This winter, doctors at RAKUS are observing a troubling trend — frostbites are increasingly affecting lonely elderly individuals who spend extended periods in unheated spaces or cannot receive timely assistance. In January, help was needed for seven elderly patients. For example, one patient, an 89-year-old man, lay in an unheated house for several days because he could no longer physically light the stove. He was taken to the State Burn Center of the Eastern Hospital. Doctors at the center urge people to frequently check on lonely relatives during the winter to ensure their well-being and provide necessary assistance in a timely manner. Sergey Smirnov, head of the State Burn Center of the Eastern Hospital and a traumatologist, emphasizes that it is crucial to seek medical help as soon as possible in cases of frostbite. If a person reaches medical professionals within three days after frostbite, there is a high chance of saving the affected body part. However, after three to four days, tissue damage often becomes irreversible — gangrene develops, and the only possible treatment remains amputation, Smirnov explains. He notes that people often do not realize they have sustained a serious frostbite because preserved mobility of the fingers and absence of pain do not necessarily mean that everything is fine. One of the main signs of frostbite is loss of sensitivity in the affected body part. In the initial stage, pain may occur, but as the tissues freeze and the damage deepens, pain often quickly disappears, and the skin becomes sharply pale. Medical professionals urge people not to be indifferent if they see someone lying on the street in the cold. A significant portion of frostbite patients are homeless individuals or those under the influence of alcohol, but frostbite also affects elderly people who feel unwell outside, as well as young people, for example, after parties when they fall into a snowdrift and remain unnoticed for a long time. Elderly individuals with circulatory disorders, such as those suffering from diabetes or cardiovascular diseases, are at higher risk. Particular attention should also be paid to those who have previously experienced frostbite — such individuals may not feel the cold. It is equally important to ensure that one is dressed appropriately for winter, especially for those who engage in outdoor sports — skiing, running, or cycling. Before participating in sports in the cold, it is advisable to consult specialized sports stores regarding suitable equipment. Among young people, frostbites are often associated with improper clothing and footwear not designed for winter weather. According to the experience of doctors at the State Burn Center, severe frostbites in homeless individuals and those who chronically consume alcohol are diagnosed only after several weeks, when the affected areas of the body are already dead and blackened. This means that during the frosty months of winter 2026, specialists predict that the number of patients with frostbite will likely increase. Smirnov explains that one of the main preventive factors is weather-appropriate clothing. Footwear should not only be warm but also loose, as tight shoes compress the toes, disrupt blood circulation, and significantly increase the risk of frostbite. It is also recommended to wear a hat to protect the ears and mittens, which retain heat better than gloves, in cold weather. It is important to ensure that shoes and gloves are dry — moisture accelerates the cooling of tissues. In severe frost, frostbite can occur in just 15 minutes, so at the first signs of cold, it is essential to find a warm place as soon as possible. If this is not possible, it is advisable to actively move the fingers of the hands and feet to improve blood circulation. Smirnov also reminds that frostbitten body parts should not be rubbed with snow — snow crystals can damage the skin and enhance tissue cooling. It is also not advisable to rub alcohol or vodka — this irritates already damaged skin and does not provide a warming effect. On the contrary, alcohol dilates blood vessels and contributes to heat loss, and in a state of intoxication, a person may not always realize that they are cold. If frostbite does occur, Smirnov advises to gradually warm the affected hands or feet. They should not be immediately placed in hot water — due to loss of sensitivity, burns can occur. The safest method is to immerse the limbs in warm water for several minutes, then gradually raise the temperature to body temperature over several dozen minutes. This method also allows for assessing the severity of the damage: if the tips of the fingers darken — this is a sign of deep damage and urgent medical assistance is needed. If the skin becomes evenly pink, there are likely no serious injuries, but it is important to protect the limbs from the cold for several days. In cases of suspected severe frostbite, residents are urged to seek help immediately at the emergency department of the Bikerneki hospital of the Riga Eastern Clinical University Hospital at 68 Lielvardes Street, Riga, and request a consultation from a specialist at the State Burn Center. Assistance can also be obtained at the emergency department of any hospital or from a family doctor. Every winter, an average of 30 to 50 patients with severe frostbites receive treatment at the State Burn Center of the Eastern Hospital. The number of patients increases during periods of sustained frost. For example, from January to December 2024, severe frostbites were treated in 47 patients, while in 2025, when winter was milder, this number dropped to 27. The State Burn Center of RAKUS is the only specialized center in the Baltic States that provides assistance to patients with thermal injuries. Here, patients with burns, frostbites, trophic ulcers, burn consequences (scars, contractures), as well as purulent skin and subcutaneous tissue diseases are treated. Outpatient consultations are available in the emergency department 24 hours a day. The center has 50 beds, of which 7 are in the intensive care unit. Both surgical and conservative treatment of thermal injuries is conducted here. Annually, more than 600 patients with burns of various etiologies, cold injuries, extensive infected wounds, and purulent pathology receive specialized care at the center. The staff of the center performs about 700 operations and more than 10,000 dressings each year.