Frostbite and hypothermia are often confused in cold weather conditions, yet they arise through different mechanisms, and both pose serious health risks. Prof. Deniz Demirci, Head of the Department of Physiotherapy and Rehabilitation, emphasized that correctly distinguishing the symptoms of these two conditions is vital for early intervention.
Prof. Demirci stated that while hypothermia affects the whole body, frostbite affects only the parts of the body directly exposed to cold, especially extremities such as fingers, toes, the nose, and the ears. “Hypothermia generally occurs as a result of staying for a long time in an environment that is very cold, windy, and humid. Frostbite, on the other hand, develops more quickly through direct exposure to cold, usually in windy and humid conditions, when bare skin comes into contact with the cold,” she said.
Prof. Deniz Demirci, Head of the Department of Physiotherapy and Rehabilitation at Üsküdar University Faculty of Health Sciences, drew attention to cold weather conditions and the fact that hypothermia can lead to fatal outcomes if not recognized in time.
What is hypothermia?
Prof. Deniz Demirci explained that hypothermia is a dangerous condition that occurs when body temperature drops below 35°C. “Normal body temperature is generally between 36.5°C and 37.5°C, and this range is necessary for the body to maintain optimal functions. When body temperature falls below 35°C, the body cannot carry out its normal functions, and there may be a life threatening risk. Hypothermia is generally associated with situations such as extreme cold weather, staying in water for a long time, not dressing warmly enough, fatigue, or hunger. In addition, alcohol and certain medications can accelerate heat loss in the body,” she said.
As body temperature drops, a series of physiological changes occur in the body
Prof. Deniz Demirci noted that as body temperature decreases, a series of physiological changes occur in the body. “The effects of hypothermia may vary depending on how much the body temperature has dropped and how long a person has remained under the influence of this low temperature,” she stated.
Explaining that many vital systems are adversely affected as body temperature drops, Prof. Demirci shared the following regarding the circulatory system: “With the drop in body temperature, blood vessels constrict (vasoconstriction). This helps direct blood from the surface of the body to internal organs, thus supporting the protection of vital organs. However, this can lead to paleness, coldness, and a bluish discoloration (cyanosis) of the skin. Prolonged hypothermia may cause a decrease in blood pressure, which can prevent sufficient blood from reaching organs and impair organ functions.”
As body temperature drops, brain functions slow down
Prof. Demirci emphasized that the effects on the nervous system are also of vital importance. “Hypothermia also affects the nervous system. As body temperature drops, brain functions slow down. Initially, symptoms such as shivering, speech impairment, and loss of coordination are seen. If the temperature drops further, the risk of loss of consciousness, coma, and eventually death increases. The brain expends more energy to regulate body temperature, and this can lead to impairments in mental functions. During hypothermia, muscles begin to shiver. Shivering results from muscle contractions to conserve heat and is a response that helps warm the body. However, when body temperature drops significantly, shivering stops and muscles weaken,” she said.
As body temperature drops, metabolism slows down
Prof. Demirci also drew attention to the effects of hypothermia on metabolism. “As body temperature decreases, metabolism slows down. Hypothermia negatively affects energy production and use. Organs such as the liver and kidneys have to work harder to generate heat, but these processes become inefficient. In addition, low blood sugar and other metabolic imbalances may be observed,” she stated.
Severe hypothermia can lead to respiratory arrest
Describing the effects on the respiratory system, Prof. Demirci said, “As body temperature drops, respiratory rate decreases, making it more difficult for oxygen to be transported efficiently throughout the body. Severe hypothermia can lead to respiratory arrest. In addition, inhaling cold air can cause dryness and irritation in the airways.”
He also emphasized the effects on the cardiovascular system: “Hypothermia can affect heartbeats. As body temperature drops, heart rate slows down and may become irregular. In cases of severe hypothermia, there is a risk of cardiac arrest. Irregular heart rhythms (arrhythmia) can be life threatening,” she stated.
Appropriate clothing should be worn in cold weather conditions
Prof. Deniz Demirci noted that in order to protect against hypothermia, it is important to wear appropriate clothing in cold weather conditions, avoid staying in extremely cold environments for prolonged periods, and take precautions to prevent a drop in body temperature. “In the treatment of hypothermia, the person’s temperature must be increased gradually. This can be done using warm drinks, warming blankets, or heating devices. However, treatment must be carried out quickly and carefully, because excessively rapid warming can adversely affect blood circulation in the body,” she said.
What are the differences between frostbite and hypothermia?
Prof. Demirci explained that although frostbite and hypothermia are both dangerous cold related health conditions, they affect the body through different mechanisms. “Hypothermia is when body temperature drops below 35°C. The body loses heat in a cold environment, which can impair organ functions and create a life threatening situation. In hypothermia, the entire body is affected. Frostbite is the freezing of body tissues, usually in extremities such as the hands, feet, nose, and ears, due to extreme cold. Frostbite leads to tissue damage, especially as a result of blood vessels becoming blocked after prolonged exposure to freezing conditions. This is a localized condition and is generally seen in the extremities,” she said.
Tissue necrosis can occur in frostbite
Prof. Demirci stated that in hypothermia, overall body temperature drops and this affects all organs. “The heart, respiratory system, and central nervous system are among the most affected. In hypothermia, muscles shiver, breathing slows, heart rate decreases, and thinking and coordination deteriorate. Frostbite occurs only in certain parts of the body. Tissue is damaged as it freezes due to extreme cold. At first, the skin becomes pale and numb, and then tissues can become icy and hard. In severe cases, tissues may undergo necrosis,” she said.
Hypothermia affects the entire body
Prof. Demirci reiterated that hypothermia affects the entire body, while frostbite affects only areas directly exposed to cold, especially extremities such as fingers, toes, the nose, and the ears. “Hypothermia generally occurs as a result of staying for a long time in an environment that is very cold, windy, and humid. Frostbite develops more quickly through direct exposure to cold, usually in windy and humid conditions, when bare skin comes into contact with the cold,” she said.
How can the symptoms of frostbite and hypothermia be distinguished?
Prof. Deniz Demirci listed the symptoms of hypothermia as follows: “Initially, there is shivering, fatigue, numbness, dizziness, impaired speech, muscle weakness, and loss of coordination. In moderate hypothermia, shivering stops, loss of consciousness occurs, there is difficulty thinking and making decisions rapidly, breathing becomes difficult, and the heartbeat slows. In severe hypothermia, there is loss of consciousness (progression to coma), body temperature drops below 30°C, and there is a risk of cardiac arrest.”
Continuing with the symptoms of frostbite, Prof. Demirci said: “Initially, the skin becomes cold and white, and there is numbness and a tingling sensation. In the advanced stage, the skin hardens, there may be discoloration, an icy cold sensation, pain or a burning feeling. The affected body part may become difficult to move. In severe frostbite, the skin and tissue freeze completely, swelling and crusting occur, and tissue death (necrosis) may develop. If not treated, the affected tissue may be lost.”
The body needs to be warmed gradually
Prof. Demirci emphasized that in the treatment of hypothermia, the body should be warmed gradually. “First, it is important to warm the person in a warm, dry environment, give warm drinks, and use warming blankets. Oral warming can be done, but rapid warming should be avoided because it may cause shock. In the treatment of frostbite, the frozen area should be warmed with lukewarm water and should not be re exposed to cold. Direct heat should be avoided on the frozen area. In cases of severe frostbite, surgical intervention may be required because tissue necrosis can develop,” she concluded.