How to Avoid Frostbite and Hypothermia While Playing or Working Outdoors
Cold weather can often stop us from doing things we like to do or make things we must do miserable because let’s face it, being cold just isn’t that comfortable for most of us! But more than that, the cold can not only be dangerous but deadly as well.
Cold weather kills more than twice as many Americans as does summer heat according to the National Center for Health Statistics (NCHS). Their research showed 63% of weather related deaths were attributed to cold temperatures and wind chill.
According to studies over the years from the US Centers for Disease Control and Prevention (CDC), the number of people who die each year from Hypothermia and from frostbite has ranged between 1000 to 1500. But that’s only part of the story, more than 10x that are affected to some degree by these conditions (many recover after being treated, some have permanent damage and effects). The primary prevention and winter safety tactic is protecting yourself with the right clothing, in the right places, the right way.
Because your face and hands are typically the most exposed and the most susceptible to cold damage, in addition to a jacket (with a hoodie ideally), it’s important to protect these areas with clothing like thermal fleece face shields, beanies and gloves to protect your nose, cheeks, lips, ears and fingers respectively.
In This Article:
- What Is Hypothermia and What Are Its Symptoms
- What Conditions Cause or Accelerate Hypothermia?
- About Frostbite
- Stages and Symptoms of Frostbite
- Who Is Most at Risk of Frostbite and Hypothermia?
- Treatment for Frostbite
- Tips to Protect Yourself From Cold Weather and Prevent Frostbite or Hypothermia
- Layering, Clothing Material, and Keeping Your Core Body Temperature Out of the Danger Zone
- Best Cold Weather Clothing to Keep Your Ears, Nose and Face Protected
What Is Hypothermia and What Are Its Symptoms
When your body loses heat faster than it creates it, your body’s temperature decreases. As this progresses, your body begins to not function properly in a myriad of ways. If this cooling continues long enough, at some point your core body temperature drops so low that the medically defined threshold of 95 degrees Fahrenheit is reached or surpassed which technically is hypothermia. However it’s important to note that each person’s body is different so this temperature can vary slightly from person to person. Ultimately the symptoms are what helps you realize the severity.
When your body is exposed to cold, blood vessels in your extremities begin to narrow. This narrowing facilitates warming and is a survival mechanism where your body is ensuring proper blood flow to your key organs. If you continue to lose heat, eventually everything starts slowing down.
After even just a few hours of your core temperature being in the hypothermic zone, damage can be done to your organs and depending on what parts of your body are exposed, frostbite can also occur simultaneously.
When your body is exposed to any amount of significant coldness it does create a stress. Obviously healthy people can withstand more stress than those who are unhealthy. But there’s been many cases of even healthy people over-stressing their bodies by going for a run in the cold while recovering from the flu for example, where the combination was too much for their body and literally killed them. To minimize this stress, dress appropriately to keep yourself warm and be mindful of your body, the outside temperature and weather forecast.
How to Identify Hypothermia:
Hypothermia may come on slowly which can sometimes make it difficult to realize what’s happening as it can creep up on you. Awareness of your body and what to look for are critical in taking the appropriate action before it gets serious.
Beginning / mild symptoms:
- Constant shivering (which may stop as the core temperature drops below 90 degrees F)
- Cold skin
- Dilated pupils
- Lack of coordination, balance and ability to move your limbs the way you intend
- Slowed and/or slurred speech
- Forgetfulness, confusion or poor decision making
- Irritable and/or irrational demeanor
Progressive / severe symptoms include:
- Stiff muscles
- Slow or weak pulse
- Shallow breathing
- Extreme tiredness
- Loss of consciousness
Left untreated, hypothermia can be fatal. Therefore the sooner you realize yourself or someone else is experiencing the symptoms, mitigating action can be taken.
What Conditions Cause or Accelerate Hypothermia?
In addition to long term exposure to a cold environment (even indoors), water and wetness are major contributors. Combine being wet with wind and cold, and things can get serious very quickly due to a substantial increase in heat dissipation compared to being dry. Any time someone gets wet, like falling into an icy pond or even stepping into a shallow cold stream without waterproof footwear, it’s important to get the wet clothes off, dry the skin and replace with dry clothes if available and do all this as quickly as possible.
Treatment for Hypothermia
Treatment depends on the severity of the hypothermia. With mild or moderate symptoms, keeping dry, getting some food and liquids into the body, wearing layered clothing and being in a warm environment are advised. For severe symptoms, getting professional medical help should be the top priority but if that’s not immediately feasible, the same treatment as mild/moderate hypothermia holds true but more so as it relates to warming one’s core temperature such as using a space blanket if available, sleeping bag, extra blankets, etc.
There are a number of ways NOT to treat hypothermia. What might seem logical actually may not be. For example, it’s not appropriate to heat the extremities of a victim as that could cause a heart attack due to too much vessel constriction. The recommended method is to raise the body’s core temperature, which will automatically cause blood to warm and subsequently circulate more normally as the vessels dilate. Similarly, someone experiencing very severe hypothermia to where it’s hard to tell if they are even alive should not have CPR performed if they are indeed alive but barely breathing (2 or more breaths a minute, and similar heartrate of just a few beats a minute). CPR could actually kill them when warming their core would slowly increase their breathing and heart rate.
Since we want to focus more on prevention and the best cold weather clothing in this article, if you are interested in more details, you can find a comprehensive guide to hypothermia and its treatment at Princeton University’s Outdoor Cold Injury Guide (link: https://www.princeton.edu/~oa/safety/hypocold.shtml)
Put simply, frostbite happens when skin and the tissue under your skin freezes. It happens when a body part is left exposed and is not adequately covered when outside in freezing temperatures and wind. Therefore it makes sense that frostbite is more common in northern states and also in high altitude areas. Once the temperature gets below 31F, frostbite becomes a real concern. It becomes even more so when wind chill is in effect. However, contact with anything that’s frozen or near 31F like ice, metal or water can cause it.
Although any part of the body can be frostbitten, the extremities are most vulnerable, especially your head and face since it’s usually the area least covered. On your face it’s ears, nose, lips and cheeks while elsewhere fingers and toes are often commonly affected since when the body loses heat, blood vessel constriction occurs in these areas thereby making them freeze faster. This in-turn, allows the fluid in and below the skin to freeze into ice crystals. Since most of the body is water and when water freezes it expands, the crystals cause cell damage. The combination of lack of blood flow (which causes lack of oxygen to the supplied area) and the cell damage puts any affected area in jeopardy of dying.
While frostbite is treatable, when it is severe there can be permanent damage in the form of tissue loss (where a procedure called debridement essentially scrapes off any dead tissue) and even amputation. In either case, this can be disfiguring which is something no one wants to have happen to them.
According to Wikipedia, the people most commonly frostbitten are in the 30 to 50 year old age group, where it is speculated that this is due to recreational or work-related exposure.
Frostbite in History
As long as there’s been cold, there probably has been frostbite. Archeological records show what is believed to be frostbite in people well over 5000 years ago. Perhaps what has caused the most people to be affected of all is military action. Historical records show Napoleon’s army was severely affected en masse and in the World Wars it is estimated over a million soldiers had frostbite at one time or another.
Stages and Symptoms of Frostbite
Frostbite is often classified into 3 stages, with each stage corresponding to how deep the freezing has penetrated through the skin into the body with the advanced stage penetrating down through to the bone. It’s also sometimes classified similar to burns, since in many ways the skin and underlying area gets for lack of a better way to explain it, “freezer burn”. Also when recovering, the skin often will blister, similar to a bad sunburn.
Because being exposed to cold hurts, we often don’t realize when that typical cold stinging feeling starts to become more serious. And because numbness can set in, it can be harder to realize frostbite has set in until it’s too late. Understanding the stages and keeping an eye on your skin for color changes if possible, can help a great deal in differentiating between just being uncomfortably cold and frostbite:
- A precursor to frostbite although it can also be considered early stage
- Redness may appear on the skin and a feeling of soreness may be felt
- If you can get out from the cold, frostbite can be avoided
- Skin color becomes white or light yellow
- Skin may become itchy or a burning sensation is felt
- These may be accompanied by a feeling of pins and needles
- Light numbness
- Skin loses its suppleness and becomes hard and doesn’t bounce back when pressed
- Skin takes on a shiny appearance
- Numbness becomes more pronounced
- The skin becomes completely inelastic if not hard
- The skin loses most if not all warmth is and very cold
- Color starts to darken to where it’s blue and eventually will turn black if exposure continues
Who Is Most at Risk of Frostbite and Hypothermia?
Anyone who is exposed to cold temperatures long enough can be affected.
When temperatures drop, people who participate in activities such as:
- Cold Weather Fishing and Ice Fishing
- Working Outdoors
- Snow Boarding
- Ice Hockey
- Winter Hunting
- Mountain Biking
- High Altitude Sports & Activities
- Motorcycle Riding (unprotected or minimally protected)
- Shoveling Snow
In addition to hypothermia and frostbite, cardiac arrest is another common condition that affects people while doing these activities. In fact, something as simple as shoveling snow results in numerous heart attack deaths every year in the US. Even if it cardiac event was initially survivable, if they were outside alone by the time anyone finds them it’s often too late. People with other health issues or who are elderly should at minimum be accompanied or watched to minimize the chances of a tragedy happening.
In addition to activities, anything that affects the blood and/or blood vessels as well as critical thinking can increase the risk. These include alcohol drinkers, smokers and various medications. The elderly, children, the homeless, anyone with mental health issues, diabetics and even someone who has the flu or any condition that can limit their movement all are more prone to succumbing to the cold.
People who have had previous cold injuries often are more susceptible and people living in higher altitudes due to cooler temperatures, the ability of the weather to change quickly and drastically and the lowered oxygen content of the air increase risk.
Beyond all those things, the bottom line is the colder it is, the faster you can be afflicted. One of the most useful tools for knowing when it’s too cold to safely be outside is the Wind Chill Chart.
When the combination of wind and temperature hit certain limits, you literally have just minutes before you are at serious risk. For example, winter winds of 25 mph aren’t uncommon, especially during storms. When the temperature falls to just ten degrees below zero only 10 minutes of skin exposure puts you in trouble. And if you went out to do a 5 minute task but it just happens to take longer than you thought, 10 minutes can go by just like that.
Therefore, it’s just smart to make sure you wear the right clothes and assume whatever you are doing will take longer than you think.
Chart Source: http://www.nws.noaa.gov/om/cold/wind_chill.shtml
Treatment for Frostbite
It’s safest to see a doctor or go to the Emergency Room when frostnip or frostbite is suspected even if you think it doesn’t look that bad. If you have continued numbness, blisters start forming and/or your skin has changed color you’ve crossed over from “suspected” to “contracted” and to minimize the chances of losing tissue or worse, get medical treatment as soon as you can.
If getting to the ER is not an option for whatever reason, mistreating frostbite can actually cause more damage rather than helping so it’s important to know what to do, and not do, if you cannot get to a hospital or doctor quickly.
Since there’s little to no blood flow, it is not advised to rub frostbitten skin as the friction on compromised skin can increase the chance of permanent damage.
A bath of warm but NOT HOT water between 104 and 108 degrees F is typically recommended to gently rewarm the area or if possible, the entire body. This can sometimes be painful, depending on the stage. If you don’t have a thermometer to correctly measure the temperature, it’s best to be too cool than too hot. Hot water can cause more damage.
Tips To Protect Yourself From Cold Weather and Prevent Frostbite or Hypothermia
Unless you’re facing extreme cold and/or wind chill, prevention is pretty straight forward and common sense:
Avoid cold temperatures (if something can wait, let it wait)
- Wear proper clothing to keep your core warm
- Cover every bit of skin you can including your eyes with full goggles
- Avoid dehydration and going out in the cold on an empty stomach
- If you are doing a sport or working, don’t overdo it as exhausting yourself puts you at more risk
- Don’t go out if you have recently or are, consuming alcohol or are under the influence of other substances
- Be ready for unexpected or rapid changes in weather and surprise storms
Being impaired by alcohol or other substances accounts for many cases of hypothermia and frostbite. From getting themselves lost to just sitting down for what they feel is going to be a quick minute to rest, too many people have been found frozen to death under these circumstances so “friends don’t let friends go out alone in cold weather alone.”
It’s a good idea to have a backpack in each of your vehicles at all times, containing things like energy bars, first aid, warmers, space blankets, signaling devices, beanies and thermal face masks, gloves, etc. Additionally, mylar space blankets come in very small packets and are only a few dollars each so putting a couple in each purse, your glove box, back pocket, etc. can be a life saver.
Layering, Clothing Material and Keeping Your Core Body Temperature Out of the Danger Zone
Before we discuss the best way to protect your head, face and extremities specifically, it’s important to first focus on keeping your body warm so your core temperature doesn’t drop to begin with.
It’s always a good idea to dress properly even if it’s to go outside for just a minute. There are numerous cases when it was extremely cold where people left the warmth of their car or home intending to be outside for a few moments and locked themselves out. It only takes seconds to put on or take off a piece of clothing.
Experts agree that you want to dress in 3 layers although in the most extreme conditions a 4th layer, called the mid-layer is often inserted over the base but under the insulating:
- The base layer
- An insulating layer
- The protective outer layer
The key thing about layering is air. The air space between different layers of clothing provides excellent insulation. Just like how energy efficient windows for cold weather buildings have 2 panes of glass separated by air instead of one thick piece of glass, you are better insulated with multiple layers instead of one big jacket. Layers also allow you to adjust as you get warmer due to activity or the sun.
Types of cold protective material used in clothing:
Synthetic fabrics – Fabrics like polypropylene and polyester have good moisture wicking ability
Merino wool – When we think of wool, we think itchy. But Merino wool is the “comfortable version of wool”. It wicks away moisture and make a great base layer.
Down – This is usually comprised of the fluffy undercoat feathers of ducks and geese and are make great insulation. The warmer you want to be, the higher the fill power the down should be.
Fleece – Typically used for the mid or insulating layer, can be natural (from a sheep or goat) or synthetic.
GORE-TEX® – Clothing made of this fabric is easily found in many outdoor and fishing stores. It has a trinity of benefits including being waterproof (vs just water resistant), breathable and wind resistant. It
Cotton – While super comfortable cotton does not wick away moisture, so it should be largely avoided in cold weather.
Each layer has a specific purpose:
Layer 1 – Keep you dry and is comfortable
Layer 2 – Provides insulation. Materials like fleece, down, wool, etc. are great for that.
Layer 3 – Waterproof is key, so GORE-TEX® is a great option and is wind resistant as well.
Layer 1 (Base)
Whatever material you use, it should fit tightly, so wear your size not a larger size. Do not wear cotton as your base layer as it traps moisture, stays wet longer and essentially cools you down when you want the opposite to happen.
Moisture wicking (evaporative) ability is the primary consideration here. So merino wool, synthetics and even silk are all good choices.
Layer 2 (Insulating)
As mentioned, down and fleece are good as the insulating layer but also as a mid layer.
Layer 3 (Outer shell)
This layer is all about keeping out the weather, be it rain, wind or both. Sizing can be tricky because if it’s ill fitting, you can let the elements in, thereby compromising all the other layers. If you buy the same size as any other clothing you wear, it may not zip or button up fully once you account for the other layers since you have artificially bulked up. For this reason it’s a good idea to buy something for the usual cold and then a size larger for those heavy blizzard super cold days when add other layers.
Keep in mind when we say 3 layers, it doesn’t necessarily mean just wear 3 things. You can wear a thin and then a thick base layer, or any layer. Doubling up on a layer is just fine and in colder conditions is a must. Also don’t forget about your legs. We often think about layering up with jackets but leave off a layer for our legs. GORE-TEX rain gear should be 2-piece so you have your legs covered. Wearing down pants isn’t so practical but fleece can be. Long john underwear is not something everyone actually owns but is a key part of your overall keep warm, keep healthy strategy for cold conditions. Similarly, doubling up on your socks is a good idea which also means having the adjustable waterproof footwear to accommodate the added space needed when you put on more than one pair. And of course, gloves or mittens to cover your hands. In colder conditions consider a thin glove as a base layer for your fingers, then a thicker one to go over it. Make sure the outer glove is waterproof. Mittens, while protecting better, may not be practical for all outdoor activities due to the loss in dexterity.
Best Cold Weather Clothing to Keep Your Face, Ears and Nose Warm
Since your ears and nose are extremely vulnerable to frostbite, making sure you have some stylish yet effective options when things get cold can make all the difference. And while the concept of layering doesn’t as easily apply, wearing more than 1 of the same piece of clothing is a good idea. Because let’s face it, very few of us look better with part of our ear or the tip of our nose missing! All joking aside, as you’ve now learned, that’s a real risk especially if you don’t own any clothes to cover your head, neck and face.
While hats are great for protecting you head in the sun, when it’s cold it’s often windy and most hats have some kind of brim that the wind can catch on and whoosh, there goes your hat. A lot of heat can be lost through your head so you want to wear something that isn’t going anywhere at the first wind gust. We feel the best protection for your head is a Beanie, and when it’s really cold, wear one over the other plus if your third layer has a hoodie, all the better so as to help keep any rain off should that be part of the forecast.
We feel the best cold protective clothing for your face are Thermal Face Shields. Again, like beanies, you can wear one over the other as needed. They are breathable and the tubular bandana style is seamless which provides 360 degree protection and can be worn many different ways to protect your head if you don’t have a beanie, be used as neck gaiter if you don’t have a scarf, and cover your lips, nose, cheeks and even ears. Because winter face shields are compact, it’s a good idea to purchase them in packs so you can have a couple in your glove box at all times, keep one in your jacket pocket, in your backpack and elsewhere so you always have the face protection close by in case you need it.
Also, don’t forget eye protection especially in windy conditions. It doesn’t take long for eyelashes or even your cornea to freeze as the wind is blowing on them, and closing your eyes may not be the best thing to do depending on your activity. Get full wrap around glasses or tight fitting snow goggles to maximize your protection. Again, like face masks, goggles don’t take up much space and are affordable so why not keep spares in different places including your glove box or behind your drivers seat should the need arise.
Lastly, while it’s not as important as staying warm and avoiding frostbite and hypothermia, it’s great when you can do that and still look stylish with fun, cool designs on your outer wear like beanies and fleece face shields!
This article is provided for informational purposes only and is in no way to be construed as medical advice nor to diagnose or treat any condition. Anyone who believes they have been adversely affected by the cold should immediately seek professional medical help.