Chilblains: Symptoms, Causes, Risk Factors, Treatment and Prevention

Chilblains (also known as perniosis or pernio) is a medical condition (a type of cold injury) that occurs to person (who is predisposed) when exposed to cold and humidity. This is sometimes confused with frostbite or trench foot, both of which occur below freezing temperature, whereas chilblains usually occur above freezing temperature. Chilblains generally lead to damage to capillary bed in exposed skin and cause redness, itching, swelling, inflammation and blister formation (in extreme and untreated cases). Common site for chilblains include toes, fingers, earlobes and nose.

Chilblains may heal on its own, especially if weather warms up in one to three weeks. There is a tendency to recur every year as this condition usually occurs to individuals predisposed to this condition. Chilblains usually do not cause permanent damage to any body parts, however may cause infection which may lead to serious problem, if left untreated. We can keep chilblains away if we take precautions and protective measures against exposure to cold, especially if anyone is predisposed to it.

What are the symptoms of chilblains?

Signs and symptoms of chilblains are,

  • Small, itchy, red, warm area on exposed part of skin, which may gradually become larger
  • Swelling of the red area
  • Pain in the area
  • Color of skin may change from red to dark blue
  • There may be blistering in the area
  • There may be ulceration in the affected area
  • Burning sensation of the affected area.

What is/are the cause(s) of chilblains?

The exact cause of chilblains is not clear. Many experts believe it to be a type of cold allergy, because it usually occurs among persons predisposed to this condition, and there is possibility of recurrence every year. Affected individuals tend to react abnormally during rewarming after getting exposed to cold.

What are the risk factors of getting chilblains?

The following factors may increase risk of getting chilblains:

  • Exposure of skin to cold (need not to be freezing cold) and damp condition may lead to development of chilblains.
  • Place where you live may increase risk of chilblains. If you live in cold non freezing temperature and high humidity risk of chilblains is high. Risk is not high if you live in dry and cold area.
  • Females are at greater risk of chilblains than males. The cause is not known.
  • People who are underweight are at greater risk of chilblains.
  • If you are suffering from Raynaud’s phenomenon (another cold-related medical condition that affects the extremities) you are at greater risk of chilblains.
  • If your blood circulation to extremities is poor you are at greater risk of chilblains.
  • Chilblains commonly occur early winter to spring and usually disappear in spring time.

What are the complications associated with chilblains?

Chilblains usually do not lead to serious complications. However, if left untreated or inadequately treated, it may lead to infection of affected area, which itself has its complications. Blister formation and ulceration may be encountered in chilblains.

What treatment modalities are available for chilblains?

Treatment options for chilblains include,

  • Corticosteroid cream applied locally to affected area for prevention of swelling (inflammation) and itching.
  • Medications: nifedipine (a commonly used blood pressure lowering drug) can be used for chilblains, because it can cause increase in blood flow by widening the arteries. Another drug that may be used is pentoxyfylline (brand name Trental) which also act by increasing blood flow to affected area.
  • Prevention of infection is also important aspect of management of chilblains. Blisters may lead to ulceration which needs to be managed to prevent infection with regular dressing and cleaning.

Prevention of chilblains:

As chilblains is a cold related problem, avoiding exposure to cold is the most important aspect of prevention. Following measures can be helpful in preventing chilblains:

  • Avoid exposure to cold, especially extremities, where chilblains commonly occur.
  • Use several layers of warm clothing.
  • Prevent moisture and try to keep extremities dry in cold weather.
  • Cover all exposed parts before going out in cold.
  • Keep hands, face and feet warm.
  • Keep your home and office warm.
  • If you get exposed to cold, re-warm gradually. Never attempt to re-warm rapidly as this may lead to chilblains.

Lifestyle and home remedies for chilblains:

Chilblains usually heal by itself, although it takes one to three weeks. Following measures may speed up healing process:

  • Avoid further exposure to cold.
  • Keep affected area warm, but keep it away from direct heat.
  • Use lotions to prevent itching and swelling. Avoid scratching the affected area.
  • Keep affected area clean and apply antiseptic and bandage.

Chilblains is a common problem in cold (need not to be freezing cold) and moist (high humidity) regions. However, it is possible to prevent chilblains with some care. You need to be extra cautious, if you are predisposed to develop chilblains.

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