Frostnip, frostbite and the extremities of cold

The pain of excessive cold, like the pain of extreme heat, is the body’s early warning system to whoever is in charge that the body is in danger of incurring damage.

Frostbite is only a word, a concept even, to a great many people who ski, snowshoe, drive snowmobiles or simply take a long walk on a snowy country road.

Nevertheless, frostbite is real, and it is dangerous.

In the right conditions, it can happen to a person in the course of one chairlift ride up and one ski run down Bald Mountain. The variables of those conditions--temperature, humidity, wind, altitude, clothing, fatigue, tightness of glove and boots, individual metabolism, personal history with cold weather, time of exposure, etc. --are so complex that there is no pat formula to describe it.

Most instances of frostbite are completely preventable, even at extremes of altitude, temperature and fatigue. The chief cause of frostbite is carelessness on the part of its victim, especially in the setting of a ski resort with an abundance of available warm lodges. It is not too much to assert that incurring frostbite within the confines of a ski resort is completely inexcusable. Still, it happens. It has happened to me.

Frostbite is unlikely to occur in still air above 20 degrees Fahrenheit or so, but it may happen at higher temperatures when the wind is blowing. This is called the wind-chill effect. The colder it is below 20 degrees the more likely it is that frostbite can occur. The same is true of wind velocity.

Skiing on Bald Mountain, Dollar Mountain or on any of the cross-country trails of the Wood River Valley when the temperature is, say, zero degrees is, for the careless, inattentive or ignorant, a recipe for frostbite. A body moving through cold air creates its own wind-chill effect.

When it gets cold, the body reacts (sometimes with some people it even overreacts) to the dropping of its core temperature. The body constricts the blood vessels in its extremities in an effort to reduce heat loss. This allows more blood to circulate in the core of the body and to maintain its temperature. The core is where all the vital organs reside, but constricting the blood vessels deprives the extremities of the warming of circulating blood. Without that warmth, fingers, toes, ears and noses can’t sustain proper body temperature. Eventually, they start to freeze.

Frostbite, then, is a problem of blood circulation. Blood and other bodily fluids will thicken and congeal and freeze as they cool, and warm blood from the rest of the body, which would normally maintain a proper body temperature, can’t pass through frozen tissue. If the tissue remains frozen long enough, the cells in the tissue will die and the injured area will turn black and fall off.

Avoiding this is reason enough not to be careless in cold weather.

Most skiing-related cold injuries are actually frostnip, rather than frostbite. This is the mildest form of injury from the cold, and it is common in situations with severe cold and wind-chill, like skiing down Bald Mountain at 20 to 60 mph on a cold day.

Frostnip usually appears on the ears, nose or cheek as a whitish, waxy-looking patch of skin, and it only takes a couple of minutes to appear. If the affected parts are immediately warmed (fingertips placed under the armpits, the face placed in a warm lodge, the feet placed at a discrete distance from a warm fireplace), the usual result is a complete recovery. The thawing process may turn the area red and painful and even cause blisters.

Superficial frostbite occurs when frostnipped skin isn’t warmed up. The tissue beneath the skin begins to freeze and appears white and bloodless, though it remains soft and pliable to the touch. A day or so later blisters will appear that will turn into a thick discolored scar tissue that takes a few weeks to be replaced by new skin.

Deep frostbite, fortunately, is extremely rare among average outdoor enthusiasts like alpine and cross-country skiers. For all practical purposes, deep frostbite with its possible amputations should not concern the recreational skier; but if it should ever happen, seeking professional help immediately is crucial.

The best prevention is to pay attention to the signals of your own body. It is also helpful to check the people around you while skiing. If a cheek or ear or nose is white and waxy, that person should probably go in immediately and thaw out.

On Bald Mountain on cold days, it is useful to dress with an extra layer or even two: neck gaiters, face masks, mittens rather than gloves, boot muffs and loose boots all help.

Avoid smoking, as nicotine contracts blood vessels. Alcohol can be useful while warming up, as it dilates blood vessels, but, of course, should only be used if skiing is finished for the day. Needless to say, skiing and drinking is as careless and dangerous as driving and drinking.