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Chilblains: Everything You Need to Know About These Itchy Spots of Inflammation

Also known as pernio or perniosis, chilblains are small, itchy spots on the skin that appear when your skin’s tiny blood vessels become inflamed. It is thought that chilblains are an abnormal circulatory reaction to repeated exposure to cold, or damp environments (non-freezing). Their appearance are usually small red patches that swell, itch, or blister, and are usually found on the feet and hands. While they aren’t sore at first, in severe cases where blisters or ulcers develop, chilblains do become painful.

Who Do They Most Commonly Affect?

Chilblains most commonly impact women more so than men, but those who are overly sensitive to weather changes and temperature can also develop chilblains. Those who have medical conditions such as anemia or Raynaud’s, are at greater risk of developing them. As well as, those who are sedentary, elderly, or those with poor circulation.

What Are the Symptoms?

You may experience any of the following symptoms within 2 -14 hours after exposure to a cold or damp environment. Chilblains normally impact the hands, lower legs, ears, and feet.

  • An intense itching on the skin.

  • An extreme burning sensation of the affected area.

  • Swollen patches that are either red, blue, or white.

  • Dry skin that splits.

  • Skin bumps or lesions.

  • Blistering or ulcers in severe cases.

  • Changes in skin tone from red to dark blue, which is accompanied by pain.

You can worsen chilblains by subjecting them to sudden temperature changes, like when you enter a warm house after being out in the cold, or by heating your cold hands or feet by placing them under hot water, or by a heater.

What Causes Chilblains & Are There Risk Factors?

While the exact cause of chilblains is unknown, the condition is thought to be associated with the body’s reaction to cold exposure, or wet and damp environments.

Medical professionals believe that chilblains have something to do with the body’s circulatory system reacting abnormally to the body rewarming after being exposed to the cold. The idea here is that as the body rewarms the cold skin, the small blood vessels expand at a faster rate than the nearby large blood vessels can handle, causing blood to leak into the tissues, causing itchiness, burning, and inflammation. Identified risk factors include:

  • Being a woman.

  • Your home is not well insulated and is therefore drafty.

  • You routinely smoke tobacco products.

  • Being underweight by at least 20% less than what is expected for your height.

  • Wearing tight-fitting clothing in cold or damp conditions.

  • You live in a high humidity, cold environment (Nov-April).

  • You have poor circulation making you more susceptible..

  • You have an autoimmune disorder like lupus (connective tissue disease).

  • You have been diagnosed with Raynaud’s disease (causes color changes in the skin)

Are There Any Complications Associated With Them?

In more severe cases, chilblains can cause complications like infections, skin ulcers, and scarring. You may also be susceptible to permanent skin discoloration of the affected area. These complications tend to be rare though, are normally tied to an underlying condition, and often occur due to rubbing or scratching the affected area.

How Are Chilblains Diagnosed?

Chilblains can be diagnosed during a routine physical examination, if they are present at the time. You may be asked questions regarding recent exposure to cold or damp environments, and in rare cases, the affected skin may be biopsied to look for underlying conditions. Your general practitioner may also want to rule out other related conditions like circulation problems, lupus, skin cancer, cold urticaria, or vasculitis.

Can You Prevent Chilblains?

The main way to prevent chilblains from forming is by keeping your entire body warm at all times, but unfortunately this isn’t always possible. So, we recommend also doing the following:

  • When in damp or cold weather, avoid long periods of exposure if possible.

  • Trap heat by wearing several layers of clothing.

  • Wear well fitted, comfortable, and warm shoes.

  • Always dry your feet after bathing or showering.

  • Purchase wool or cotton socks, so your feet can breathe.

  • Improve peripheral circulation by doing gentle exercises every day.

  • See a podiatrist or foot doctor for regular checkups on your feet.

  • Keep your hands, feet, and face, as dry and warm as possible.

  • When going out in cold weather, cover all exposed skin.

  • Decrease sudden temperature changes to a gradual process instead.

  • Quit smoking.

What Is the Treatment Path Like?

Chilblains will typically go away within 2-3 weeks after they develop, but there are some things that you can do at home to ease your symptoms.

  • Do not apply direct heat to the affected skin.

  • Do not massage, scratch, or rub the chilblains.

  • Always rewarm your skin gently and gradually.

  • Keep your skin dry.

  • Clean the skin with antiseptic to reduce infection risk.

  • Soothe the skin with calamine lotion or other anti-itch lotions (unscented)

If you find yourself with severe chilblains that have resulted in recurring ulcers, then seek out a podiatrist for medical treatment. You may also want to get checked for any underlying health conditions that would impact your circulatory system.

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