Chilblains

Chilblains are small, itchy swellings on the skin that occur as a reaction to cold temperatures.

They most often affect the body's extremities, such as the toes, fingers, heels, ears and nose.

Chilblains can be uncomfortable, but rarely cause any permanent damage. They normally heal within a few weeks if further exposure to the 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 for chilblains

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

Non-urgent advice: Speak to your GP or chiropodist 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

What causes chilblains?

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

Some people develop chilblains that last for several months every 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.

Who's more at 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 – a long-term condition that causes swelling in the body's tissues
Raynaud's phenomenon – a common condition that affects the blood supply to certain parts of the body, usually the fingers and toes

People who smoke are more at risk of chilblains as nicotine constricts blood vessels.

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.

It may help to use a soothing lotion, such as calamine or witch hazel, to relieve itching. Your pharmacist may also be able to recommend a suitable product.

If your chilblains are severe and keep returning, speak to your GP. They may recommend taking a daily tablet or capsule of a medication called nifedipine. This works by relaxing the blood vessels, improving your circulation.

Nifedipine can be used to help existing chilblains heal, or can be taken during the winter to stop them developing.

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 – for example, by placing your feet in hot water or near a heater – is one of the main causes of chilblains.

Do

stop smoking – nicotine causes the blood vessels to constrict, which can make chilblains worse
keep active – this helps improve your circulation
wear warm clothes and insulate your hands, feet and legs – wearing long johns, long boots, tights, leg warmers or long socks will help, and it's a good idea to wear a clean pair of socks if you get cold feet in bed
avoid tight shoes and boots – these can restrict the circulation to your toes and feet
moisturise your feet regularly – this stops them drying out and the skin cracking
eat at least one hot meal during the day – this'll help warm your whole body, particularly in cold weather
warm your shoes on the radiator before you put them on – make sure damp shoes are dry before you wear them; if your feet are already cold, make sure your shoes aren't too hot to avoid causing chilblains
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; if your hands are already cold, make sure not to warm them up too quickly to avoid causing chilblains
keep your house well heated – try to keep one room in the house warm and avoid drafts
if you're diabetic, regularly check your feet (or ask someone else to do this) – 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

Avoiding complications of chilblains

It's often possible to avoid complications of chilblains.

Don't

do not scratch or rub the affected areas of skin
do not directly overheat 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.