Chilblains

Chilblains are small, itchy swellings on the skin that occur as a reaction to cold temperatures. They usually affect the body's extremities, such as toes, fingers, ears and nose. Chilblains can be uncomfortable, but rarely cause any permanent damage. They normally heal within a few weeks if cold is avoided.

Signs and symptoms of chilblains

Chilblains usually develop several hours after exposure to the cold. They typically cause a burning and itching sensation in the affected areas, which can become more intense if you go into a warm room.

The affected skin may also swell and turn red or dark blue. In severe cases, the surface of the skin may break and sores or blisters can develop.  It's important not to scratch the skin as it can break easily and become infected.

When to seek medical advice

Most people don't need to seek medical advice if they have chilblains. They usually heal within a few weeks and don't cause any permanent problems.

See your GP or chiropodist for advice if you have:

  • severe or recurring chilblains
  • chilblains that don't improve within a few weeks

You should also seek medical advice if you think your skin may have become infected.

Signs of infection include:

  • swelling and pus forming in the affected area
  • feeling generally unwell
  • a high temperature (fever) of 38C (100.4F) or above
  • swollen glands

Causes of chilblains

Chilblains are the result of an abnormal reaction to the cold. They're common in places where damp, cold weather is common in winter.

When the skin is cold, blood vessels near its surface get narrower. If the skin is then exposed to heat, the blood vessels become wider. If this happens too quickly, blood vessels near the surface of the skin can't always handle the increased blood flow.

This can cause blood to leak into the surrounding tissue, which may cause the swelling and itchiness associated with chilblains.

People at a higher risk of chilblains

Some people are more at risk of chilblains than others.

This includes people with:

  • poor circulation
  • a family history of chilblains
  • regular exposure to cold, damp or draughty conditions
  • a poor diet or low body weight
  • lupus
  • Raynaud's phenomenon
  • people who smoke

Chilblains can also occur on areas of the feet exposed to pressure, such as a bunion or a toe that's squeezed by tight shoes.

Treating chilblains

Chilblains often get better on their own after a week or two without treatment. No evidence supports the use of over-the-counter topical preparations for chilblains, and they are not recommended (NICE). If your chilblains are severe and keep returning, speak to your GP. They may recommend taking medication which relaxes the blood vessels, improving your circulation.

Preventing chilblains

If you're susceptible to chilblains, you can reduce your risk of developing them by:

  • limiting your exposure to the cold
  • looking after your feet
  • taking steps to improve your circulation

If your skin gets cold, it's important to warm it up gradually. Heating the skin too quickly is one of the main causes of chilblains.

The following advice should help:

  • stop smoking
  • keep active to improve your circulation
  • wear warm clothes and insulate your hands, feet and legs
  • avoid tight shoes and boots as these can restrict the circulation to your toes and feet
  • moisturise your feet regularly to stops them drying out and the skin cracking
  • eat at least one hot meal during the day to help warm your whole body
  • warm your shoes before you put them on and make sure damp shoes are dry before wearing them
  • warm your hands before going outdoors – soak them in warm water for several minutes and dry thoroughly, and wear cotton-lined waterproof gloves if necessary
  • keep your house well heated
  • if you're diabetic, regularly check your feet – people with diabetes may not be able to feel their feet and could have infected chilblains without realising it

Complications of chilblains

If you have severe or recurring chilblains, there's a small risk of further problems developing, such as:

  • infection from blistered or scratched skin
  • ulcers forming on the skin
  • permanent discolouration of the skin
  • scarring of the skin

It's often possible to avoid these complications by:

  • not scratching or rubbing the affected areas of skin
  • not directly overheating the chilblains (by using hot water, for example)

You can also help reduce your risk of infection by cleaning any breaks in your skin with antiseptic and covering the area with an antiseptic dressing. The dressing should be changed every other day until the skin heals.

If the skin does become infected, antibiotics may be prescribed to treat the infection.

The information on this page has been adapted from original content from the NHS website.

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