Chilblains

Chilblains are small, itchy, painful, red swellings on the skin. They typically affect toes but other 'extremeties' such as fingers, nose and earlobes may be affected. About 1 in 10 people in the UK get chilblains at some stage in their life.

What causes chilblains?

Chilblains are thought to be caused by an abnormal skin reaction to cold. It is not clear why some people get chilblains when their skin gets cold. It is probably due to 'poor circulation' in the extremities (toes, fingers, etc). The tiny blood vessels under the skin narrow (constrict) when the skin is cool. The blood supply to areas of skin may then become very slow. In some way this causes areas of inflammation leading to chilblains.

The speed of temperature change may play a part. Some people get chilblains if they warm up cold skin too quickly with a hot water bottle or by sitting very close to a fire.

What are the symptoms of chilblains?

One chilblain may occur but often several develop. They may join together to form a larger swollen, red area of skin.

  • Chilblains are very itchy. A burning sensation is also typical.
  • They are usually red to start with but may become purple.
  • Pain and tenderness over the chilblains often develops.
  • In some cases the skin over a chilblain may blister which may delay healing.
  • Sometimes the skin may break due to scratching. The skin is then prone to infection.

Chilblains typically last a few days and then gradually ease and go over a week or so unless the exposure to cold continues.

Can you prevent chilblains?

If you are prone to chilblains then trying to prevent them is sensible.

  • Keep your hands and feet warm when out by using warm gloves and socks. Consider special heated gloves and socks if chilblains are a recurring problem.
  • Keep your home warm.
  • If possible, take regular vigorous exercise. This should be indoors such as on an exercise bike or in a gym. The theory is that this will improve the circulation to the hands and feet. There is no clear evidence to confirm that this works but it is traditional advice.
  • Do not heat the skin quickly after being out in the cold with hot water bottles, etc. Gradually warm up.
  • Side effects to some medicines may constrict (narrow) tiny blood vessels. This may be enough to make you prone to recurring chilblains. For example, beta-blocker medicines may have this effect. Tell your doctor if you have become prone to chilblains since starting any medication.

What is the treatment for chilblains?

  • Keep the affected areas warm. This means staying out of the cold, or wearing warm gloves, socks, etc, when outdoors.
  • No other treatment is normally needed as they usually go away by themselves.
  • A range of soothing creams and lotions (such as calamine lotion) can be bought from a pharmacy. These may ease the soreness until symptoms go.
  • Medication - is rarely needed. Medicines that dilate (open wide) blood vessels, for example nifedipine, may speed recovery in severe cases. Medication taken regularly may also help to prevent chilblains. A doctor may prescribe medication for he winter months if you get recurring chilblains.

© EMIS and PIP 2004   Updated: June 2001   CHIQ Accredited