What are Chilblains?
As the winter months begin, and the weather becomes even colder, various skin pathology can present. A rare but interesting skin condition known as Chilblains can be seen in our patient population. Chilblains (pernio) are an inflammatory skin reaction to cold, damp exposure—usually affecting fingers, toes, ears, or nose.
What they look/feel like
- Red, purple, or bluish patches or bumps
- Swelling, tenderness
- Itching or burning (often worse as the skin warms)
- Sometimes blistering or small ulcers in severe cases
Why they happen
Cold causes blood vessels to constrict. With rapid re-warming, vessels may leak, leading to inflammation—especially in people with:
- Repeated cold exposure
- Poor circulation
- Low body weight
- Smoking history
- Certain conditions (e.g., Raynaud’s, Lupus, Covid)
Treatment
Most cases are mild and self-limited (2–3 weeks).
- Gradual re-warming (avoid hot water/heaters directly on skin)
- Keep affected areas warm and dry
- Moisturizers for skin barrier
- Topical corticosteroid (low–medium potency) for itching/inflammation
- Avoid smoking and caffeine (vasoconstriction)
For frequent or severe cases (doctor-guided):
- Oral vasodilators (e.g., nifedipine)
- Evaluate for underlying conditions
Prevention
- Layered clothing, insulated gloves/socks
- Avoid tight footwear
- Change out of wet clothes quickly
- Warm up gradually after cold exposure
