Chilblains

Chilblains

Chilblains are small, itchy swellings on the skin that can appear after you’ve been in the cold.

Chilblains can be uncomfortable, but they usually get better on their own within a few weeks.

Symptoms of chilblains

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

They usually develop several hours after being in the cold.

Symptoms of chilblains include:

• a burning or itching feeling in the affected areas, which can get worse if you go into a warm room
• swelling
• the affected skin turning red or dark blue
• in severe cases, the surface of the skin breaks, and sores or blisters develop

Do not scratch your skin if you have chilblains. It can break easily and become infected.

When to get medical advice

You do not usually need to see a GP, as chilblains normally get better on their own within a few weeks.

Speak to your GP practice if:

• you have chilblains and your skin has not got any better after 2 to 3 weeks
• there is pus coming out of your skin
• your temperature is very high or you feel hot or shivery
• you keep getting chilblains
• your chilblains are severe
• you have diabetes and have chilblains – foot problems can be more serious if you have diabetes

Treatment for chilblains

Chilblains often get better on their own without treatment.

Things you can do to help your symptoms

A soothing lotion, such as calamine or witch hazel, can help relieve itching. A pharmacist can give you advice about the right product for you.

Find your nearest pharmacy

Treatment from your doctor

If your chilblains are severe and keep returning, your GP may prescribe a medication called nifedipine. You take nifedipine as a daily tablet or capsule. It works by relaxing the blood vessels, improving your circulation.

Nifedipine can help existing chilblains heal, or can be taken to stop them developing.

What causes chilblains?

Chilblains are caused by an abnormal reaction to the cold. They’re common in the UK because the weather is damp and cold 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. Blood can leak into the surrounding tissue, which may cause the swelling and itchiness of 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. For example, a bunion or a toe that’s squeezed by tight shoes.

How to prevent chilblains

If you’re more at risk of chilblains, you help prevent them by:

• staying out of the cold where possible
• looking after your feet
• improving your circulation

If your skin gets cold, you should 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
• 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 1 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 at least 1 room in the house warm and avoid draughts
• 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 complications 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 reduce your risk of infection by:

• cleaning any breaks in your skin with antiseptic
• covering the area with an antiseptic dressing
• changing the dressing every other day until your skin heals

If the skin does become infected, you may be prescribed antibiotics.