Winter brings the hazard of the effects of the cold temperatures. It is logical that the colder the temperatures the higher the risks. However certain surfaces such as metal can be extremely cold and conduct heat from the skin. Exposed areas such as the nose, fingers and ears are most at risk although toes and feet in wet and cold footwear are also affected. Injury can be mild in the form of frostnip, which can cause a whitish patch of skin, which might even blister over a period of 24-72 hours. More severe thermal injury or frostbite causes white areas that may start out as painful and become numb. These injuries when warmed may become red, swollen and itchy. At the extreme end of the spectrum this can go onto causing tissue loss. Remember the best treatment for these thermal injuries is prevention. Proper clothing and mittens or gloves, limiting playtime outside in very cold weather, and slow warming of areas that appear pale or stinging. Medical personnel should check any areas of concern.