chilblains

Why do we want to talk about Chilblains you ask?

With the onset of the colder months misery can arrive for many people with feet (& hands) that are prone to the effects of cold. Frostbite is now uncommon but chilblains, although less common since central heating has become widespread, can still be a very painful condition. Chilblains are a very common condition affecting the old and young alike and they have no quick fix, but the good news is that with some preparation they can be prevented in many (not all) people. If you are a regular sufferer following the advice below may not totally prevent you getting chilblains but I’m certain it will reduce the severity and number of chilblains you get.

Chilblains. What are they?

Chilblains (also called erythema pernio) are small itchy, red (and sometimes purple) swellings on the skin, which can be painful. They can swell and then dry out leaving cracks in the skin that expose the foot to the risk of infection. You can get them on your toes, fingers, the face (especially the nose) and the lobes of the ears. They can break down to become a small ulcer prone to infection.

What causes them?

Chilblains develop when the tiny blood vessels under the skin constrict under cold conditions reducing the flow of blood until the area warms up again and causes some leakage of fluid into the surrounding tissue. They are caused by the skin’s abnormal reaction to cold but not everyone develops them as this depends to a large extent on the efficiency of your circulation. People with poor circulation and other health problems involving their blood vessels are likely to be more prone to developing chilblains. In addition, damp or draughty conditions, dietary factors and hormonal imbalance can also be contributory factors. It is thought that rapid temperature changes from cold to hot can also be a cause. If the skin is chilled and is then followed by too rapid warming next to a fire or through using a hot water bottle, chilblains may result.

Will I get them?

Chilblains are common. The main groups susceptible are young adults, outdoor workers or people working in cold places or people who do not wear socks or tights in winter. Other groups include elderly people with poor circulation, inactive people as they are not stimulating their circulation system and people suffering with anaemia.

How do I know I have them?

During the onset of winter, susceptible people will experience burning and itching on their hands and feet. Upon entering a warm room, the itching and burning is intensified. There may also be some swelling or colour changes (red/purple areas) and in extreme cases the surface of the skin may break and sores (ulcers) may develop.

The best treatment is PREVENTION!

The following tips will greatly reduce the severity and hopefully prevent the onset of chilblains.

Avoid rapid changes in temperature. Don’t have a hot bath or stand in front of a heat source when you are very cold. Warm yourself up first perhaps by walking around the house a few times.

Dress warmly when going out in the cold. If you don’t get cold in the first place you are less likely to
develop chilblains. In particular keep your legs and feet warm by wearing trousers and thick socks.

Socks. Try and ensure socks are natural fibre (Wool/Bamboo) and thick. I have found the thick bamboo sock to be particularly warm in the colder months. They also wick the moisture from your feet keeping them warmer. (Don’t forget coats, hats & gloves as well).

Footwear. Thick soled shoes will insulate your feet much better than very thin-soled shoes. If you are an out-door worker try and use Gortex lined footwear. Shoe linings like Gortex allow moisture out of the shoe but not into the shoe – this will keep your feet drier and therefore warmer. If you wear traditional wellies to work or walk the dog, consider switching to the new Neoprene type wellies. These have a thicker sturdier sole which provide better insulation against the cold ground, and the neoprene will keep you significantly warmer. Also, wear warm slippers inside rather than bare feet.

Keep your feet dry. Wet shoes and feet will very quickly get icy cold in winter.

Foot Warming Cream/Massage. If your feet are still cold perhaps a foot massage or using a foot warming cream will stimulate circulation. There are a few foot warming creams available now which do seem to help keep your feet warm more consistently and for longer if used alongside the sock and footwear advice.

Seek professional advice. If you are unsure of any aspect of your footcare with regard to chilblains you should seek professional advice. This is especially important for chilblain sufferers who have diabetes or other circulatory problems.

Treatments

As I have previously said the best treatment is prevention. Remember: The whole body, rather than just the feet, needs to be kept warm. Trousers, long boots, tights, leg warmers, long socks and gloves will also help.

If despite this you have chilblains there are steps you can take in their care. They should eventually resolve as the warmer weather returns.

If you have developed chilblains do not scratch them, there are various chilblain remedies available which will soothe (not cure) them. (Snowbrite Spray, Snowfire, Gehwol’s - Fusskraft Red, Balmosa cream).

If the chilblain has ulcerated, apply an antiseptic dressing. If you have diabetes or are undergoing medical treatment or have an ulcerated chilblain that is not healing/getting better do have the ulcer assessed by your Podiatrist or GP ASAP.

Always consult your Podiatrist or GP if you have any queries. If your condition is worsening further intervention may be needed which will include vascular assessment and possibly prescribed medication.