First Aid for Frostbite: How to Recognise, Treat, and Prevent Cold-Related Tissue Damage
Frostbite is a serious cold-related injury that occurs when skin and underlying tissues freeze due to prolonged exposure to extreme cold, wind or moisture. In winter mountain environments, where temperatures fluctuate rapidly and wind chill intensifies heat loss, frostbite becomes a genuine risk even for well-prepared hikers. Understanding how to identify frostbite early, respond correctly and prevent further harm is crucial for safe winter travel. Quick, informed action can prevent long-term damage and ensure you remain stable until professional care is available.
Key Safety Principles and Common Risks
Frostbite typically affects extremities—fingers, toes, ears, cheeks and nose—because these body parts are furthest from the core and receive reduced blood flow in cold conditions. Wind, snow, wet clothing, tight boots and fatigue all increase vulnerability.
Common risks include:
Exposure to temperatures below freezing, especially with strong wind
Wearing insufficient or wet gloves, socks or boots
Reduced circulation due to tight clothing or restricted movement
Dehydration and exhaustion, which impair the body’s ability to generate heat
Failing to recognise early symptoms and continuing the hike
Frostbite develops in stages, and understanding these stages is essential for early intervention.
Practical Advice & First Aid Response
Recognising the Stages of Frostbite
Frostnip (early stage):
Skin feels cold and numb
Tingling or “pins and needles” sensation
Skin appears pale but not frozen
Frostnip is reversible with quick warming and does not cause permanent damage.
Superficial frostbite:
Skin turns white, pale or waxy
Ice crystals may form on the surface
The area feels hard or brittle
Numbness increases significantly
After rewarming, blisters may appear.
Deep frostbite:
Entire tissue layer is frozen
Skin becomes blue or black
Complete loss of sensation
Joints may feel immobile
This is a medical emergency requiring immediate evacuation.
Immediate First Aid Steps
a) Move to a sheltered environment
If possible, seek refuge indoors or behind natural wind barriers. Continuing exposure will worsen the injury.
b) Remove wet or restrictive clothing
Wet gloves, socks or boots accelerate heat loss. Replace them with dry, loose layers.
c) Warm the affected area gradually
Use body heat (e.g., placing hands under armpits or warming toes inside dry gloves).
Avoid direct heat such as campfires, heating pads or hot water—damaged tissue burns easily.
d) Do not rub or massage frostbitten skin
Rubbing causes further tissue damage and may break frozen cells.
e) Avoid walking on frostbitten feet or toes if possible
Movement can cause additional injury and complicate recovery.
Rewarming Procedures
Rewarming should only occur if you are certain the area will not refreeze—repeated freezing and thawing causes severe tissue damage. If stable to proceed:
Use warm water between 37–39°C
Submerge the affected area for 20–30 minutes
Expect pain, tingling and redness as circulation returns
Do not stop rewarming early, even if discomfort increases
If blisters form, do not puncture them. Cover gently with sterile gauze and seek medical care as soon as possible.
Pain Management and Hydration
Frostbite rewarming is painful. Over-the-counter pain relief can reduce discomfort. Hydration is also critical—warm fluids help restore body temperature and support circulation.
When to Call Emergency Services
Seek immediate help if:
Skin turns blue, black or hard
There is complete numbness after rewarming
Blisters are large or filled with bloody fluid
The person develops hypothermia symptoms
The injury involves hands, feet, face or multiple body parts
Evacuation is required for any suspected deep frostbite.
Prevention Strategies
Dress Appropriately for Winter Conditions
Layering is essential:
Moisture-wicking base layer
Insulating mid-layer
Windproof, waterproof outer shell
Use insulated gloves, mittens, warm socks and properly fitted winter boots. Always carry spare dry layers.
Protect Exposed Skin
Wear a face mask, neck gaiter, balaclava and insulated hat. Even short exposure in high wind can lead to frostbite.
Monitor Weather and Wind Chill
Wind drastically accelerates heat loss. Avoid exposed ridgelines during storms or intense cold.
Move Regularly
Frequent movement promotes blood flow. Avoid long breaks in freezing temperatures.
Stay Hydrated and Energised
Your body needs fuel to generate heat. Eat high-calorie snacks and drink warm fluids.
Essential Gear
Insulated gloves and spare pairs
Wool socks and winter boots
Face protection (balaclava or neck gaiter)
Hand and foot warmers
Waterproof shell layers
First-aid kit with sterile gauze
Thermos with warm liquids
Emergency blanket
Frostbite is a preventable but potentially severe injury, especially in alpine winter conditions. Recognising early symptoms, warming affected areas safely and taking swift protective action can prevent long-term damage. With the right equipment, awareness and preparation, hikers can enjoy winter landscapes while staying safe from cold-related dangers.
