Chilblains (CHILL-blayns) are the painful inflammation of small blood vessels in your skin that occur in response to repeated exposure to cold but not freezing air. Also known as pernio, chilblains can cause itching, red patches, swelling and blistering on your hands and feet.
Chilblains usually clear up within one to three weeks, especially if the weather gets warmer. You may have recurrences seasonally for years. Treatment involves protecting yourself from the cold and using lotions to ease the symptoms. Chilblains don't usually result in permanent injury. But the condition can lead to infection, which may cause severe damage if left untreated.
The best approach to chilblains is to avoid developing them by limiting your exposure to cold, dressing warmly and covering exposed skin.
Signs and symptoms of chilblains may include:
- Small, itchy red areas on your skin, often on your feet or hands
- Possible blistering or skin ulcers
- Swelling of your skin
- Burning sensation on your skin
- Changes in skin color from red to dark blue, accompanied by pain
When to see a doctor
Chilblains will usually get better on their own. Seek medical care to check for complications if the pain is unusually severe, if you suspect an infection, or if your symptoms aren't improving after one to two weeks. If the symptoms extend into the warm season, see a doctor to rule out other conditions.
If you have diabetes or poor circulation, healing may be impaired. Be cautious and seek care.
No one knows exactly what causes chilblains. They may be an abnormal reaction of your body to cold exposure followed by rewarming. Rewarming of cold skin can cause small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle. This results in a bottleneck effect and the blood leaking into nearby tissues.
Factors that may increase your risk of chilblains include:
- Clothing that is tight or exposes skin to the cold. Wearing tight-fitting clothing and shoes in cold, damp weather may make you more susceptible to chilblains. And skin that's exposed to cold, damp conditions is more likely to develop chilblains.
- Your sex. Women are more likely to get chilblains than are men.
- Being underweight. People who weigh about 20 percent less than is expected for their height have an increased risk of chilblains.
- Environment and season. Chilblains are less likely in colder and drier areas because the living conditions and clothing used in these areas are more protective against cold. Your risk of chilblains is higher if you live in an area with high humidity and cold, but not freezing, temperatures. They are more common from November to April.
- Having poor circulation. People with poor circulation tend to be more sensitive to changes in temperature, making them more susceptible to chilblains.
- Having Raynaud's disease. People with Raynaud's disease are more susceptible to chilblains. Either condition can result in sores, but Raynaud's causes different types of color changes on the skin.
- Having an autoimmune disorder. Lupus — an autoimmune connective tissue disease — is the most common autoimmune disorder associated with chilblains.
Chilblains may cause complications if your skin blisters. If that happens, you may develop ulcers and infections. Besides being painful, infections are potentially life-threatening if left untreated. See a doctor if you suspect infection.
To prevent chilblains:
- Avoid or limit your exposure to cold.
- Dress in layers of loose clothing and wear mittens and warm, water-resistant footwear.
- Cover all exposed skin as completely as possible when going outside in cold weather.
- Keep your hands, feet and face dry and warm.
- Keep your home and workplace comfortably warm.
- Don't smoke.
If your skin is exposed to cold, it's helpful to rewarm it gradually because sudden rewarming of cold skin may worsen chilblains.