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What are chilblains?

Warming cold hands and feet up too quickly can lead to chilblains.
Warming cold hands and feet up too quickly can lead to chilblains.
Goodshoot/Jupiterimages/Thinkstock

The word chilblains may sound old-fashioned to many of us -- an ailment like lumbago or rheumatism that might have afflicted our great-grandparents. But chilblains are still very real. Today, the condition is also known as perniosis or pernio, but all the terms mean the same thing: a painful skin problem that results from exposure to cold and damp. The number of people in the U.S. who have contracted chilblains is not known, but in Britain, one in 10 is affected every year [source: Maroon].

Doctors aren't entirely sure what causes chilblains. The condition tends to develop when a person is exposed for a period of time to cold but not freezing conditions -- that is, temperatures from 32 to 60 degrees Fahrenheit (0 to 15 Celsius) [source: NIOSH]. The cold causes tiny blood vessels to constrict, usually in locations that have the poorest circulation like the fingers and toes (the ears, nose and cheeks can also be affected). When the flesh is rewarmed quickly, blood can leak from these vessels. The result is swelling and inflammation accompanied by itching and pain: chilblains.

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Dampness also seems to be a contributing factor. The disease is less common in cold, dry climates than in moderate, damp ones. This may be partly because people in the colder areas tend to take more precautions against the cold [source: NIOSH].

Chilblains differ from frostbite, a more serious cold-weather condition in which flesh actually freezes. Nor are chilblains the same as hypothermia, an overall drop in body temperature that can be life-threatening. A similar condition, trench foot, results from prolonged immersion in cold water, but it's much more severe than chilblains and can lead to gangrene [source: Doerr].

Chilblains most commonly affect children and young to middle-aged women; it's not known exactly why. Those who have poor circulation are more likely to contract the condition, and it occurs more often in thin people. Smoking, drinking coffee and taking decongestants, all of which restrict circulation in the skin, can contribute as well. If members of your family have had chilblains, you are also more likely to have them.

Some drugs, such as beta-blockers, may worsen chilblains, though they don't actually cause the condition [source: Newson]. The pressure from tight shoes or from bunions and corns, which limits blood circulation, can bring on chilblains in the cold. When tight, low-slung jeans became fashionable, doctors began to see cases of chilblains in the young women who wore them during the winter [source: Weismann]. The clothing restricts circulation even as it exposes skin to cold, creating the right conditions for the ailment.

A case of chilblains is no fun. It begins with itchy, burning skin a few hours after the exposure. Blisters or sores may develop, with the skin turning a red to purple color, and there might be swelling, pain and tenderness. Once a person has had chilblains, the condition is more likely to recur with each exposure to cold.

On the next page, you'll find out how to treat chilblains, and more importantly, how to prevent them in the first place.

 

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Chilblains can be very annoying, but they're usually not serious. They go away on their own in a week or two. But if they result in open sores, if blisters break, or if scratching opens the skin, infection is possible. This is a more serious problem and can result in scarring. An infection can even be life-threatening if left untreated [source: Mayo Clinic]. Because diabetes often creates circulation problems, diabetics need to see a doctor if chilblains develop in order to avoid complications.

Most patients need no treatment for chilblains except to avoid cold. A soothing, anti-itch cream like calamine lotion can help. You should apply an antiseptic and sterile dressing if the skin is broken. Try to avoid scratching the affected area or breaking blisters. Exposure to ultraviolet light and application of corticosteroid creams have been tried in order to alleviate chilblains, but the effectiveness of these treatments is still being debated [source: Bohman].

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Doctors sometimes prescribe the drug nifedipine (Procardia) for chilblains. This drug relaxes and widens blood vessels and can both ease the symptoms of chilblains and prevent recurrence of the condition in people who are susceptible [source: Maroon].

The best approach is to try to keep from getting chilblains in the first place. Here are some prevention tips that can help:

  • Warm your hands and feet before going out into the cold.
  • Always wear warm clothing outside, even if the temperature is not frigid. Dress in layers.
  • Remain active when outside in the winter to keep your blood circulating. Don't sit around in a cold environment.
  • Wear a hat and scarf, and be sure your gloves and socks will help you stay warm.
  • Try battery-heated shoe inserts or chemical toe and hand warmers if you tend to get chilblains.
  • Give up smoking and go easy on coffee when you're going to be in the cold.
  • Avoid wet or damp conditions.
  • If you do get cold, never put your hands or feet near a radiator or fire. Rewarm them gradually.

If you ever get chilblains, you'll want to redouble your efforts to prevent a recurrence of the condition.

Read on to find out more about chilblains and other cold-weather skin conditions and how to prevent them.

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Sources

  • Beacham, Bruce E., M.S., M.D; Philip H. Cooper, M.D.; C. Stuart Buchanan, M.D.; and Peyton E. Weary, M.D. "Equestrian Cold Panniculitis in Women." Archives of Dermatology, 1980. (accessed June 10, 2010)http://archderm.ama-assn.org/cgi/content/abstract/116/9/1025
  • Bohman, Keith D.; Thomas. J. Papadimos; Lorie D. Gottwald; and Zhixing K. Pan. "Perniosis (chilblains) masquerading as CA-MRSA: a case report." Case Journal, 2009. (accessed June 10, 2010)http://casesjournal.com/content/2/1/6500
  • Doerr, Steven, M.D. "Frostbite, Chilblains, and Trench Foot." MedicineNet. (accessed June 10, 2010)http://www.medicinenet.com/frostbite/article.htm
  • National Institute for Occupational Safety and Health (NIOSH). "Cold Stress." (accessed June 10, 2010)http://www.cdc.gov/niosh/topics/coldstress/
  • Newson, Louise. "The management of chilblains." Onmedica.com. January 19, 2010. (accessed June 10, 2010)http://www.onmedica.com/NewsArticle.aspx?id=4dc68325-0af8-4a4f-b163-b2f004a520ff
  • Maroon, Michele S, M.D., and David Hensley, M.D. "Pernio." eMedicine from WebMD. Updated March 26, 2010. (accessed June 10, 2010)http://emedicine.medscape.com/article/1087946-overview
  • Mayo Clinic. "Chilblains." September 3, 2008. (accessed June 10, 2010)http://www.mayoclinic.com/health/chilblains/ds01091
  • Weismann, Kaare and Frederik Gronhoj Larsen. "Pernio of the Hips in Young Girls Wearing Tight-fitting Jeans with a Low Waistband." Acta Dermato-Venereologica. November 2006. (accessed June 10, 2010)http://adv.medicaljournals.se/files/pdf/86/6/2549.pdf

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