What are Chilblains?

Chilblains can also be referred to as Pernio or Perniosis. They most commonly present as itchy red bumps on the toes, fingers, ears or nose. They might appear after they have been subjected to extremely cold temperatures. A possible reason why people get Chilblains is due to poor circulation of the affected area. This might include the way in which the body adapts when subjected to cold weather. The small blood vessels underneath the skin of the extremities (i.e. the fingers) will naturally begin to narrow when the temperature is colder and in order to allow less blood to flow through and reach the skin. When you suddenly come in from the cold weather to warm up, your blood vessels will want to increase in size in order to increase the amount of blood that reaches the skin. When the blood vessels do this very quickly, small amounts of blood might leak through the blood vessels and sit underneath your skin of your fingers and toes, and, this will appear swollen and will possibly be painful. These swollen and inflamed bumps on the skin are Chilblains
Chilblains are common and may occur in people from a variety of ages and backgrounds.

Common Symptoms:
• Itchy, red/ purple coloured bumps on the extremities of the body including ears, nose, fingers and toes
• Burning feeling around the area of the swellings
• Sensitive skin on and around the bumps
• Blistering of skin
• Ulcers may form if the chilblains have broken open

Who gets Chilblains?

The chances of getting Chilblains increase if,
• You have a poor circulation
• You are over the age of 50
• Your are living in cold conditions
• Your are Living in Humid conditions
• You have other medical conditions which may increase the chances of getting chilblains e.g. Anaemia, bone marrow disorders, amongst other disorders.
However young and/ or healthy people still get Chilblains.

Other Problems which are similar to Chilblains
• Trench Foot
• Frost Bite
• Equestrian Perniosis
• Erythrocyanosis crurum

What causes Chilblains?

Chilblains may be caused randomly due to unknown reasons or they may be the symptom of another medical condition.

Things that make Chilblains worse
• Working outside or in cold environments
• Damp living conditions
• Ill fitting footwear

How are Chilblains treated?

There is no prescribed treatment for Chilblains but there are plenty of anointments on the market to ease the symptoms of Chilblains, including those that contain calamine or witch hazel extracts. If you have persistent problems with Chilblains your doctor may prescribe you with drugs that may be able to open up your blood vessels and therefore increase the blood flow to the affected areas. A new alternative is UV light treatment from a podiatrist at the beginning of winter. UV light treatment may help those people who are regular sufferers of chilblains.

If the Chilblain has broken open then every attempt must be made to cover this up with antiseptic dressing as soon as possible, this will prevent infection. If the Chilblain remains unbroken and the skin is not cracked then the Chilblain can be painted with a range of coatings which are available from your pharmacist.
Chilblains will usually heal within 1-2 weeks
Drug treatment:
If Chilblains are a reoccurring problem then your Doctor may prescribe you with drugs to treat the problem
• Diltiazem
• This drug will open up your blood vessels in order to allow increased blood flow around your body. This may also be prescribed to you if you maybe have high blood pressure or having suffered with angina.
• Nifedipine
• This drug will open up your blood vessels in order to allow increased blood flow around your body. It will increase the amount of blood that can reach the extremities, possibly, overcoming the problems associated with the cause of Chilblains
• Steroid cream
• The Steroids in certain creams and ointments will reduce the inflammation and swelling at the site of the Chilblains.

What can I do to try and feel better?

• Protect your extremities when out in the cold. This might include wearing warm gloves and socks to protect the common areas of Chilblains.
• To keep warm when you are outside, do various hand and feet exercises to increase movement to your fingers and toes which will increase the amount of blood that is reaching your extremities.
• Check the medication that you have been prescribed. Some drugs maybe working to make your blood vessels narrower and so may not be helping with your Chilblains. Explain your occurrence of Chilblains to your doctor if you are regularly suffering from the symptoms described.
• When you are coming in from cold weather, increase your body temperature slowly, therefore, if you are going to put your hands into a hot bath, try putting them into a warm bath first of all and increase the temperature slowly
• If Chilblains do occur try to not scratch the site, as, this may break open the skin and make the Chilblain more susceptible to infection.
• People who suffer from Chilblains are advised not to smoke, to exercise regular, and, to have a diet rich in Potassium and low in fat in order to help maintain a good circulation and therefore lower the chances of getting Chilblains.
• If you have diabetes or have suffered with poor circulation in the past it is advisable that you seek medical help. A podiatrist, a health care professional that diagnoses and treats problems associated with the foot, will be able to give you guidance on how best to treat your Chilblains and how to prevent infection. If Corns and Calluses are present in the area of a Chilblain, then, the removal or reduction of these will help ease the discomfort and pain of the Chilblains.


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