmandu or Biratnagar. While the temperatures here aren't as extreme, wind, wet weather, or high-altitude trekking can still cause this cold injury. Knowing the risks and how to prevent frostbite can help keep us safe during winter, no matter where we are.
Dr
Vikash Paudel, a consultant dermatologist at Patan Hospital, Elite Health
Clinic, and Shankhamul Healthcare, explains frostbite, its early signs, and the
methods to prevent it.
What
is frostbite, and how does it occur?
Frostbite
is a cold-induced injury when the skin and its surroundings freeze due to
exposure to temperatures below 32°F (0°C). The cold constricts blood vessels in
the affected area, reducing blood flow and depriving tissues of oxygen.
As
time passes, this leads to ice crystal formation in cells, causing damage to
the skin and deeper tissues.
Frostbite
typically progresses in three stages. Frostnip (mild) is the first stage. Here,
initial redness and numbness occur without permanent tissue damage. In the superficial
frostbite stage (moderate), skin becomes pale, cold, and hard, sometimes with
potential blister formation. Lastly, in the deep frostbite (severe) stage,
tissue damage extends below the skin, potentially leading to permanent loss of
sensation, gangrene, or amputation.
What
parts of the body are most commonly affected by frostbite?
Frostbite
most commonly affects the body’s extremities and exposed areas, such as fingers
and toes, nose and ears, cheeks, and chin.
Fingers
and toes are prone to frostbite due to their distance from the heart and
reduced blood flow in cold conditions. The nose and ears have thin skin and
limited fat for insulation, leading to frostbite. Cheeks and chins are
frequently exposed to cold in winter.
Can
frostbite happen in regions with moderate winters like Kathmandu or Biratnagar?
While
frostbite is more prevalent in frigid climates, it can also occur in regions
with moderate winters, like Kathmandu or Biratnagar. It shows up more rapidly
in windy, wet, or high-altitude conditions, as these factors exacerbate heat
loss.
People
in Kathmandu Valley or Biratnagar may develop frostbite if they spend extended
hours outdoors without adequate protection. Moreover, encountering unexpected
cold fronts or high winds in moderate climates can lead to frostbite. Some
individuals with underlying medical conditions such as peripheral vascular
disease (due to poor circulation), Raynaud’s syndrome (Cold triggers excessive
constriction of blood vessels), diabetes (impaired nerve function and
circulation), hypothyroidism and malnutrition (decreased body heat production
and energy reserves) are even at higher risk no matter where they live.
In
moderate climates, frostbite risk increases during activities like
high-altitude trekking, where temperatures drop significantly, or during
prolonged exposure to near-freezing temperatures combined with wind or wet
conditions. People who smoke cigarettes are more prone to cold-related damage
because tobacco use restricts blood flow.
What
age group are more at risk of having frostbite?
Frostbite
can affect anyone exposed to freezing temperatures for prolonged periods.
Children and teens have a larger surface area relative to their body mass,
making them lose heat faster.
In
older adults (65+), ageing reduces their body’s ability to retain heat, making
them more vulnerable to frostbite.
What
are the early signs of frostbite?
Early
signs of frostbite include a tingling, numbness, or pins-and-needles sensation
in the affected area. Skin appears red, pale, or bluish and feels unusually
cold. As frostbite becomes more severe, skin becomes hard or waxy.
What
are the immediate steps one should take upon noticing frostbite symptoms?
If
frostbite symptoms are noticed, gradually submerge the affected area in warm
(not hot) water between 98.6°F–102.2°F (37°C–39°C) for 15–30 minutes, which
helps restore circulation without causing burns. Wrap the
affected
area in sterile gauze to prevent infection and avoid further injury.
However,
do not use heaters, fires, or heating pads, as numb skin is vulnerable to
burns. Rubbing frostbitten skin can further damage delicate tissues.
Consult
a healthcare provider promptly, especially if the frostbite is severe
(blisters, blackened skin, or persistent numbness).
What
preventive measures can people take to avoid frostbite, especially in areas
with mild winters?
To
prevent frostbite, it is essential to take several precautions. Dress
appropriately using multi-layered clothing, including moisture-wicking base
layers, insulating middle layers, and windproof or waterproof outer layers.
Protect extremities using gloves, hats or caps, scarves, thick thermal socks,
and waterproof boots. Ensure your clothing is not too tight to allow proper
blood circulation and keep your clothes dry, as wetness accelerates heat loss.
Stay
updated on weather conditions, paying attention to wind chill factors that can
make temperatures feel significantly colder.
Avoid
alcohol, which impairs judgment and heat retention, and nicotine, which
restricts blood flow to extremities. Lastly, stay nourished and hydrated, as a
well-fed and hydrated body generates heat more effectively, providing better
protection against frostbite.
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