Chilblains 

Chilblains occur most commonly in winter in cold climates. This is because chilblains are a skin condition that is due to an abnormal vascular reaction to the cold. Chilblains appear on the skin as small, itchy patches that are swollen, discoloured and painful. The discolouration may be pink, red, blue or white.

Why do chilblains develop?

Your extremities such as fingers and toes, are more prone to this condition than other parts of your body. When your toes and fingers get cold, the tiny blood vessels constrict and this reduces the blood supply to the flesh. When the skin warms up, the blood vessels enlarge and leak a small amount of fluid into the surrounding tissues. This process is linked to the inflammation and swelling seen with chilblains.

Certain medicines may have the side effect of constricting blood vessels. Also, cigarette smoking constricts blood vessels and as a result can make an individual more prone to chilblains and further complications. Chilblains can also occur due to unknown causes. A history of recurring chilblains may be indicative of other medical conditions, such as connective tissue disease.

Another condition that is associated with this condition is Raynaud’s syndrome. It is different to chilblains as it is a medical condition where the blood vessels in the ends of the digits contract. This happens when the muscles opening and closing the vessels go into spasm. As a result, all the blood is squeezed from the area and the digits become discoloured. Episodes of Raynaud’s syndrome can be triggered by emotional stress or changes in temperature.  An example of a change in temperature is stepping onto cold bathroom floor tiles after a hot shower. For more information read our Raynaud’s Syndrome Information Sheet.

What are the symptoms of chilblains?

Chilblains often develop a few hours after being exposed to the cold and will mostly resolve in 1-2 weeks. It is more common for several patches to develop rather than just one. Symptoms usually include:

• Discoloured patches of skin (pink, red, blue or white)
• Itching
• A burning feeling
• Pain and tenderness over the chilblains
• Blisters may develop which will delay healing and make the skin prone to infections. In rare cases the skin may break down and form a small ulcer.

Prevention 

Although chilblains feel painful they do not commonly cause permanent damage to the toes. If further exposure to cold can be avoided, they will normally heal on their own.

• Avoid extended periods in cold & damp weather
• Keep your feet warm by wearing good quality socks
• Wear well fitted shoes
• Avoid socks and shoes which are tight
• Keep your feet dry and remember to thoroughly dry them after showering or bathing
• If your feet become cold avoid warming them up rapidly e.g. using a hot water bottle, instead try to warm your body up as a whole
• Wear several layers of clothing as this is better at trapping body heat
• Exercise regularly to improve blood circulation to the peripheral blood vessels
• Do not smoke, as cigarette smoking will make chilblains worse and lead to further lower limb complications

If you do develop chilblains it is important to seek medical advice from your local podiatrist. Additionally, do not scratch them as this will damage the skin and cause a longer healing time. Make sure you wear warm socks, keep your whole body warm and do gentle foot exercises to help improve blood circulation in your feet.