First Published: Investigator - July 2008
For many people, the cold winter months signal the return of painful and itchy chilblains. Health Talk speaks to Bec Daebeler, the manager of the Flinders Medical Centre Department of Podiatry about chilblains, their treatment and prevention.
What are chilblains?
Chilblains are tender and itchy red or purple ‘bumps’ on the skin that generally erupt during bouts of cold or changeable weather. Women, children, the elderly and those with poor circulation are most susceptible to them. Extremities such as the toes, fingers, nose and earlobes are the most common sites for chilblains. Chilblains can cause discomfort, but generally don’t cause any permanent damage to skin tissue.
The most common symptoms of chilblains are:
- A burning, intensely itching sensation
- Red, swollen patches
- Dry skin
- Possible secondary infection
In severe cases, ulceration of the skin may result
What causes chilblains?
Researchers are unsure about the exact cause of chilblains, but believe that the body’s reaction to cold weather is a major factor. The body’s circulatory system comprises arteries, veins and capillaries that shunt blood to every cell. The circulatory system is sensitive to temperature.
In hot conditions, the body expands blood vessels close to the skin so that excess heat can be lost to the air, thereby cooling the body.
In cold weather, these blood vessels constrict to conserve body heat. This constriction can starve extremities - such as the toes - of blood and warmth, if your peripheral circulation is sluggish.
Chilblains tend to get worse when there is a sudden change in the temperature. Sudden changes can be caused by entering a very warm room after being outside in the cold weather, or trying to warm up fingers and toes too quickly, by placing them close to a heater or placing them in hot water.
Home treatment for chilblains involving staying warm and keeping active. For example:
- Keep your whole body warm.
- Resist the urge to scratch, as this will further damage the skin
- Use calamine lotion or Vicks/menthol to soothe the itching if the skin is not broken
- Gentle massage with a moisturiser can improve circulation.
- Wear woollen or cotton socks.
- Gentle exercise will improve circulation to your feet.
It is important to keep your hands and feet warm and to avoid long periods in the cold or damp. Smoking can further inhibit you circulation.
Tips to stay warm include:
- Wear several light layers of clothing as this can help ‘trap’ heat between the layers. Wear ‘ugg’ boots around the house to keep your feet warm. Remember ugg boots have little support for your feet and are not designed for all day use
- Gently exercise to warm up before going out
- Exercise regularly throughout the week
- Wear cotton-lined waterproof gloves to wash the dishes
- Dry feet thoroughly after showering or bathing.
- Use woollen or cotton socks to allow your feet to ‘breathe’
- Have regular massage.
When to seek professional help
Severe, ulcerating or recurring chilblains need professional attention. A qualified podiatrist can treat your chilblains and offer advice on prevention. Your doctor can also prescribe a corticosteroid ointment or cream. If you suffer from severe and recurring chilblains, your doctor may prescribe a preventive drug, such as a vasodilator to keep the blood vessels open. If you have a pre-existing condition, such as diabetes, you must see your doctor and a podiatrist to check the circulation in the affected area without delay.
This article was compiled with the resources of the Flinders Medical Centre Dermatology Unit and the Better Health Channel (www.betterhealth.vic.gov.au)