Chilblains

Chilblains are one of the mildest but most common forms of cold injury and can occur when there is exposure to cold and dampness. Chilblains most frequently occur on the fingers, toes, ears and face but may also affect other areas of the body.

Symptoms

  • The affected area may be itchy, reddish-blue in colour and swollen.
  • Chilblains develop over the course of a few hours.
  • Pain and burning of the affected area.
  • Blisters containing clear fluid may form and the affected area will have an ongoing sensitivity to cold. There is usually no other permanent damage.

Causes

The basic cause of chilblains is sensitivity to cold (leading to inflammation in local blood vessels), but they can also be the result of poor circulation or skin sensitivity. The cold constricts the small blood vessels, and then when the skin is suddenly warmed up from being cold, the blood supply returns, but leaks into the surrounding tissues, leading to swelling. This condition should not be confused with frostbite.

Risk factors

Risk factors for chilblains include:

  • Being female;
  • Having poor circulation;
  • Having Raynaud’s phenomenon;
  • Being underweight;
  • Having lupus;
  • Having peripheral vascular disease, due to diabetes or smoking or high cholesterol.

What you can do

  • If you are temperature-sensitive you should always try to keep your feet and hands warm and avoid extreme changes in temperature.
  • Lanolin-based creams that you can get from your pharmacy can be applied to ease irritation and stop the skin from swelling.
  • Regular exercise and a healthy diet will assist in correcting circulatory problems.
  • Smoking should be avoided as it restricts blood vessels and hinders circulation.
  • Chilblains are often itchy, but should not be scratched as this aggravates the condition and slows the healing. Because of underlying circulatory problems, infection of open scratches can be a problem.
  • Massaging the affected area, if appropriate (it is not too painful or ulcerated), often helps — especially if the problem is associated with circulatory problems.
  • The affected area should be kept warm, but do not apply hot packs as the condition can be made worse because of temperature sensitivity.
  • Severe cases will need medical attention. Treatments your doctor may use include cortisone creams, ointment or patches that dilate blood vessels, and occasionally, tablets that improve blood flow to the affected area.

When you should see a doctor

  • If the pain becomes severe.
  • If the skin looks infected.
  • If the chilblains become cracked or sore.
  • If the skin doesn't improve after a week.
  • If you have diabetes or a circulation disorder, see a doctor immediately.
  • Persistent chilblains. If you have persistent chilblains, your doctor may be able to prescribe a medicine which improves the circulation.

Treatment

Chilblains will usually heal themselves after a couple of weeks. Severe cases will need medical attention. Treatments your doctor may use include cortisone creams, ointment or patches that dilate blood vessels, and occasionally, tablets that improve blood flow to the affected area. If the chilblains become infected, antibiotics may be needed.

Complications

Complications that may affect chilblains are:

  • Infection - often arising from scratching or from blistered skin.
  • Ulcers.
  • Permanent scarring or discoloration of the skin.

References

1. DermNet NZ. Chilblains. (Reviewed Dec 2013). http://www.dermnetnz.org/reactions/chilblains.html (accessed Sept 2015).
2. Mayo Clinic. Chilblains. (Updated Dec 2012). http://www.mayoclinic.org/diseases-conditions/chilblains/basics/definition/con-20033727 (accessed Sept 2015).
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