Fingers, toes, ears, nose, and cheeks are some of the most common areas affected. How injury to tissue occurs is complex. It is a combination of direct cold injury to cells, indirect injury from ice crystal formation, and impaired circulation resulting in anoxia to the exposed area. Frozen skin appears white or yellowish and waxy. Initially there is numbness and no sensation of pain.
Damage can be mild or severe.
With mild frostbite, there is redness and discomfort during rewarming, but skin returns to normal in a few hours. In more severe cases, cyanosis and mottling are noted and then you typically see redness, swelling, and burning pain. Within 24-48 hours, vesicles and bullae appear. The vesicles and bullae will crust and eventually slough off. The new skin is thin.