Chilblains: Causes, Symptoms, and Treatments

Chilblains are a common, painful skin condition caused by exposure to cold and damp conditions. They can affect various parts of the body, but they are particularly troublesome when they occur on the feet. Understanding the causes, recognising the symptoms, and knowing the treatment options can help manage and prevent chilblains effectively.

What are Chilblains?

Chilblains, also known as pernio, are small, itchy, red or purple swellings on the skin that occur as a reaction to cold temperatures. They usually appear on extremities such as the toes, fingers, ears, and nose. Chilblains develop when the skin is exposed to cold, damp conditions, causing blood vessels to constrict. 

When the skin warms up too quickly, the blood vessels expand more rapidly than the nearby smaller vessels can handle, leading to blood leakage into the surrounding tissues, which causes swelling and inflammation. Chilblains can be uncomfortable and, if left untreated, can lead to more severe complications such as ulcers or infections.

Causes of Chilblains

Chilblains are caused by the body’s abnormal reaction to cold and damp conditions. Several factors can contribute to their development:

Cold Exposure

Prolonged exposure to cold, damp weather is the primary trigger for chilblains. Sudden warming of cold skin can exacerbate the condition.

Poor Circulation

Individuals with poor circulation are more susceptible to chilblains because their blood vessels may not respond efficiently to temperature changes.

Underlying Health Conditions

Conditions such as Raynaud’s disease, which affects blood flow to certain parts of the body, can increase the risk of developing chilblains.

Environmental Factors

Living or working in cold, damp environments without adequate protection can lead to chilblains.

Age and Gender

Chilblains are more common in women and children, possibly due to differences in the body’s response to cold.

Low Body Weight

People with lower body weight or less body fat may be more prone to chilblains because they have less natural insulation against the cold.

Recognising Symptoms of Chilblains

Recognising the symptoms of chilblains early can help in managing and treating them effectively. Common symptoms include:

  • Red or Purple Patches: Small, discoloured areas on the skin that can become swollen and itchy.
  • Itching and Burning Sensation: Intense itching and burning in the affected areas, can be very uncomfortable.
  • Swelling: Swelling of the skin, which can lead to a feeling of tightness and discomfort.
  • Blisters: In severe cases, blisters may form on the affected skin, which can break and become infected.
  • Ulcers: Chronic chilblains can lead to ulcers, which are painful open sores that can become infected if not treated.
  • Tenderness and Pain: The affected areas may become tender to the touch and painful, especially when exposed to warmth.
  • Skin Changes: The skin may become dry, cracked, and in severe cases, lead to permanent discoloration.

Diagnosis of Chilblains

Diagnosing chilblains typically involves a physical examination and a review of the patient’s medical history. Here’s what to expect during the diagnosis process:

  • Medical History: The healthcare provider will ask about your symptoms, when they occur, and any activities or environmental exposures that may trigger them. They will also inquire about any underlying health conditions that might contribute to poor circulation.
  • Physical Examination: A thorough examination of the affected areas will be conducted to look for the characteristic signs of chilblains, such as red or purple patches, swelling, and blisters.
  • Additional Tests: In some cases, your doctor may recommend blood tests to rule out other conditions that can mimic chilblains, such as lupus or other connective tissue diseases.
  • Skin Biopsy: Rarely, a skin biopsy may be performed to examine the tissue under a microscope if the diagnosis is uncertain.

Accurate diagnosis is essential to differentiate chilblains from other conditions with similar symptoms and to develop an effective treatment plan.

Treatment Options for Chilblains

Treating chilblains involves relieving symptoms, promoting healing, and preventing future occurrences. Treatment options include:

  • Medications:
    • Topical Corticosteroids: These creams can reduce inflammation and itching.
    • Nifedipine: A medication that can improve blood flow by dilating blood vessels, which is sometimes prescribed for severe or recurrent cases.
    • Pain Relievers: Over-the-counter pain relievers like ibuprofen can help manage pain and inflammation.
  • Wound Care: For severe chilblains with blisters or ulcers, proper wound care is essential to prevent infection. Clean the affected area with antiseptic and apply sterile dressings.
  • Warmth and Protection: Keep the affected areas warm but avoid rapid warming. Gradually warming the skin can prevent further damage. Wear insulated gloves, socks, and appropriate footwear to protect against cold.
  • Lifestyle Adjustments:
    • Avoid Smoking: Smoking can constrict blood vessels and worsen circulation, increasing the risk of chilblains.
    • Healthy Diet: A diet rich in vitamins and minerals supports overall circulation and skin health.
  • Alternative Therapies: Some people find relief with alternative treatments such as acupuncture, though these should be discussed with a healthcare provider.

Preventing Chilblains

Preventing chilblains involves adopting strategies to protect your skin from cold and damp conditions while improving overall circulation. Dressing warmly in layered clothing, gloves, and thick socks is essential to keep your extremities insulated against the cold. Ensuring your skin stays dry by changing out of wet clothing and using moisture-wicking materials can also help prevent chilblains. 

Gradually warming your skin if it gets cold, rather than using direct heat sources, reduces the risk of blood vessel damage. Regular physical activity can improve circulation and help prevent chilblains, while avoiding tight clothing and footwear ensures proper blood flow. 

Maintaining a healthy lifestyle, including a balanced diet rich in vitamins and minerals, avoiding smoking, and managing any underlying health conditions, can further reduce the risk of developing chilblains.

Home Remedies for Chilblains

In addition to medical treatments, several home remedies can help manage and alleviate the symptoms of chilblains:

  • Aloe Vera: Apply aloe vera gel to the affected areas to soothe inflammation and promote healing.
  • Honey: Honey has natural antiseptic properties. Apply a thin layer to reduce infection risk and aid healing.
  • Ginger: Drinking ginger tea can improve circulation and provide warmth from within.
  • Calendula Cream: Known for its healing properties, calendula cream can be applied to reduce inflammation and soothe the skin.
  • Warm Foot Baths: Soak your feet in warm (not hot) water with added Epsom salts to relieve itching and pain. Ensure you dry your feet thoroughly afterward.

When to Seek Professional Help

While chilblains can often be managed with home care and over-the-counter treatments, there are times when professional help is necessary:

  1. Persistent or Severe Symptoms: If symptoms persist for more than two to three weeks or are particularly severe, seek medical advice.
  2. Signs of Infection: Redness, warmth, pus, or increased pain could indicate an infection that requires medical treatment.
  3. Recurrent Chilblains: Frequent episodes of chilblains may indicate an underlying health condition that needs addressing.
  4. Uncertainty About Diagnosis: If you’re unsure whether your symptoms are due to chilblains or another condition, a healthcare provider can provide an accurate diagnosis.
  5. Complications: If you develop ulcers or other complications, professional care is necessary to prevent further issues.

At Manly Cove Podiatry, our experienced team is ready to help you manage and treat chilblains effectively. Contact us if you experience any of the above symptoms or need expert advice on foot care.