Chilblains are a skin inflammation caused by exposure to cold and damp conditions. They can cause symptoms such as red or bluish patches on the hands, feet, or ears, itching, and a burning sensation in the affected area.
This inflammation happens when blood vessels narrow as a protective response to prolonged exposure to cold or very humid environments. Chilblains can affect people of any age, but they are more common in young and middle-aged adults and in women.
Treatment for chilblains, also known as pernio or perniosis, is usually guided by a primary care provider or dermatologist. Management may include avoiding cold exposure and using corticosteroid ointments or medications like nifedipine to help relieve symptoms.
Main symptoms
The main symptoms of chilblains are:
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Red or bluish patches on the skin
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Swelling and pain in the affected area
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Itching
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A burning sensation on the skin
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Sores, blisters, or ulcers on the skin
Chilblains symptoms usually appear in areas of the body that are exposed to cold, damp conditions for long periods. According to NHS Inform, chilblains most often affect the toes, fingers, heels, ears, and nose, and usually develop several hours after being in the cold.
If symptoms of chilblains occur, it is important to see a rheumatologist to confirm the diagnosis, rule out other health conditions, and start the most appropriate treatment.
Confirming a diagnosis
Chilblains are usually diagnosed by a healthcare provider based on symptoms, medical history, history of prolonged exposure to cold and damp conditions, and a physical exam of the affected skin.
The diagnosis is primarily clinical, and additional tests are usually not needed.
However, tests such as a complete blood count (CBC), antinuclear antibody test (ANA), serum protein electrophoresis, or cryoglobulin testing may be ordered to rule out conditions with similar symptoms, such as lupus, vasculitis, cold panniculitis, or Raynaud’s syndrome.
Although less common, the doctor may also request a skin biopsy.
Possible causes
Chilblains are caused by prolonged exposure to cold and damp conditions. This causes the blood vessels in the skin to narrow as a protective response to low temperatures, which reduces oxygen supply to the skin and leads to local inflammation.
Risk factors for developing chilblains include:
- Living or working in cold, damp environments that are not below freezing
- Smoking
- Playing sports in cold environments, such as ice skating
- Lupus
- Acute lymphoblastic leukemia
- Acrocyanosis
- Cryoglobulinemia
Other risk factors include wearing tight shoes or clothing when exposed to cold, damp weather, being underweight, or having Raynaud’s syndrome.
Treatment options
Treatment for chilblains is usually guided by a primary care provider or dermatologist. It typically involves keeping the hands, feet, and ears warm, avoiding prolonged exposure to cold, and using medications to relieve symptoms.
Topical corticosteroids, such as betamethasone or triamcinolone, may be recommended to treat sores, blisters, or skin ulcers.
In more persistent or severe cases, a doctor may prescribe medications such as nifedipine to help improve blood circulation and reduce the risk of recurrence.
Prevention measures
To prevent chilblains, it is recommended to:
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Avoid prolonged exposure to cold, damp conditions.
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Avoid wearing tight clothing or shoes in cold, damp weather.
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Wear warm layers, gloves, a hat, and waterproof shoes.
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Keep the hands, feet, and face warm and dry.
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Stop smoking.
It is also important to exercise regularly to help keep the body warm and improve blood circulation.