Frostbite is a concern at high altitudes because of the cold environment and because reduced oxygen means your body is less efficient at generating internal warmth, making hands and feet more susceptible to freezing.

Frostbite is freezing of the tissues, and most commonly affects toes, fingers, and face. It occurs when an extremity loses heat faster than it can be replaced by the circulating blood, or it may result from direct exposure to extreme cold or high wind. Damp feet can freeze when moisture conducts heat away from the skin and destroys the insulating valĂșe of socks and boots. With continued cold or inactivity, circulation to the extremities is steadily reduced, accelerating the freezing process. If you're using good mountaineering clothing and equipment, frostbite is not likely to occur.

An area of superficial frostbite looks white or gray. Surface skin feels hard, but the underlying tissue will be soft. As the frostbite intensifies, the affected area becomes hard, cold, and insensitive.

You can warm superficially frostbitten areas by placing them against warm skin. Put your feet against a companion's abdomen or armpits. Warm your fingers in your own armpits. During rewarm-ing, large blisters may appear on the surface, as well as in the underlying tissue. Two important cautions. You must not raise the temperature of the frostbitten area much above body temperature, such as by warming near a fire. And never rub the injured part, especially not with snow. The additional cooling and the abrasive action further damage devitalized tissues. Misguided efforts to give speedy relief invariably increase the injury.

You can thaw extensive or deep frostbite, in which the affected area is white, has no feeling, and appears deeply frozen. Immerse the damaged area in water that is at a temperature between 99 and 104 degrees Fahrenheit until it is thawed. But do not start the thawing unless you are sure you can thaw the part completely and without interruption. It's better to wait for medical help than risk incomplete thawing or refreezing. Sometimes it's better to make no attempt to thaw frozen feet until after you retreat from the mountains and can get transportation and medical aid. If you leave your feet frozen, it's still possible to walk on them and suffer little or no additional tissue damage. But once your feet are thawed, you won't be able to walk and you will probably experience severe pain.

Continue reading here: Acclimatization

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