By Dr. Sarah Voelkel
KyForward columnist
My toes are freezing!
With the frigid temperatures we’re dealing with, I find it a good time to talk about protecting your feet.
What happens to your feet when the temperature drops? As the temperatures approach freezing, the blood vessels close to the skin begin to constrict in an effort to keep the circulation at the core of your body to keep your body temperature up as the outside temperature drops. The colder the temperature outside, the sooner you have tissue damage from the constriction of the blood vessels. Your toes are very susceptible to this and can easily have damage from the cold due to frostbite.
Different degrees of frostbite:
• First-degree frostbite is commonly called frostnip and involves freezing of the skin surface. There may be itching and pain, red and white color changes, sometimes temporary numbness. Permanent damage from frostnip is uncommon, but you could have insensitivity to hot and cold as a long-term effect.
• Second-degree frostbite involves freezing of the skin and blister formation. The deep tissues still do not freeze with this stage, but you are more likely to have permanent insensitivity to hot and cold.
• Third- and fourth-degree frostbite involves freezing of the deep tissues including the blood vessels, nerves, muscles and tendons. These stages cause dark purplish blisters, numbness due to nerve damage, loss of function of the toes, and the final stage can lead to gangrene … leading to the need for amputation. Some toes that go untreated in this stage may fall off on their own.
What to do if this happens to you:
It is important to get to a warm environment as soon as possible and stay in a warm environment, because if rewarmed tissue is re-exposed to freezing temperatures more tissue damage can occur. Rewarming is best done by immersing the affected area in water at temperature of 104 F – 108 F. If blisters have formed, it is best to seek medical treatment for care as infection may occur if not treated appropriately.
How to prevent this from happening to you:
– wear warm moisture-wicking socks,
– avoid mesh shoes which allow the cold air and moisture to easily affect your feet,
– limit your time in the cold, especially if it is windy and if there is precipitation as well, and
– do not allow your skin or clothing to be wet as this increases risk of frostbite.
Who’s at increased risk for developing frostbite:
– children and the elderly,
– diabetics and those with peripheral neuropathy and circulation problems,
– those who take beta blockers, as they can cause decreased circulation to the skin, and
– smokers and those who drink alcohol when exposed to the cold.
With all the buzz about cold weather preparedness, I hope you’ll put some special consideration into taking care of your feet. As we always say, an ounce of prevention is worth much more than expensive correction down the line.
Dr. Sarah Voelkel is a foot and ankle surgeon at Lexington Podiatry and the Kentucky Heel Pain Center. Her column regularly appears on KyForward.com and is reprinted with permission.
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