Chilblains

Chilblains are damage to the skin caused by changes in temperatures typically affecting the hands and feet. The small blood vessels that supply the skin dilate and contract in response to changing temperature, fast changes can cause the leaking of fluid and chemicals under the skin causing swelling and injury to the skin.Chilblains are more common in winter and affect children and the elderly most commonly they also can affect other areas including the ears, buttocks and nose. They are also referred to as Pernio or Perniosis.Strangely, chilblains are less common in very cold climates as the air is drier and people are more likely to use appropriate clothing for the weather and buildings are specially designed with more insulation.

Symptoms

Symptoms include painful itchy red or purple lumps with a shinny appearance to the skin. In severe cases blistering, pustules, scabs and progression to ulceration can occur. Chilblains normally show up a few hours after exposure and take around 7-14 days to reside. They can become persistent with ongoing exposure and last for months if not managed appropriately.

Who gets chilblains

Chilblains are most common in children and elderly adults and are more likely to affect people with:
  • Acrocyanosis – mottled appearance to the skin
  • Poor circulation – caused by smoking, diabetes, hyperlipidaemia
  • Low body weight
  • Family history
  • Connective tissue disorders – Raynaud’s phenomenon, scleroderma, and lupus
  • Bone marrow disorders

Management and avoiding triggers

Unfortunately, chilblains don’t respond well to treatment. Treatments include corticosteroid creams, vasodilator medications to relax the vessel walls and antibiotic may be needed if there is a secondary infection.The best way chilblains can be managed is through prevention and avoid triggers.Avoiding the triggers:
  • Avoid smoking and smoke exposure as nicotine constricts theblood vessels
  • Avoid caffeinated drinks including tea and coffee, energy drinks and cola drinks.
  • Living and work area should be kept warm and without breezes.
  • Warm clothing should be worn including socks, gloves, uggboots and slippers.
  • Indoor exercise helps to keep the body warm.
  • Medicines that constrictblood vessels should be minimised decongestants and diet aids.
Keep warm this winter and prevent chilblains. See your medical practitioner for more information.