Last Updated: October 28, 2016

Chilblains

Overview

Skiing, sledding and enjoying the outdoors are great ways to stay in shape during the colder months. But if you do venture out, it’s important to protect your skin from injury. Most people have heard of frostbite, but cold can also cause another painful condition called chilblains.

chilblains on toes (source: james heilman md)

Chilblains are patches of skin in which the capillaries (tiny blood vessels) have been injured by chilling and rewarming. They’re typically red, swollen, itchy and painful. Chilblains most commonly affect the nose, fingers, toes, heels and ears.

Chilblains usually aren’t dangerous, but they can be very painful and unpleasant. The condition also makes the skin susceptible to infection, which can cause serious illness and permanent tissue damage. Because chilblains cause permanent damage to the capillaries, they tend to recur (come back) if your skin gets really cold again.

Experts aren’t sure how common chilblains are in the United States. In England, which has a cold damp climate, about ten percent of the population develop the condition each year.

Risk factors for chilblains include:

Causes

Chilblains usually appear after skin is exposed to cold, damp air for several hours. They typically develop in temperatures between 32 and 60 degrees F. (Interestingly, they’re rare in extremely cold climates, which tend to be drier.)

No one is sure exactly how chilblains form, but experts believe they’re an abnormal reaction to rewarming. When the skin is cold, the capillaries get narrow. Sudden warming causes blood to rush toward these constricted vessels before they can open again. The excess blood leaks into surrounding tissue, causing pain and swelling.

Symptoms

The first signs of chilblains are small patches of itchy, red skin that appear on the skin 12 to 24 hours after exposure to cold and rewarming.
These may be accompanied by:

Diagnosis and Treatment

Home Care

It’s usually fine to treat chilblains at home if symptoms aren’t too bad. Keep the affected body part warm, but not too hot. (Don’t place the area against a heat source like a stove and heating pad.) Avoid scratching the chilblain and use over-the-counter lotion to combat itching. If skin is broken, clean the affected area with antiseptic, keep it bandaged, and change the bandage every other day.

See your primary care provider if you notice the following infection symptoms:

Other reasons to seek medical attention:

Diagnosis

Most cases of chilblains can be treated by a primary care provider. A history and physical exam are usually enough to diagnose the problem.

Chronic (long-term, recurring) chilblains can be a sign of another illness such as lupus disease or leukemia. To help diagnose any underlying medical conditions, your doctor may order:

To help heal chilblains and prevent recurrences, your doctor may prescribe:

Prognosis

If no infection is present, chilblains should clear up without treatment in one to three weeks.

Prevention

The best way to prevent chilblains is to avoid exposing your skin to the cold. Some tips:

Sources

Additional Resources

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Authored by: Sarah Maurer