Chilblain’s are a condition which results from defective blood circulation on exposure to cold. The skin may first become itchy, then red and swollen with a burning sensation and very tender to touch. An infection may occur should the skin break down. Chilblains usually appear on the extremities fingers, toes and ears. Dampness and cold winds when temperatures are around freezing, can cause damage to unprotected skin.
Chilblains are common. It is thought that about 1 in 10 people in the UK get chilblains at some stage in their life. It is not clear why some people get chilblains when their skin gets cold. It is probably due to poor circulation in the extremities (toes, fingers, etc.). The tiny blood vessels under the skin narrow (constrict) when the skin becomes cold and the blood supply to areas of skin may then become very slow. As the skin re-warms there is some leakage of fluid from the blood vessels into the tissues which in some way causes areas of inflammation and swelling leading to chilblains.
Older people more commonly suffer from chilblains but anyone can be affected. When extremities such as the toes and fingers are exposed to the cold, not enough blood gets through to them. As a result of this cold sensation, the extremities become very itchy, then swollen and red. The skin often feels like it is burning and the area may feel painful to the touch.
The following are some signs and symptoms related to chilblains:
- chilblains appear as small itchy, red areas on the skin
- in some cases the skin over a chilblain may blister which may delay healing
- sometimes the skin breaks down to leave a small ulcer which is prone to infection
- possible secondary infection
- finger skin inflammation
- the chilblain may become ulcerated
- chilblains become increasingly painful as they get congested and take on a dark blue appearance
- a burning sensation on the skin
- toe skin inflammation – the affected area is swollen
Chilblains usually go away from 7 – 14 days. It advised to avoid exposure to the cold during this time.
The best advice is to keep warm – wear several layers of thin, loose clothing rather than one thick layer as this helps to trap insulating air between the layers. Make sure all of your limbs are warm. When outside keep hands well protected and use wrist warmers to bridge the gap between the sleeves and gloves or mittens. Keep your feet and legs warm with woolly tights or long thermal, wool or silver fibre socks. Avoid draughts or changes in temperature e.g. coming in from the cold and standing close to a fire or radiator. Have a warm bath in the morning to encourage your circulation. When going outside, cover your head and ears as a large amount of body heat is lost through an exposed head. Use ear muffs or a woolly hat which will pull down over the ears.
If chilblains have developed, cover them with a loose, dry dressing (e.g. Melolin) and try to avoid clothing that rubs. If the skin is unbroken, 1% hydrocortisone cream from your doctor is soothing. There is some evidence that Vitamin B (nicotinic acid) helps to prevent chilblains. Vasodilators which are recommended for improving the circulation in Raynaud’s phenomenon by opening up the blood vessels, can also be useful in the treatment and prevention of chilblains. Other compounds, for example those derived from Vitamin K, may also help but you should discuss these with your doctor. Calamine lotion and witch hazel are both soothing and cooling, whilst antiseptic should be applied to broken chilblains until medical attention is sought. A steroid cream rubbed onto the chilblains may reduce itch and soreness. Creams and ointments containing camphor or local anaesthetic can also be used for relief of pain in unbroken chilblains. Balmosa cream, available on prescription or from your local pharmacy, and some other topical creams can be effective.
Chilblains will itch and burn and become itchier still when warm. It is tempting to scratch, but this can break and ulcerate the chilblain
Having chilblains does not necessarily mean that you have Raynaud’s. However, as both conditions are related to the circulation many people with Raynaud’s also have chilblains. Raynaud’s is a condition in which the blood supply to the extremities, usually the fingers and toes is interrupted usually due to cold exposure, a change in temperature or stress. During an attack they first become white, they may then turn blue and finally bright red. There may be considerable pain, numbness or tingling.
Chilblains may be confused with Raynaud’s as both conditions occur after exposure to the cold and affect similar areas of the body.