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Chilblains - Causes, Symptoms and Treatment


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Chilblains are a painful abnormal reaction of the small blood vessels in the skin when exposed to cold temperatures. An episode of chilblains usually clears up within seven to 14 days. The cause of chilblains isn't known. But blood tests in some people with chilblains may reveal abnormal proteins that tend to sludge in cold temperatures. Chilblains usually occur on the smaller toes. However, it can occur on the fingers, face and the nose. Chilblains are itchy and/or tender red or purple bumps that occur as a reaction to cold. Chilblains are common. It is thought that about 1 in 10 people in the UK get chilblains at some stage in their life. The condition is also known as pernio and is a localised form of vasculitis. Tight shoes can also contribute by irritating and pressing on the skin of the toes, especially the little toe. They tend to occur on the 'extremities' that more easily become cold. That is, the toes, fingers, nose, and earlobes. Chilblains does not usually cause permanent injury, but can result in severe damage if left untreated. Some patients have reported a sensitivity to cold in the affected area, long after the condition has healed. A chilblain can chap, crack, or ulcerate; and then is known as a kibe.

Damage to the tissues from the effects of the cold result in chilblains and this condition is quite similar to frostbite in this respect. It is seen most often in young people who have Raynaud's syndrome and people who are exposed to damp, cold weather. Chilblains are not very common in countries where the cold is more extreme as the air is drier. The living conditions and clothing used in these climates are protective. Chilblains are more likely to develop in those with poor peripheral circulation i.e. blue-red mottled skin on the limbs. Chilblains are painful but they cause little or no permanent impairment. The speed (rate) of temperature change may play a part. Some people get chilblains if they warm up cold skin too quickly. For example, with a hot water bottle or by sitting very close to a fire. Not everyone exposed to cold and damp conditions will develop chilblains, which leads some researchers to believe that those who do are overly sensitive to changes in weather and temperature. A chilblain may also occur on a pressure bearing area such as a bunion. They can be prevented by keeping the feet and hands warm in cold weather.

Causes of Chilblains

The comman causes of Chilblains include the following:

  • Chilblains are usually caused by an abnormal reaction of the body to the cold.
  • If the skin is chilled and then followed by too rapid warming such as a gas fire, a chilblain may develop.
  • Chilblains are more common in those that are just more susceptible to them - the reasons for this are not entirely clear.
  • Poor nutrition.
  • Hormonal changes and some connective tissue and bone marrow disorders.
  • Young adults who work outdoors or in cold conditions, such as butchers, are also at risk.
  • People who have poor circulation, an inadequate diet, or an allergic response to low temperatures are vulerable to chilblains.
  • Other contributing factors include dietary, hormonal imbalance and people who suffer from anemia.

Symptoms of Chilblains

Some sign and symptoms related to Chilblains are as follows:

  • Chilblains appear as small itchy, red areas on the skin.
  • In some cases the skin over a chilblain may blister which may delay healing.
  • Possible secondary infection.
  • Finger skin inflammation.
  • The chilblain may become ulcerated and infected.
  • Chilblains become increasingly painful as they get congested and take on a dark blue appearance.
  • A burning sensation on the skin.
  • Ulceration, in severe cases.
  • Toe skin inflammation.
  • The affected area is swollen.
  • Sometimes the skin breaks down to leave a small ulcer which is prone to infection.

Treatment of Chilblains

Here is list of the methods for treating Chilblains:

  • A potent topical steroid applied accurately for a few days may relieve itch and swelling.
  • Avoid scratching.
  • Calamine lotion.
  • Medication is sometimes used to prevent chilblains in people who have recurring chilblains.
  • A drug called nifedipine can dilate (open wide) the small blood vessels and may help to prevent chilblains.
  • Corticosteroid creams to relieve itching and swelling.
  • Topical steroid creams can help.
  • Lanolin or similar, rubbed into the feet, will help retain body heat.
  • Treating broken skin on chilblain with topical antibiotic cream.
  • The best treatment is to avoid having the chilblain problem in the first place by - wearing proper protection against the cold.