On Friday, physicians who work in the burn center at University of Utah Health warned Utahns about the seriousness of frostbite, how to avoid it or treat it, and when to seek medical help.

Dr. Giavonni Lewis, a surgeon and medical director of the burn center at U of U Health, said that when it’s cold outside, a lot of people tend to forget about the potential hazards of frostbite, an injury to the skin caused by severe cold.

“We are really encouraging people to bundle up,” she said. “Everyone has had frostnip (the first stage of frostbite) where your hands get cold, red and numb, but you can have second-degree frostbite, which is more than just cold. You can have numbness, pain, hands can feel chapped and you can develop a lot of clear blisters. Third-degree frostbite is where all of the tissue is exposed to cold and actually freezes and no longer has any blood flow and it starts to die, and in those cases, that’s where we want to help prevent frostbite so we don’t end up losing fingers and toes.”

Lewis said the most vulnerable parts of the body at risk for frostbite include the hands, feet, nose and ears.

“When it comes to children, the No. 1 issue is that they don’t usually tell you, so you have to be vigilant and bring them in every 30 minutes and be aware of how cold it is outside,” Lewis said. “Make sure they are warm and dry and wearing the appropriate gear, such as mittens rather than gloves, waterproof shoes, and socks that are water wicking and allow the toes to stay warm.”

Irma Fleming, also a surgeon and assistant medical director at the burn center, said there are many ways to prevent frostbite and hypothermia.

“Mittens, headbands, hats, scarves, face masks to cover the nose as well as moisture wicking socks, jackets and windbreakers,” she said. “When you are wet in addition to being cold, you are even more prone to frostbite, even if temperatures aren’t at the freezing point. It doesn’t have to be 32 degrees for you to get frostbite. If you’re cold and wet, you may still get some symptoms.”

Fleming said some of the symptoms of frostbite include shivering, confusion, slurred speech, moving slowly, lethargy, numbness, redness, swelling and itching. A person may also have pain, redness, pale skin and blisters. In severe cases, skin can turn black and hard.

Treatment depends on the level of frostbite, said Lewis and Fleming. Mild cases can be treated by gradually warming up and placing the affected skin in warm, but not hot, water. If the frostbite is more serious than that, medical attention should be sought. Treatments can include warming up the skin, applying wound dressings, testing the blood flow of limbs, IV fluids, antibiotics, pain relievers and, in severe cases, surgery to remove dead skin or even amputation.

“We also support five states, so your local physician can reach out to us and we can give them pointers about your care,” Fleming said.

While the elderly and very young are at high risk for frostbite, those who are homeless are at the highest risk, said Tricia Davis Winter, director of the Utah Office of Homeless Services. In 2023, the Utah Legislature approved the implementation of Code Blue alerts, which are issued in any county where temperatures fall to 18 degrees or lower (including the wind chill) for two hours or longer in a 24-hour period. When the alert is issued, Winter said, shelters allow for overflow occupancy, and state agency staff members along with volunteers go around and seek out those who need help.

“Our first Code Blue this year was on Oct. 18 and, to date, we’ve experienced 66 Code Blue nights throughout the state,” she said.

This week’s temperatures will be very cold, according to local forecasters, with daytime highs in the upper 20s and low 30s, and lows are expected to be in the teens and single digits. With the wind chill, some places could drop below zero.

Humans aren’t the only ones that can suffer from frostbite and other cold-related symptoms. The American Red Cross suggests bringing pets indoors during cold weather, protecting their paws from salt and other chemicals used to melt ice and snow, keeping them away from antifreeze, which is a deadly poison, and always checking a vehicle’s engine by pounding on the hood or honking the horn to ensure an animal hasn’t sought refuge there. Also watch for signs of hypothermia in pets and avoid walking them on frozen ponds or lakes. Owners also can apply a vet-approved paw protectant before letting them go outside for brief periods.

The American Veterinary Medical Association also recommends talking with a veterinarian about giving pets more calories to generate enough body heat without putting unnecessary weight on them.