The Collison Newsletter July 2015




"A painful, itching swelling on a hand or foot, caused by poor circulation in the skin when exposed to cold". (Oxford English dictionary)

Chilblains are patches of discoloured (red, blue, white) and itchy skin, due to inflammation of small blood vessels in the skin, believed to be caused by a combination of cold weather and poor circulation, in response to sudden warming from cold temperatures. They are also known as pernio. The toes are particularly vulnerable, but other extremities that can develop chilblains include fingers, earlobes and the nose.

Despite the discomfort, most chilblains do not cause permanent damage to tissue, although in serious cases, can possibly result in an ulcer. They generally get better without treatment, especially as the weather gets warmer.

Chilblains may be confused with frostbite.

Since not everyone exposed to cold and damp conditions will develop chilblains, it is believed that those who do are overly sensitive to changes in the weather and temperature. The elderly, sedentary people, teenagers and people with medical conditions (such as anaemia and diabetes) are most susceptible.

Women are more likely to get chilblains, why is unknown.

Other predisposing factors are being underweight, having poor circulation, and Raynaudís phenomenon (spasm in the digital arteries).

Signs and Symptoms of Chilblains

  • A burning sensation on the skin in the affected area (toes, fingers, earlobes or nose)
  • Intense itching
  • Swelling of the skin, with possible blistering
  • Changes in skin colour, red, blue or white
  • Ulceration in severe cases.

The Circulation and Temperature

Although the exact cause of chilblains remains unknown, it is thought to be associated with the body's reaction to cold weather. The circulatory system, made up of arteries, veins and capillaries, is sensitive to temperature.

In warm conditions, the body dilates blood vessels near to the skin so that excessive heat can be lost to the air, thereby cooling the body. This cooling is aided by moisture on the surface of the skin, from sweating, evaporating.

In cold weather, these blood vessels constrict to conserve body heat. This constriction can starve extremities, such as the toes, of blood and warmth, especially if the circulation is sluggish. It is suggested that rewarming cold skin can cause small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle, resulting in a 'bottleneck' effect and the blood leaking into nearby tissues with resultant swelling and inflammation and irritation of the nerves of the skin (causing the discomfort and itch).

The symptoms of chilblains are made worse with sudden temperature changes - for example, coming into a warm house after being outside in the cold. Similarly, heating cold feet too quickly, by being too close to a heater, or even the use of a hot water bottle, will also exacerbate the condition. It is best to warm the whole body than just the extremities.

Prevention of Chilblains

The following are approaches which can help prevent chilblains from forming:

  • Avoid long periods of exposure to cold and damp weather
  • Avoid rapid changes in temperature
  • Wear several layers of clothing, which trap heat more effectively than one bulky layer
  • Shoes should be comfortable and well fitted. Tight shoes restrict circulation
  • Dry feet thoroughly after showing or bathing
  • Use woollen or cotton socks to allow feet to breathe
  • Daily walking to improve circulation
  • If your skin is exposed to cold, it is helpful to rewarm gradually.

Treatment of Chilblains

Chilblains usually clear up without treatment after one to three weeks. In the meantime, there are several approaches that can reduce symptoms and perhaps accelerate healing:

  • Wear woollen or cotton socks
  • Keep your whole body warm, as well as the extremities
  • Resist the urge to scratch, as this will further damage the skin
  • Calamine lotion can soothe itching
  • Topical steroid cream may relieve the itch and reduce swelling
  • Lanolin or similar, rubbed into the feet, may help retain body heat
  • Several topical solutions have been found to help. One example is†apple cider vinegar with added salt, another is†a mixture of Friar's balsam and a weak iodine solution.

Infection prevention: If the skin has broken, treatment should include cleaning and protection of the wound to prevent infection. If infection does happen, appropriate antibiotic treatment is indicted.

Prescription medications: Nifedipine or Adalat (a blood pressure lowering drug) is sometimes used to help open up blood vessels. Pentoxifyline or Trental (a treatment for intermittent claudication) can also help improve blood flow. These should only be considered in severe cases and have to be prescribed by a doctor. sets out a variety of combinations of different substances that have shown promise in relieving the symptoms of chilblains. Trial one and, if it works, continue. If no improvement, try another. None of the suggested remedies will cause harm.



*Copyright 2015: The Huntly Centre.


Disclaimer: All material in the website provided for informational or educational purposes only. Consult a health professional regarding the applicability of any opinions or recommendations expressed herein, with respect to your symptoms or medical condition.


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