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Chilblains

What are chilblains?
They are small, itchy, red lesions that appear on the skin on the end of a toe. They can become purple/blue and sometimes they may blister or breakdown into a small ulcer.

What causes chilblains?
They are caused by a ‘vasospastic disorder’ where the tiny blood vessels in the feet close rapidly in response to cold and then do not respond quickly enough during rewarming. If rewarming is too extreme (very cold to very hot), there can be a leakage of fluid from the blood vessels into the tissues of the toe, causing inflammation and pain.

Treatment options

Although chilblains are uncomfortable, they do not usually cause any permanent damage. They will usually heal on their own if any further exposure to the cold is avoided.

Keep the affected areas warm. This means staying out of the cold or wearing warm gloves, socks, etc, when outdoors. You may also want to add insulating insoles to your shoes and ensure you wear shoes with a thick rubber sole.

No other treatment is normally needed as they usually go away by themselves.

A range of creams and lotions can be bought from a pharmacy. These are called rubifacient creams which act to warm the skin they are applied to. You must discuss the use of these creams with a pharmacist before use.

If you smoke, then you should try and stop as smoking can make chilblains worse.

Medication is sometimes used to prevent chilblains in people who have recurring chilblains. A drug called nifedipine can dilate (open wide) the small blood vessels and may help to prevent chilblains.

Outcomes
Chilblains do not cause any permanent problems. They are largely uncomfortable but will resolve themselves with management.