Winter cold and snow provide a number of opportunities to get outside and participate in activities such as skiing, sledding, and snowmobiling. However, without proper protection, cold weather-related injuries can occur even when temperatures are above freezing (32°F, 0°C). This is especially true if there are high winds or your clothing is wet. It is a combination of the temperature and the duration of exposure that play a role in determining the severity of cold weather-related injuries.

Cold weather-related injuries can be divided into two general categories. They are those that occur without the freezing of body tissue (chilblains and trench foot) and those that occur with the freezing of body tissue (frostbite).

Chilblains is a common type of cold weather-related injury that can develop several hours after exposure to extreme cold. Chilblains are itchy, painful, reddish, or purplish areas of swelling that usually affect the fingers, toes, nose, and ears. In some individuals, blisters or small open sores may also appear. Chilblains usually last for several days, and the affected area usually heals after several weeks. Though the affected area may remain sensitive to the cold in the future, there is usually no permanent damage.

Trench foot (immersion injury) was named after the condition suffered by many Soldiers in the trenches during World War I. Trench foot develops after prolonged exposure to a wet, cold environment and is typically a more serious condition than chilblains. The symptoms of trench foot include pain, numbness, and swelling to the affected area. The area may appear red, blotchy, pale, bluish or even black with advanced injury. The usual recovery period from uncomplicated trench foot can be for several weeks and subsequent cold sensitivity of the affected area may also occur.

Frostbite occurs when there is freezing of the affected area and it is the most serious of the cold weather-related injuries. Frostbite usually affects the hands, feet, nose, and ears. This type of injury results from decreased blood flow and heat delivery to body tissues resulting in damaging ice crystal formation.

Frostbite injuries can be classified as either superficial or deep depending on the depth of injury. Superficial frostbite injuries involve the skin and soft tissues, while deep frostbite injuries extend beyond the soft tissues and involve the tendons, muscles, nerves, and even bone.

The symptoms of frostbite may progress from pain/burning to numbness and eventual complete loss of sensation. Depending on the extent and time of injury, the affected area may appear pale, red, bluish/gray or black with the presence of clear or purplish colored blisters. The skin and underlying tissue may feel hard to the touch with advanced injury. The prognosis for frostbite injuries depends on the extent of injury and whether or not there are any resultant complications from the initial injury, such as infection.

Anybody can develop a cold weather-related injury, but the young and the elderly are especially prone to these types of injuries. In the young, the small size of their extremities and their limited mobility makes them more likely to be affected while in the elderly, poor circulation and limited mobility increase their susceptibility. Individuals who work outdoors, the homeless, and those who engage in outdoor activities are also at increased risk for developing cold weather-related injuries. Alcohol and illicit drug use make it more likely that individuals will develop a cold weather-related injury because these people may not sense that they are in danger. Certain medical conditions and circulatory problems can also make it more likely that one will develop a cold weather-related injury.

The prevention of cold weather-related injuries is best achieved through careful preplanning and preparation for the cold, when possible. Dress warmly using multiple layers and adequately cover body areas prone to injury. Try to have an extra change of dry clothing so you can remove any wet clothing if necessary. Always keep your hands and feet dry and avoid wearing tight fitting clothing on these areas as it may decrease the circulation. Most importantly, however, move indoors to a warmer environment when you begin to feel cold.

The treatments for cold weather-related injuries involve removing yourself from the precipitating cold environment, with rewarming of the affected areas using moist heat. The use of dry heat (such as over a fire or a portable heater) can lead to burns because of the lack of sensation and it can also further dry out the already injured tissue. Avoid massaging or rubbing the affected area with snow (a common "folk remedy") as this will only aggravate the injury. It is important NOT to thaw the frostbite areas if there is a risk of it re-freezing.