Chilblains

Last reviewed by Dr.Mary on October 3rd, 2018.

What exactly are Chilblains?

This is a very painful condition involving the inflammation of blood vessels in the skin that are small. This response is triggered by any rapid warming from cold temperatures. It is also referred to as pernio. Chilblains cause red patches, itching, blistering as well as swelling on the extremities, for instance your nose, ears, toes and fingers.

Chilblains normally react well with treatment and within 1 to 3 weeks usually clear up. But, this condition can reappear seasonally for years. Different medications and lotions are characteristically treatments for this condition. Chilblains do not normally cause injuries that are permanent but they can cause infections which can cause serious damage when left not treated.

The best method to prevent this condition is to elude having it develop simply by regulating any exposure to cold, warmly dressing and being certain that any exposed skin is covered.

Chilblains Symptoms

The symptoms and signs of chilblains can include:

Itchy red, small areas on the skin, most often on the hands or feet
Swelling of the skin
Potential blistering
Feeling of burning on the skin
Possible ulceration
Skin color which changes from red or dark blue and also causes pain

Most individual with chilblains at no time need to visit a physician – as using lotions to help with the itching and pain seems to manage this condition well. But, the pain can become so severe or the skin which is affected starts to look as if it could be infected and at that time the individual should seek medical help so that this condition can be treated more effectively. An individual should also seek medical management if the skin has not gotten better in over two weeks.

If an individual has circulation which is poor or has diabetes, they need to see their primary care physician as soon as chilblains appear in order to prevent complications.

Chilblains Causes

The condition that develops chilblains is the product of an extreme reaction of the body to cold. Chilblains tend to start on skin which is exposed to the cold and is then warmed too rapidly, for instance warming cold hands in front of a fire or heater. This heating of the cold skin rapidly causes small vessels of the blood system directly beneath the skin to quickly expand faster than the larger blood vessels nearby can handle. This results in what is known as the “bottleneck” effect – causing blood to leak into nearby tissues. Why this reaction happens with some people and not with others, is not known.

Factors that can increase the risk of chilblains occurring include:

Skin exposure to cold

Any skin that is exposed to conditions which are cold and then rapidly warmed may develop chilblains.

Female

Women are most apt to get chilblains, but why is not known.

Underweight

Individuals who weight 20% less than are projected for their height have an enlarged hazard of chilblains.

Where a person lives

Oddly, chilblains are less likely in areas which are drier and colder since the living conditions as well as the clothing used in these areas are more protective against cold. But then, if an individual lives in an area with humidity that is high and low temperatures but not necessarily freezing, the hazard of chilblains is greater.

Time of year

Chilblains are most common from November to April.

Shoes are ill-fitting

Chilblains can develop from or be provoked by any unusual pressure on the skin, for instance tight shoes.

Poor circulation

Individuals with circulation that is poor tend to be most sensitive to changes in the temperature, making them most prone to chilblains.

Diagnosed with Raynaud’s phenomenon

An individual with Raynaud’s phenomenon which is another condition related to cold and affects the extremities, are also more vulnerable to chilblains. Both conditions can cause sores, although Raynaud’s causes types of color changes on the skin which are different.

Chilblains can create complications if the skin blisters. When that occurs, the individual can develop infections and ulcers. Besides being extremely painful, infections are possibly life-threatening especially if left untreated. The individual should see a physician if an infection is suspected.

Chilblains Treatment

Options for treatment can include:

Corticosteroid creams

Corticosteroids which are topical help to relieve swelling as well as itching.

Medications for blood pressure

A medication which lowers blood pressure called nifedipine (Procardia, Adalat) is often used to manage the cause of chilblains since it helps the blood vessels to open up.

Prevention of Infection

If the skin has broken, management should also include cleaning and shielding the wounds in order to avoid infection.

Chilblains normally clear up after 1 to 3 weeks. There are steps that can be taken at home to ease the symptoms, these include:

Using lotions to alleviate swelling or itching
Keeping the affected skin warm, but keep away from sources of heat
Keep affected skin clean with an antiseptic in order to avert infection.
Avoiding any scratching

In order to prevent chilblains it is important to limit or avoid any exposure to cold. Follow these tips:

Dress in layers of warm clothing
Make certain the hands, face and feet are warm
All exposed skin should be covered when going outside in weather which is cold
Keep workplace and home comfortably warm

If the skin is exposed to cold weather, it is useful to rewarm the skin gradually, since any sudden rewarming of cold skin will only worsen chilblains.