Water boils when it gets hot enough and freezes when the temperature drops below a certain point. The tiny blood vessels just below the surface of the skin are susceptible to extremes in temperature and will definitely shut down if too cold. When this happens, the result is frostbite.

Frostbite is more likely to occur in younger children whose surface area is proportionately larger than that of a grownup and whose skin is also more sensitive. When exposed tissues get too cold, tiny ice crystals from beneath the surface of the skin and the small blood vessels or capillaries freeze or “thrombose.” If the skin is not warmed so that circulation of blood is restored, tissues begin to die.


  • At first, skin becomes red.
  • Next, skin color becomes pale; rarely, blue color is seen.
  • When thawing begins, blisters may develop.
  • If prolonged freezing occurs, gangrene will develop. This is characterized by dead skin that may slough off and have a variety of colors.


  • Skin that is white should be rapidly warmed.
  • Relieve pain, which is frequent, with ibuprofen or acetaminophen.
  • Do not massage the affected areas or rub with snow or ice. This will increase the damage to the skin.


  • Be aware of weather forecasts and avoid exposure when chill factors are in the danger zone.
  • Children who are playing or working outdoors in cold weather should have skin protected with woolen caps, gloves and stockings. Facemasks should be worn.
  • Avoid prolonged exposure to sub-freezing temperatures.
  • Be sure children keep on the clothing you provide for them!

Call the Doctor If:

  • Known prolonged exposure to sub-freezing temperatures has occurred.
  • The skin, after exposure, turns pale or white.

Frostbite can occur in any climate zone where temperatures drop below freezing or when wind chill factors are below freezing. Always dress children warmly when they play outside in cold weather. Check to make sure that susceptible areas, such as face and hands, are protected.

It is of interest that feet and hands have remarkable ability to recover from even severe frostbite. However, prevention is always the best treatment, so, when winter comes calling, cover up!