BIG RAPIDS \u2014 Keeping bundled up and dry during the winter isn't just important, it could be the difference between life, death or loss of limb. The 2013-14 season has been filled with ice, snow, harsh winds and temperatures falling into negative temperatures for weeks, which can pose dangers to the human body if individuals are out in the weather for too long or do not prepare for what the elements can bring. "We are pretty hearty folk in Michigan, but we're not used to 20 to 30 degrees below zero," said Dr. David Elwell, a physician in emergency medicine at Spectrum Health Big Rapids Hospital. "It's significantly more important to make sure to cover up properly given the combination of temperatures and wind chill." One of the most common risks individuals face in severe cold is frostbite, which is damage to the skin and underlying tissue due to extreme cold. Even if someone is dry and dressed in warm clothes and accessories, any uncovered skin can succumb to the damage. Elwell said frostnip, which occurs prior to frostbite, is common. During frostnip, the body's blood vessels constrict, and the skin turns white, tingles and becomes numb. Typically, the area of skin is not damaged permanently, but is painful when warmed and can reduce the sensitivity to heat and cold for a short period of time. In addition, the body must be fully warmed from frostnip and should not be subjected back into the frigid temperatures right away, Elwell added. Important areas of the body to keep protected include ears, the tip of the nose, feet and hands, as they are more likely to become cold first. If the affected parts do not become warm again quickly, cellular freezing can take place. Frostbite can take place on the smallest sections of skin and create blistering within 20 minutes depending on the temperature. "Even if you recover, there's usually some degree of damage at that point," Elwell said. Further stages of frostbite include skin and subcutaneous tissue death, where the skin will become blackened. Amputation of the affected body part or removal of tissue is the worst case scenario, when the deep tissue, muscle and bone marrow has frozen. If frostnip or frostbite does occur, Elwell said the most important thing is to warm the skin and tissue. Individuals should not rub the skin, which can cause additional skin damage. "The way is to put the area in water than is about 102 to 106 degrees," he added. "It seems really warm and it probably will be really painful, but true frostbite needs to be warmed fairly quickly and properly. If after 24 hours you see blistering or patches of white, go see a doctor." Hypothermia, which is a total loss of bodily heat and means the body's core temperature is reduced, also is a large danger during the winter cold. He said individuals should take care not to become wet or sweaty while outside in the severe cold, as it makes the body lose heat more quickly and there is a higher chance for harm. "At about 95 degrees, your body starts to respond to that low temperature in ways that changes your physiology," Elwell said. "During hypothermia, the body starts shivering, people start to slow down physically and mentally because the body starts to conserve energy." Before the body gets too cold, individuals can use their own methods to bring the body back up to normal temperature, which can take up to 24 hours. Layering clothing, drinking hot fluids, keeping the head covered and bundling in blankets or using a heated blanket can help. However, because the body will lack sensitivity to heat, individuals should take caution not to burn themselves. Elwell said as a rule of thumb, people should think about preparing for worst case scenarios when the temperature is as low as 20 degrees and when wind chills make it feel even colder. "You really have to think ahead, because you can get hypothermia or frostbite quite quickly if you're stranded somewhere," Elwell said. "It's more significant given the combination of temperature and wind." Elwell has a number of tips for those who have to be out in the cold for significant periods of time. Local warming stations also should be utilized before numbness sets in, keep an extra supply of clothing, boots, mittens, and other supplies in vehicles in case of an emergency and make sure to prepare for any situation, Elwell added. "The most important thing is to keep your head covered, because we lose most of our heat through our head," he said. "Try to dress in a way that you know you're not going to sweat. Keep moving and keep dry."