Chicago has earned the nickname “Chiberia” thanks to its frigid temperatures, fierce winds and blinding snowstorms. Below-zero temperatures and wind chill advisories make going outside a daring feat.
While Chicagoans pride themselves on fearlessly facing the frightening weather, the bone-chilling temperatures and teeth-chattering wind can cause frostbite, an injury created by the freezing of the skin and underlying tissues and, in severe cases, the muscles, tendons, blood vessels, nerves and bones. Frostnip, which affects the superficial layers of the skin, is the initial stage of frostbite.
“One of the natural responses when people get cold is called the hunting response,” says Lawrence Gottlieb, MD, director of the Burn and Complex Wound Center at UChicago Medicine. “The vessels tighten up to preserve the core temperature, and then they dilate in a cycle that happens about every 10 minutes. As soon as you have less blood flow to the nose, ears, hands and feet, you have more risk of cold injury, whether it be frostnip or superficial or severe frostbite.”
Both frostnip and frostbite are caused by a combination of factors, including the weather temperature, the velocity of the wind and the length of time one is exposed to the elements.
With frostnip, the mildest level of frostbite, skin looks pale and feels cold, numb and stiff. The condition causes pain and then numbness but no permanent tissue damage.
Frostnip is not uncommon for athletes unfazed by the elements. ”We see a lot of joggers with frostnip whose ears and noses are exposed to the cold,” Gottlieb says. “If you have endorphins going, you might not be conscious of the cold, but you have to remember that we’re all mortal and the fact that you can run a marathon doesn’t mean you can endure the cold. One of the problems in exercising in extreme temperatures is that the blood rushes to your muscles and makes the exposure of your skin even worse.”
To treat frostnip, hands and/or feet should be soaked in warm water. A warm wet washcloth can be used for the nose and ears. Hot water or other sources of high heat should never be used because they could inadvertently burn skin that is numb. In addition, don’t rub areas of the body experiencing frostnip or frostbite to warm them to avoid further damage.
People who have frostbite, characterized by skin that is hard and cold to the touch, has changed color to blue or black and has blisters, should go to the emergency room. “We do controlled rewarming and then evaluate the injury,” Gottlieb says. Frostbite can cause pain and sensitivity to cold and heat that can last a year or longer and in extreme cases may require amputation.
Gottlieb notes that frostbite typically isn’t a problem for those who wear proper clothing. Those most at risk are people with issues of alcohol or drug abuse, smokers, those with mental illness or those with vascular disease and neuropathy who can’t feel their hands or feet and don’t know when they’re starting to get injured.
The National Institute on Aging offers guidelines for cold weather safety for older adults. Also, experts advise that layers are key, beginning with a garment next to the skin that lets moisture evaporate, followed by one or more layers to keep the heat in and topped by a layer that is rain- and wind-proof. Other essentials include a warm hat, face mask, scarf, mittens (which are warmer than gloves), wool or polypropylene socks and warm, waterproof boots or shoes.
Appropriate clothing is especially important for kids. “Children are at a somewhat higher risk than adults because the size of their overall body surface compared to their core is relatively larger and because of the size of their blood vessels,” says Elizabeth Powell, MD, attending physician of emergency medicine at Ann and Robert H. Lurie Children’s Hospital of Chicago.
Powell says it is especially important to keep a child’s head, hands and feet warm. Wet clothes, including socks that get wet when snow gets into their boots, can contribute to cold-related injuries. “Wet makes the cold colder,” she explains. Children stay warmer when they’re active and are at a greater risk of getting cold when they’re inactive, she adds.
With the necessary precautions to prevent frostbite, it’s possible to safely survive the chill of Chicago winters.