AUBURN - When the weather turns cold and Jack Frost nips at your nose, take care not to let Jack give you frostbite. It can take only seconds of exposure to be frostbitten, but there are simple precautions you can take to avoid the injury.

Because central New Yorkers are used to the cold weather and tend to take precautions, frostbite is not commonly seen at Auburn Memorial Hospital, said Dr. Jamie Ciaccio, director of the hospital's emergency room.

“People are aware of the dangers,” he said. “They're careful.”

More common is frostnip, the precursor to frostbite. It is a superficial injury that does not go as deeply as frostbite. Skin becomes pale and numb.

“We see that fairly often,” Ciaccio said.

Frostnip can be treated with warm compresses, as long as there is no danger of refreezing.

On the other hand, frostbite is more serious. There is damage to the tissue and blisters form, with continued pain. The area appears solid, hard and frozen.

Preventing frostbite is simple - dress warmly and keep skin covered. Keep clothes dry, as ice can form on wet clothes. Avoid spending long periods of time in the cold. In subzero temperatures, frostbite can happen in a snap.

“In -10, -15 degree weather, if you're exposed more than 30 seconds, you're going to get frostbite,” said nurse practitioner Bill Myers of SUNY Upstate Medical University in Syracuse.

Frostbite is a freezing of the tissue and is dependent on the length of time a person is exposed to the cold. The most common areas for frostbite are the toes, fingers, ears and nose.

“The colder it is, the faster it will happen, including the wind chill,” Ciaccio said. The treatment is warming the skin. “Once we get them inside, we warm the tissue in lukewarm water.”

Frostbite patients may need to be treated in a burn unit. In the worst case, the affected area may need to be amputated.

In the long-term, treatment of frostbite is like that of a burn. The affected area is washed with soap and water daily; ointment or creams - usually bacitracin or silvidine - are applied, and the area is bandaged.

In the Clark Burn Unit at Upstate, where Myers works, three or four patients have been treated so far this year, and “we've only really had a couple of days when it's been pretty cold.”

Myers said most patients are not those regularly working in the cold, who know how to prevent frostbite.

“It's the homeless, a mugging victim, the kid running away from home.”

He said frostbite can occur at any temperature below 32 degrees, “but it's the wind chill that really determines the temperature that's in contact with the skin.”

Myers recalled a situation after a snowmobile accident a couple of years ago. One rider performed cardiopulmonary resuscitation on the other before an ambulance arrived minutes later.

“In the amount of time that he took his gloves off, he got frostbite on his hands,” Myers said.

Diabetics and alcoholics are at high risk for frostbite, along with the very young and the very old, who have thin skin.

Diabetics tend to have poor blood supply to the extremities. People who have been drinking may walk home through the cold or pass out in a snow bank.

“They just don't feel the temperature,” Myers said.

People from warmer climates also are at risk because they are not acclimatized, Ciaccio said.

Quoting from a medical text, Myers summed it up: “Cold injuries are almost exclusively a result of man's inability to properly protect himself from the environment.”