Chilblains are small, itchy swellings on the skin that occur as a reaction to cold temperatures. They most often affect the body’s extremities, such as the toes, fingers, heels, ears and nose.
Chilblains can be uncomfortable, but they rarely cause any permanent damage and will normally heal within a few weeks if further exposure to the cold is avoided.
Signs and symptoms of chilblains
Chilblains usually develop several hours after exposure to the cold. They typically cause a burning and itching sensation in the affected areas, which can become more intense if you go into a warm room.
The affected skin may also swell and turn red or dark blue. In severe cases, the surface of the skin may break and sores or blisters can develop.
It’s important not to scratch the skin as it can break easily and become infected.
When to seek medical advice
Most people don’t need to seek medical advice if they have chilblains as they usually heal within a few weeks and don’t cause any permanent problems.
However, you should see your GP or chiropodist for advice if you have severe or recurring chilblains, or if they don’t improve within a few weeks. You should also seek medical advice if you think your skin may have become infected.
What causes chilblains?
Chilblains are the result of an abnormal reaction to the cold.
When the skin is cold, blood vessels near its surface get narrower. If the skin is then exposed to heat, the blood vessels become wider.
If this happens too quickly, blood can leak into the surrounding tissue. This is thought to be the reason for the swelling and itchiness associated with chilblains.
Chilblains can occur at any age, but are more common in children and elderly people. The condition also affects women more than men. Certain people, such as people with poor circulation, are more susceptible to the condition.
Chilblains are common in the UK because damp, cold weather is usual in the winter. Some people develop chilblains every winter that last for several months.
Read more about the causes of chilblains.
Chilblains will often get better on their own without treatment after a week or two.
Several creams and lotions are available that claim to treat chilblains, but there is no clinical evidence that they work and they are not recommended.
If your chilblains are severe and they keep returning, your GP may recommend taking a daily tablet or capsule of a medication called nifedipine. This works by relaxing the blood vessels, improving your circulation.
Nifedipine can be used to help existing chilblains heal or can be taken during the winter to stop them developing.
If you are susceptible to chilblains, you can reduce your risk of developing them by limiting your exposure to the cold, looking after your feet and taking steps to improve your circulation.
A number of self-help measures can help, including:
- wearing warm clothes and ensuring your home is well heated
- keeping active
- stopping smoking
- avoiding tight-fitting shoes and boots
If your skin gets cold, it’s important to warm it up gradually. Heating the skin too quickly, for example by placing your feet in hot water or near a heater, is one of the main causes of chilblains.
Read more about preventing chilblains.
Complications of chilblains
If you have severe or recurring chilblains, there is a small risk of further problems developing, such as:
- infection from blistered or scratched skin
- ulcers forming on the skin
- permanent discolouration of the skin
- scarring of the skin
It is often possible to avoid these complications by not scratching or rubbing the affected areas of skin, and not directly overheating the chilblains (by using hot water, for example).
You can also help reduce your risk of infection by cleaning any breaks in your skin with antiseptic and covering the area with an antiseptic dressing. The dressing should be changed every other day until the skin heals.
If the skin does become infected, antibiotics may be prescribed to treat the infection.
Causes of chilblains
Chilblains are the result of an abnormal reaction to the cold.
During cold weather blood vessels near the surface of the skin get narrower, causing the blood to flow deeper in the skin. This is your body’s normal response to cold and is designed to preserve your core body temperature.
When skin is exposed to warmth again, the blood vessels near the surface of the skin expand and blood flow returns to normal.
If skin is heated up too quickly, for example by placing your feet in hot water or near a heater, the blood vessels near the surface of the extremities, such as the hands and feet, cannot always handle the increased blood flow.
This creates a “bottleneck” effect that can cause blood to leak into surrounding tissue. This is thought to be the reason for the swelling and itchiness associated with chilblains.
People at risk
Some people are more at risk of chilblains than others. This includes people with:
- poor circulation
- a family history of chilblains
- regular exposure to cold, damp or draughty conditions
- a poor diet or low body weight
- lupus – a long-term condition that causes swelling in the body’s tissues
- Raynaud’s phenomenon – a common condition that affects the blood supply to certain parts of the body, usually the fingers and toes
People who smoke are more at risk of chilblains as nicotine constricts blood vessels.
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.
The best way to prevent chilblains is to limit your exposure to the cold and try to improve your circulation.
The following advice may help prevent chilblains:
- stop smoking – nicotine causes the blood vessels to constrict, which can make chilblains worse
- 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, and it’s a good idea to wear a clean pair of socks if you get cold feet in bed
- avoid tight shoes and boots – these can restrict the circulation to your toes and feet
- moisturise your feet regularly – this stops them drying out and the skin cracking
- eat at least one hot meal during the day – this will help warm your whole body, particularly in cold weather
- warm your shoes on the radiator before you put them on – make sure damp shoes are dry before you wear them; if your feet are already cold, make sure that your shoes are not too hot to avoid causing chilblains
- warm your hands before going outdoors – soak them in warm water for several minutes and dry thoroughly, and wear cotton-lined waterproof gloves if necessary; if your hands are already cold, make sure not to warm them up too quickly to avoid causing chilblains
- keep your house well heated – try to keep one room in the house warm and avoid drafts
- if you are diabetic, regularly check your feet (or ask someone else to do this) – people with diabetes may not be able to feel their feet and could have infected chilblains without realising it
If your skin gets cold, warm it gradually. Heating it up too quickly is one of the main causes of chilblains.