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Definition
Chilblains is a painful inflammation of small blood vessels in your skin responding to sudden warming from cold temperatures. Also known as pernio, chilblains can cause itching, red patches, swelling and blistering on extremities, such as on your toes, fingers, ears and nose.
Chilblains usually responds well to treatment and clears up within 14 days. Treatments typically consist of lotions and medication. While it doesn't usually result in permanent injury, chilblains can lead to severe damage if left untreated.
The best approach to chilblains is to avoid developing it by limiting your exposure to cold, dressing warmly and covering exposed skin.
Symptoms
Signs and symptoms of chilblains usually include:
- Small, itchy red areas on your skin
- Possible blistering
- Inflammation of your skin
- Burning sensation on your skin
- Swelling
- Changes in skin color from red to dark blue, accompanied by pain
- Possible ulceration
When to see a doctor
Some people with chilblains never need to see a doctor, simply using lotions to alleviate the pain and itching. However, if the pain becomes too severe or the affected skin begins to look alarming, a doctor may help you treat it more effectively. Also, make sure to seek medical attention if the skin becomes infected or if it doesn't improve after 14 days.
If you have poor circulation or diabetes, see a doctor immediately after discovering chilblains to prevent further possible complications.
Causes
Chilblains is usually the result of an abnormal reaction of your body to cold. It tends to develop on skin that's exposed to cold and is then warmed too quickly, such as by warming your hands directly in front of a heater or fire. This cooling and rapid heating can cause small blood vessels under your skin to expand more quickly than nearby larger blood vessels can handle, resulting in a "bottleneck" effect and the blood leaking into nearby tissues. Exactly why this occurs in certain people is unknown.
Risk factors
Because chilblains is a reaction to cold, any exposure of skin to cold weather may be risky.
Ironically, chilblains is less likely in colder and drier countries because the living conditions and clothing used in these climates are more protective against cold. Chilblains may result from or be aggravated by unusual pressure on your skin, such as tight shoes or a bunion on your foot.
People with poor circulation or who are overly sensitive to changes in temperature are more susceptible to chilblains. Women are more likely to get chilblains, though why is not known.
Complications
Chilblains may cause complications if your skin blisters. If that happens, you may develop ulcers and infections. Besides being painful, infections are potentially life-threatening if left untreated. See a doctor if you suspect infection.
Preparing for your appointment
If you're seeing a doctor to confirm or help treat your chilblains, it's always helpful to have all information and questions ready. This might mean making a list of your symptoms, recent activity and any other useful information, as well as making a list of questions you might have.
Be sure to dress warmly and cover up all exposed skin if traveling in cold weather.
Treatments and drugs
Treating chilblains is usually simple and painless. The earliest symptoms can be treated with corticosteroid creams, which relieve the itching and swelling. A drug called nifedipine (Adalat, Procardia) is sometimes used to treat the cause of chilblains, since it can help open up blood vessels; however, it's only a moderately successful drug, and alternatives are being sought. If your skin has broken, treatment also includes cleaning and protecting your wounds to prevent infection.
Lifestyle and home remedies
Chilblains usually clears up after 14 days. Keep the affected skin away from sources of heat, but make sure to keep it warm and comfortable. You can use lotions to alleviate the itching and swelling. Rubbing the topical emollient lanolin into your feet will help retain body heat. If your skin is broken, make sure to clean it and dress it appropriately with an antiseptic to prevent infection.
Make sure not to scratch any affected skin.
Prevention
To prevent chilblains, avoid or limit your exposure to cold. Follow this advice:
- Dress warmly.
- Cover all exposed skin when going outside in cold weather.
- Make sure you keep your hands, feet and face warm.
- Keep your home and workplace comfortably warm.
If your skin is exposed to cold, be sure to warm it gradually, since the sudden rewarming of cold skin causes and exacerbates chilblains.
