Chillblains

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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. 

Although chilblains are common, the condition mainly affects young adults working outdoors in cold places or people who do not wear socks or tights in winter. Elderly people, whose circulation is less efficient than it used to be, people who don’t take enough exercise and those suffering from anaemia are also susceptible. 

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 redness and in extreme cases the surface of the skin may break and sores (ulcers) may develop. 

There are three principles regarding cold feet and associated syndromes. Looking at  

• Understand – what happens when the feet get cold and then warm again 

• Prevent – coldness or heating too quickly 

• Protect – keep the feet dry and soft and address any underlying condition 

• Cold feet is a common Podiatric condition and one that can have many causes and outcomes. Ultimately much the advice is directed to prevention – trying to retain heat in the feet and avoiding exposure to the cold. Identification of any underlying problem is important as well as dealing with any complications of the fluctuations in temperature of the toes.  

• Whatever the cause, the small blood vessels are unresponsive to the changes in temperature. They will go white or purple when they get cold as the circulation slows down to preserve body heat. Feet and fingers are more exposed. It then takes time for the blood vessels to ‘open’ up again after being cold. This can cause inflammation and the redness and swollen toes commonly seen with chilblains. 

• When the skin cells are heated they begin metabolising faster and require oxygen and release waste products. The circulation hasn’t returned to normal yet and hence the toxic build up in the tissues causes the sore chilblains.  

• The ears, nose, cheeks and hands can also be affected as well as the feet. The repeated and often prolonged exposure of the body part to the cold causes damage. Often there is an element of moisture or damp and this is commonly seen in the shoes/feet.   

If you have developed chilblains do not scratch them, instead use soothing lotions such as witch hazel and calamine on them to take away most of the discomfort. If the chilblains have not broken, you can use friar’s balsam or a product called Balmosa, which is available from your pharmacy. At night, rub some lanolin ointment well into the feet to help retain the heat. 

The best way to prevent chilblains is to keep your legs, feet and body warm, especially if your circulation is poor and your mobility is limited. 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 you experience any foot care issues which do not resolve themselves naturally or through routine foot care within three weeks, it is recommended to seek the help of a healthcare professional such as a Podiatrist. Further information can be obtained from the NHS choices website link below: