Chilblains

Page last reviewed: 13/07/2011

Chilblains are small, itchy swellings on the skin that occur as a reaction to cold temperatures. They affect the body's extremities, such as the toes, fingers, heels, ears and nose. Chilblains are uncomfortable but can be prevented.

Chilblains can be:

  • acute (short-term), developing within 12-24 hours after exposure to the cold and getting better after one to two weeks if you keep warm
  • chronic, lasting for a minimum of five months a year for the past three years and causing persistent sores that can lead to scarring

Who is affected?

Chilblains can occur at any age but are more common in children and elderly people. The condition affects women more than men. Certain people, such as people with poor circulation, are susceptible to chilblains .

Chilblains are common in northern Europe, where damp, cold weather is usual in winter. They are less common in countries with extremely cold winters, because the air is drier and people have homes and clothing that conserve heat better.

Outlook

Chilblains are usually self-limiting, which means they get better on their own after a few weeks. However, while they disappear during warmer weather, they may return during cold seasons.

Chilblains do not respond well to treatment, but there are ways to prevent them

Page last reviewed: 13/07/2011

Chilblains typically occur a few hours after you are exposed to the cold.

When it is cold, people who are susceptible to chilblains will experience burning and itching on their hands and feet. If they go into a warm room, the itching and burning sensation intensifies.

This can be accompanied by swelling and redness of the skin. In extreme cases, the surface of the skin may break and sores or blisters can sometimes develop.

Although they are uncomfortable, chilblains do not cause permanent damage and will heal on their own if further exposure to cold is avoided.

Chilblains usually take one to two weeks to get better if you keep warm. Some cases can last months and may flare up whenever the weather gets cold.

Page last reviewed: 13/07/2011

Chilblains occur when the small arteries and veins in the skin constrict (get narrower) as a result of cold weather. This is your body's normal response to cold (see box, right) and is designed to preserve your core body temperature.

However, when the body is exposed to sudden warmth after cold, the surface vessels on the extremities (such as hands and feet) cannot handle the sudden expansion and increased blood flow to the skin. Blood can leak into surrounding tissue and cause the swelling and irritation that is characteristic of chilblains.

At-risk people

Some people are more at risk of chilblains than others. They include:

  • people with poor circulation
  • people with a family history of chilblains
  • people who are regularly exposed to damp or draughty conditions
  • people who have a poor diet or low body weight 
  • people with lupus, a long-term condition that causes inflammation (swelling) in the body's tissues 
  • people with Raynaud's phenomenon, where the small blood vessels of the fingers constrict excessively
  • people who smoke (nicotine constricts blood vessels)
  • people taking medication such as Beta-blockers or ergotamine

Chilblains can also occur on areas of the feet that are exposed to pressure, such as a bunion or a toe that is squeezed by tight shoes.

Blood flow in response to temperature change

When it is cold, blood vessels near the surface of the skin constrict (get narrower) to reduce blood flow to the skin and subsequent heat loss. Blood is instead diverted to vessels deeper in the body. This helps to preserve core body temperature.

When skin is exposed to warmth, surface blood vessels expand and blood flow is returned to the skin.

Page last reviewed: 13/07/2011

Redness and itching on the skin of your feet, hands or other extremities are obvious signs that you have chilblains.

If you are unsure, your GP or chiropodist will examine the area.

Page last reviewed: 13/07/2011

Self care

If you have chilblains that are not ulcerated or infected, you can treat them yourself by painting them with a mixture of friar's balsam and a weak solution of iodine (which your pharmacist can make up for you), or an over-the-counter preparation.

You can remove pressure caused by shoes by using foam dressings, which insulate and cushion the feet.

At night, rub some lanolin ointment into your feet to keep the skin supple.

Antiseptic cream or lotion can prevent the chilblains becoming septic.

When to see your GP or chiropodist

If your chilblains have broken, cracked or become sore, see your GP or chiropodist. Do not scratch the skin as it can break easily and become infected.

If the chilblains have become septic, your GP or chiropodist may recommend antibiotics.

Page last reviewed: 13/07/2011

The possible complications of chilblains are:

  • infection from blistered or scratched skin
  • ulcers forming on the skin
  • permanent discolouration of the skin
  • scarring of the skin

Complications are more likely if you have an underlying disease of the blood vessels, such as Raynaud's phenomenon, if you repeatedly scratch the skin or if you apply excessive heat directly to the skin (never use a hot water bottle or sit in front of a hot fire after you have been exposed to the cold). 

Page last reviewed: 13/07/2011

The following advice may help prevent chilblains:

  • Stop smoking. Nicotine causes the blood vessels to constrict (get narrower), which can make chilblains worse.
  • Avoid medicines that may constrict blood vessels, such as caffeine and decongestants.
  • Keep active. This helps improve your circulation.
  • Wear warm clothes and insulate your hands, feet and legs. Wearing long johns, long boots, tights, leg warmers or long socks will help. If you get cold feet in bed, wear a pair of clean socks.
  • Avoid tight shoes and boots as these can restrict the circulation to toes and feet.
  • Moisturise your feet regularly. This stops them drying out and the skin cracking.
  • In cold weather, eat at least one hot meal during the day. This will help warm your whole body.
  • Warm your shoes on the radiator before you put them on. Make sure damp shoes are dry before wearing them. 
  • Warm your hands before going outdoors by soaking them in warm water for several minutes and drying them thoroughly. Wear cotton-lined waterproof gloves if necessary.
  • Turn up the central heating. Try to keep one room in the house warm and avoid drafts.
  • If you are diabetic, give yourself regular foot checks (or ask someone else to do this). Diabetics may not be able to feel their feet and could have septic chilblains without realising.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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