Chilblains – What are they?
Chilblains are caused by an abnormal vascular reaction to the cold. Extreme chilling (due to draughts, cold, damp and pressure) followed by too rapid warming (e.g. hotwater bottle, electric blanket) can result in red or purple, swollen, itchy, painful lesions which can split open. They usually subside within 2-3 weeks.
Usually develop at the extremities i.e. fingers, toes, ears and nose, or over areas of pressure eg heels and bunions. They usually occur in the winter or damp weather, and in susceptible people, such as children and young adults, people with poor circulation or anaemia, and with poor diets.
What can you do?
- Prevention is much more effective than treatment once you have a problem.
- Avoid cold and damp environments.
- Keep warm living and working conditions.
- Wear warm clothes – if your body is warmer so also will your feet.
- Take adequate exercise and eat a good diet.
- Replace wet shoes/hosiery immediately.
- Footwear – boots are better than shoes, try to wear ones with a thick sole and lined (fur/fleece), and not too tight which can restrict circulation even more.
- Wear thick socks or 2 pairs of thin socks (provided there is room in the shoes), and warm them before dressing.
- Try adding thermal insoles to your shoes if there is room.
- If feet do get cold, warm them up very slowly, do not place near a fire/radiator, or in a hot bath.
Acute phase – the lesion appears bright red and blotchy, hot, itchy, or tender, and is exacerbated by warmth. Apply cooling lotions eg calamine, witch hazel, or a cool soaked gauze dressing, or an anti-inflammatory gel e.g. ibuprofen.
Chronic phase – the lesion appears a sluggish purple/blue and feels cool, you will have had repeated episodes. Apply camphor, menthol in aqueous cream, iodine, methyl salicylate 20% (wintergreen), or Balsam of Peru (12.5% in simple ointment) and lightly massage the area.
If the lesion is rubbed/scratched, the skin may break down, be slow to heal, and risk infection. Apply an antiseptic dressing. If you have repeated episodes every year or circulation problems, talk to your Podiatrist about oral medications.