Chilblains (CHILL-blayns) are the painful inflammation of small blood vessels in your skin that occur in response to repeated exposure to cold but not freezing air. Also known as pernio, chilblains can cause itching, red patches, swelling and blistering on your hands and feet.

Chilblains usually clear up within one to three weeks, especially if the weather gets warmer. You may have recurrences seasonally for years. Treatment involves protecting yourself from the cold and using lotions to ease the symptoms. Chilblains don’t usually result in permanent injury. But the condition can lead to infection, which may cause severe damage if left untreated.

The best approach to chilblains is to avoid developing them by limiting your exposure to cold, dressing warmly and covering exposed skin.

Symptoms

Signs and symptoms of chilblains may include:

  • Small, itchy red areas on your skin, often on your feet or hands
  • Possible blistering or skin ulcers
  • Swelling of your skin
  • Burning sensation on your skin
  • Changes in skin color from red to dark blue, accompanied by pain

When to see a doctor

Chilblains will usually get better on their own. Seek medical care to check for complications if the pain is unusually severe, if you suspect an infection, or if your symptoms aren’t improving after one to two weeks. If the symptoms extend into the warm season, see a doctor to rule out other conditions.

If you have diabetes or poor circulation, healing may be impaired. Be cautious and seek care.

Causes

No one knows exactly what causes chilblains. They may be an abnormal reaction of your body to cold exposure followed by rewarming. Rewarming of cold skin can cause small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle. This results in a bottleneck effect and the blood leaking into nearby tissues.

Risk factors

Factors that may increase your risk of chilblains include:

  • Clothing that is tight or exposes skin to the cold. Wearing tight-fitting clothing and shoes in cold, damp weather may make you more susceptible to chilblains. And skin that’s exposed to cold, damp conditions is more likely to develop chilblains.
  • Your sex and weight. Women are more likely to get chilblains than are children and males. Also, people who weigh about 20 percent less than is expected for their height have an increased risk of chilblains.
  • Environment and season. Chilblains are less likely in colder and drier areas because the living conditions and clothing used in these areas are more protective against cold. Your risk of chilblains is higher if you live in an area with high humidity and cold, but not freezing, temperatures. They are more common from November to April.
  • Having poor circulation. People with poor circulation tend to be more sensitive to changes in temperature, making them more susceptible to chilblains.
  • Having been diagnosed with Raynaud’s disease. People with Raynaud’s disease are more susceptible to chilblains. Either condition can result in sores, but Raynaud’s causes different types of color changes on the skin.

Complications

Chilblains may cause complications if your skin blisters. If that happens, you may develop ulcers and infections. Besides being painful, infections are potentially life-threatening if left untreated. See a doctor if you suspect infection.

Diagnosis

You generally won’t need to see your doctor for chilblains. If you do visit your doctor, he or she will be able to diagnose your skin condition by looking at it and talking with you about any recent cold exposure. The exam might also include checking your circulation.

He or she may do further tests, such as a skin biopsy, to rule out other causes for your signs and symptoms.

Treatment

For adults whose chilblains don’t clear up with home remedies, treatment may include prescription drugs:

  • Topical corticosteroid. A corticosteroid such as triamcinolone 0.1 percent cream is applied to the affected area.
  • Blood pressure medicine. A blood pressure lowering drug called nifedipine (Procardia). It can help open up blood vessels.

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