Frost bites: cold weather dangers, easy to avoid Published Feb. 4, 2011 By A1C Jack Sanders JBER PAO JOINT BASE ELMENDORF-RICHARDSON, Alaska -- Alaska's cold climate can be dangerous for workers, outdoor hobbyists or anyone participating in any activities that expose them to the elements for too long. There are a variety of problems that can arise from prolonged exposure. "Some of the most common injuries are frostbite, hypothermia, which is probably even the most severe one because it can be fatal, and then frost nip, which is a milder form of frostbite," said Air Force Capt. (Dr.) David Belcher, 673d Medical Group family practitioner. "Many of these injuries can be avoided by taking some small precautions," Belcher said. Belcher is a family doctor who sees children, middle aged adults and the elderly for all kinds of illness. "We pretty much treat whatever comes in the door," he said. According to Belcher, frost nip is a condition most people are unaware of. Frost nip causes paresthesia, which is a numbness and tingling sensation, but can be cured simply by warming up the body part by, rubbing hands together or placing them in warmer areas of the body like the underarms, he said. "Frost nip is an early warning sign that you're in danger of getting frostbite," Belcher said. People who enjoy outdoor activities or who will be exposed to the elements for prolonged periods of time like hikers, hunters, construction workers, any sport enthusiast or even people shoveling their driveways are the ones at the highest risk for cold weather injuries, Belcher said. "One easy way to prevent some of these injuries would be paying attention to the forecast to know how to dress that day," Belcher said. "If you know that it's going to be extremely cold outside then you can dress appropriately. Wind is a big thing to watch out for too. People can actually have their corneas frostbitten due to wind exposure." Appropriate clothing to wear includes, "a hat, face protection, eye protection under extreme conditions, mittens (as opposed to gloves), warm and water-resistant shoes, and several layers of loose-fitting cloths, according to www.uptodate.com, a website used to keep doctors informed with the most up to date information. "The inner-most layer should be a wicking material, such as silk or polypropylene, that will draw moisture away from the skin," Belcher said. "The next layer should be of an insulating material such as fleece or wool. The outer-most layer should provide protection against wind, rain, and snow. Wet clothing should be changed as soon as is feasible." The best way to avoid cold weather injuries is to limit the time you're in the cold, Belcher said. With an outside job that can be difficult, but according to Belcher, it's important to always check for symptoms and inform those in charge that, "Hey I'm getting just a little too cold." "We're here to look out for each other in any situation," Belcher said. Some people may not be aware of medical conditions or activities which may put them at heightened risk for cold weather injuries, Belcher said. "Sometimes people don't realize that if they have diabetes or (blood vessel disease) if they're smokers or if they're drinking; all those things increase your likelihood of getting hypothermia or frostbite," Belcher said. "Also, drinking caffeinated beverages can potentially increase your risk. Alcohol causes vasodilation, where the blood vessels become larger, so they get closer to the surface of the skin." When you drink you may feel as though you're getting warmer, but actually you're releasing more heat faster. Those people can get chilled much quicker," he said. "Some people can be on heart medication like beta blockers, they might think, 'Oh, I'm just treating my blood pressure,' but actually beta blockers can affect the dynamics of your blood vessels to adapt to the cold weather," Belcher said. There are many things which can affect the body's ability to adapt to heat and cold. "Your body, through the hypothalamus in your brain, will regulate your core temperature, and the beta blocker can inhibited the proper adjustment of your blood vessels when you're cold," Belcher said. According to Belcher, the condition isn't uncommon and can be brought on through other processes as well. "There is also the condition known as Raymond's Phenomenon that works similarly. With Raymond's Phenomenon, if you're outside working with a machine that causes vibration you would be at higher risk than someone not using that machine because the vibrations cause your body to be unable to respond to the cold environment," he said. "So basically, you can get colder faster," Belcher said. "On the reverse side of that are people with perivascular disease from cholesterol or from smoking (who) will get vasoconstriction - smaller blood vessels - towards the extremities. Because of this, smoking outside when it's cold and then working like a construction worker isn't a good idea."