Written by Brian Sloan, M.D.
In the northern hemisphere, winter has been thrust upon us. As we all strive to continue maintaining a healthy lifestyle and exploring the great outdoors, we must also prepare ourselves and our largest body organ—our skin—for the harsh and extreme conditions that Mother Nature may throw our way.
Skin exposure to cold can be as benign as a red face and numb fingers or as crippling as frostbite with amputations, hypothermia and even death. The earliest symptoms of cold injury are numbness and tingling, called “frostnip.” For patients with symptoms of frostnip, there will be no long-term damage to the skin if they are removed from the cold.
Continuous and severe exposure to cold puts one at risk for developing frostbite. The symptoms of frostbite include loss of sensation to the affected skin tissue, white or blue skin, blister formation and possibly swelling to the affected body part. As is true with frostnip, the most commonly affected body parts for frostbite are the fingers, toes, nose, ears and cheeks.
The hands, feet, ears and nose take the brunt of exposure to the cold, simply because blood flow to these extremities decreases in an effort to prevent the body’s internal temperature from dropping and developing hypothermia. If the body’s internal temperature drops below 95°F, then the signs and symptoms of hypothermia will likely be present. Early symptoms of hypothermia may include chills, hunger, nausea, confusion, itching and difficulty with judgment.
The hallmark of preventing any cold weather exposure injury is preparation. When you are going on your cold-weather hike, or when you get in your car to trek to Grandma’s, remember that if you are prepared for winter’s onslaught, you will be more likely to survive. Also take the time to look out for those who may not have the ability to prepare. Young children, the elderly, those with mental illness or those with medical conditions or on medications will need your assistance before venturing out into the cold.
If you or your loved ones are going to be near the water or exposed to wind, realize that these two factors, along with the length of time that you are out in the cold, are very important considerations in cold injury prevention. Moisture and cold are vicious enemies of the skin, and it is critical to remember that water is a superior conductor of cold. The combination of wind and cold make the wind chill index, which is commonly reported by weather forecasters. Wind chill indices are usually reported with a warning that should be closely observed by those with plans on venturing out into the cold during the winter months.
When you are planning your winter wardrobe on those cold, wet and blustery days, remember to layer your clothing. The inner layer should have a moisture-wicking material, such as cotton or wool. Air trapped between layers of clothing acts as insulation against the cold. Layers may also be removed if you become too hot. Ensure all clothing is in good condition, clean and dry. Change out of wet clothes immediately.
Protect your feet by wearing quality socks and boots. Carry an extra pair of socks in case you get wet. Do not over-tighten boots and avoid tight socks. Remember that to promote good blood flow, snug—but not tight—footwear is critical.
Hands should be covered with gloves or mittens. In extreme cold, mittens are preferred. Carry an extra pair of gloves or mittens with you in case yours gets wet. Also, do your best to avoid hand contact with snow, water or bare metal. These are excellent cold conductors that can accelerate the affects of cold injury.
Don’t neglect your head, face and ears. Wear a hat. Remember that 70 percent of your body’s heat can be lost through an uncovered head. Increase your thermal insulation by adding a scarf to your hat wardrobe. Sunscreen is crucial for skin protection in the winter. That’s right—sunscreen. The snow is an excellent reflector of the sun’s rays, and sunburn can creep up on you rapidly in the winter.
In case of injury, medical care is important. If you happen to be the victim of frostnip, frostbite or hypothermia, remember to immediately begin warming your affected body parts. Start by removing any cold or wet clothing and replacing it with dry clean clothes, socks, hats, gloves or mittens. If you notice extreme changes in your skin, such as blisters, loss of feeling, extreme pain or change in color, proceed to the nearest medical provider to be evaluated. In these extreme cases, advanced medical treatment might be necessary to avoid long-term problems with your skin, such as tissue loss, nerve damage or blood vessel injury.
The winter weather can be a great time to enjoy the outdoors if you prepare properly. Spending time with your friends and family on the ice rink, a sledding hill, the slopes, hiking or whatever you choose can be fun and exciting if you plan ahead and protect your body’s largest organ—your skin!
View the full winter 2011 issue of the ACSM Fit Society® Page supported by Liberty Mutual online.