Frostbite and hypothermia: first aid and what not to do

In short

• Hypothermia is an abnormally low body temperature, and the CDC calls it a medical emergency.
• Warning signs include shivering, exhaustion, confusion, fumbling hands, slurred speech and drowsiness.
• Get the person out of the cold, remove wet clothing, and warm the center of the body first.
• Never rub frostbitten skin, never use direct dry heat and never give alcohol.
• Dress in loose layers, keep dry, and cover your head, ears, hands, feet and face.

Hypothermia: the warning signs

Hypothermia happens when the body loses heat faster than it can produce it. A body temperature below 95 °F (35 °C) is a medical emergency. Because it develops gradually and affects thinking, the person may not realize they need help, so the people around them have to watch for the signs.

• In adults: shivering, exhaustion, confusion, fumbling hands, memory loss, slurred speech and drowsiness.
• Skin that is pale, cold and dry, which may look blue or gray. On black or brown skin, check the palms or soles.
• Slow breathing and tiredness.
• In infants: bright red, cold skin and very low energy. The NHS also lists a baby who is floppy, unusually quiet or sleepy, or refusing feeds.

Hypothermia first aid

1. Call for help.Call 911, or go to the emergency department. If the temperature is below 95 °F, get medical attention immediately. Do not drive yourself if you are the one affected.
2. Get out of the cold.Move the person indoors, or at least to a sheltered place, as quickly as possible.
3. Take off wet clothing.Wrap the person in a blanket, sleeping bag or dry towel, and cover the head and neck.
4. Warm the center first.The CDC advises warming the chest, neck, head and groin, with an electric blanket if available or skin-to-skin contact under dry layers.
5. Offer a warm drink if awake.A warm, non-alcoholic drink and some sugary food can help if the person is fully awake and able to swallow. Never give a drink to someone who is unconscious.
6. Stay with them.Keep the person awake by talking to them, and stay until help arrives.
7. If they stop responding.If a person is unconscious or seems to have no pulse or breathing, get emergency help right away and start CPR, then continue CPR and warming until they respond or medical aid arrives.

What not to do

• Do not give alcohol. Alcohol is on the avoid list for both hypothermia and frostbite.
• Do not use a hot bath, hot water bottle or heat lamp to warm someone with hypothermia.
• Do not rub their arms, legs, hands or feet.
• Do not rub frostbitten skin or massage it, and do not break blisters.
• Do not use direct dry heat such as a radiator, campfire, heating pad or hair dryer on frostbitten skin.

Frostbite: the signs

Frostbite is cold injury to skin and the tissue under it, most often in the fingers, toes, nose, ears, cheeks and chin. MedlinePlus lists these symptoms:

• a pins-and-needles feeling, then numbness;
• hard, pale, cold skin;
• aching, throbbing or loss of feeling;
• red, very painful skin and muscle as the area thaws;
• in very severe cases, blisters, gangrene, or damage to tendons, muscles, nerves and bone.

Frostbite first aid

1. Check for hypothermia first.Treat hypothermia if it is present.
2. Get warm.Move to a warmer place, and remove tight jewelry and wet clothing.
3. If medical help is quick to reach.Cover the areas with sterile dressings, separate affected fingers and toes, and go to an emergency department.
4. If help is far away.MedlinePlus advises soaking the area in water warmed to 104 °F to 108 °F (40 °C to 42.2 °C) for 15 to 30 minutes. Never use hot water. For ears, nose and cheeks, use a warm cloth repeatedly. Warming is complete when the skin is soft and color and feeling return.
5. Dress it.Apply dry, sterile dressings, placing them between affected fingers or toes.
6. Prevent refreezing.If it cannot be prevented, it may be better to delay rewarming until you reach a warm, safe place, because thawing and refreezing worsens damage.

Why alcohol and smoking make it worse

Alcohol is on the do-not-give list for hypothermia in both NHS and CDC guidance. MedlinePlus adds that smoking and alcohol during frostbite recovery can impair circulation. People who drink alcohol or use illicit drugs are listed by the CDC among those at greater risk of hypothermia, so the best drink in the cold is a warm, non-alcoholic one.

How to dress and plan for cold

• Wear several layers of loose-fitting clothing topped with a water-resistant coat and boots.
• Wear a hat or scarf that covers your ears, a scarf or knit mask over your face and mouth, and mittens, which the CDC suggests over gloves.
• Wear two pairs of socks and avoid tight boots or clothing that reduce circulation.
• Keep dry. The CDC notes wetness from rain, sweat or cold water can cause hypothermia even above 40 °F.
• Carry extra socks, gloves, a hat and a blanket, and avoid touching cold metal with bare skin.
• Stay indoors when it is extremely cold, and find shelter early in a severe snowstorm.

Who is at higher risk

The CDC and NHS name older adults without enough food, clothing or heating, babies sleeping in cold bedrooms, people outdoors for long periods, such as hikers, hunters and people experiencing homelessness, anyone whose clothes are wet and who gets cold, and people who drink alcohol or use illicit drugs. Smoking, fatigue and certain medicines can reduce circulation and raise frostbite risk. Ask your clinician whether your medicines do.

Red flags: when to call 911

Call 911 for confusion, slurred speech, drowsiness or loss of consciousness in the cold, for slow breathing, or for no pulse or breathing. Contact a medical professional for severe frostbite, for normal feeling and color that do not return promptly after home care of mild frostbite, or for fever, feeling unwell, skin discoloration or drainage from the area after a recent frostbite.

Questions and answers

Sources

1. CDC — Preventing Hypothermia
2. CDC NIOSH — Cold Stress
3. NHS — Hypothermia
4. MedlinePlus — Frostbite
5. MedlinePlus — Hypothermia

Sources checked on 29 October 2026.