Fast Five Quiz: Can You Properly Identify and Treat Frostbite?

C. Crawford Mechem, MD, MS


January 15, 2015

First-degree frostbite has the following characteristics:

  • Insensate, central, white plaque surrounded by a ring of hyperemia;

  • Epidermal involvement;

  • Erythema; and

  • Mild edema.

Second-degree frostbite has the following characteristics:

  • Full-thickness skin freezing;

  • Clear blister formation with surrounding erythema;

  • Hard outer skin but resilient tissue underneath; and

  • Substantial edema.

Third-degree frostbite has the following characteristics:

  • Subdermal plexus freezing;

  • Hemorrhagic blister formation;

  • Blue-gray discoloration of the skin;

  • Deep, burning pain on rewarming, lasting 5 weeks; and

  • Thick gangrenous eschar formation within 2 weeks.

Fourth-degree frostbite has the following characteristics:

  • Involvement of muscle, bone, and tendons;

  • Frozen, hard, and avascular skin and tissue underneath;

  • Mottled tissue, with nonblanching cyanotic skin that eventually becomes dry, black, and mummified;

  • Relatively little pain experienced on rewarming; and

  • Minimal to mild post-thaw edema

For more on the presentation of frostbite, read here.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: