Chilblains (also called pernio) are small itchy, red (purple sometimes) swellings on the skin, which if not addressed become very painful and can sometimes ulcerate, exposing the foot to the risk of infection. They occur on the toes, fingers, the face (especially the nose) and the lobes of the ears. Sometimes they occur on exposed areas of the legs and arms.
Chilblains develop when the body is exposed to colder conditions, which the tiny blood vessels under the skins in the peripheral areas constrict and shut the blood flow to these areas conserving the blood supply to the main organs in the body.
However, when the body returns into a warmer environment then the small blood vessels should open up again and allow the blood back into the extremities (toes, fingers, ears. People who are prone to chilblains, have a time delay in the blood returning to the smaller vessels, causing damage to the tissues, which then presents as pain and discomfort.
Although chilblains are common, the condition mainly affects young adults working outdoors with inadequate clothing, the elderly whose circulation is less efficient than it used to be, people who are anaemic and some medications can cause them as a side effect and those who have Raynaud’s syndrome have a predisposition to present with chilblains.
They are present from the onset of winter, the areas of the skin affected can feel like they are burning and or itching, which can intensify upon entering a warm room. There may be some swelling or redness and in some cases the skin breaks and ulcers may be present.
The best form of treatment is to prevent them in the first place, keeping the whole of the body warm not just the extremities. Wear layers rather than one thick layer of clothes, use natural fibres like silk. Footwear plays a vital part in prevention with insulating insoles.
If the chilblains are not broken then they will benefit from some creams and lotions. If they are ulcerated they will need immediate attention from the Gp or a Podiatrist.
There is a prescription medication for people who struggle yearly with chilblains.