Introduction: As winter settles in, along with its frosty bite, many of us bundle up in layers of clothing to protect ourselves from the cold. Despite our efforts, some may still find themselves facing an uncomfortable and sometimes painful condition known as chillblains. Chillblains, also spelled chilblains, are a common affliction during colder months, yet they remain relatively misunderstood. Chilblains is the common term used for this and Pernio is the medical term for chilblains. Very similar conditions include Raynaulds phenomenon and acral cyanosis. In this blog post, we discussed the details of chillblains, exploring their causes, symptoms, and effective treatments.

What are Chillblains? Chillblains, medically termed pernio, are a localized reaction of the skin to cold temperatures. They occur when the skin is exposed to cold but not freezing temperatures and then undergoes rapid warming, causing blood vessels to expand and leak. This leakage leads to inflammation and injury to the surrounding tissues.

Causes of Chillblains: Chillblains typically develop in response to repeated exposure to cold, damp conditions. Individuals living in cold climates or those who spend prolonged periods outdoors during winter are at higher risk. Certain factors may predispose individuals to chillblains, including poor circulation, hormonal changes, and medical conditions such as Raynaud's disease.

Discussion: Vasospasm of the smaller blood vessels in the digits are common in this case pulses in the feet may be intact but despite this the blood flow to the digits is essentially cut off. With a lack of oxygen there can be tissue damage and resultant inflammation even after the blood flow is reestablished. It also can be common for the individual’s foot to be moist from perspiration such that a “damp chill” on the feet occurs. This is why one of the strategies is to keep the feet dry and wool socks do a great job with this. In addition in the toes if there is a place where the toes often rub together that seems to be a common location to get purple/cyanotic nodular enlargement and irritation from the contact between the toes. Patient will come into the clinic with these purple painful nodules on their toes and states that they been to other clinics and owns quite certain what it is. They commonly think that they started out as a blisters.

Symptoms of Chillblains: The symptoms of chillblains can vary in severity but commonly include:

1. Redness or purplish discoloration of the skin
2. Swelling and tenderness with nodular enlargement
3. Itching or burning sensation
4. Blistering or ulceration in severe cases, often these are purple or cyanotic.
5. Pain or discomfort, particularly upon warming the affected area

Chillblains most commonly affect the extremities, such as the toes, fingers, ears, and nose, but can also appear on other parts of the body exposed to the cold.

Treatment and Management: While chillblains can be uncomfortable, they typically resolve on their own within a few weeks once the affected individual is no longer exposed to cold temperatures. It’s not uncommon for these to last often on through the winter and then totally resolved each summer. But as the years go by sometimes the become progressively more of a challenge or problem. However, several measures can help alleviate symptoms and promote healing:

1. Keep the affected area warm but avoid sudden temperature changes.
2. Gently massage the area to improve circulation.
3. Apply soothing lotions or creams to relieve itching and discomfort.
4. Avoid scratching or rubbing the affected skin to prevent further irritation.
5. Protect the skin from further exposure to cold and moisture by wearing appropriate clothing and using gloves, socks, or earmuffs.

In more severe cases or if complications arise, medical intervention may be necessary. This may include prescription medications to reduce inflammation, promote healing, or manage underlying conditions contributing to poor circulation.

Prevention: Prevention is key to avoiding the discomfort of chillblains. Some tips to prevent chillblains include:

1. Dress warmly in layers, paying particular attention to extremities.
2. Keep indoor environments warm and dry, especially during colder months.
3. Limit exposure to cold and damp conditions, and take breaks to warm up if spending extended periods outdoors.
4. Wear moisture-wicking socks and breathable footwear to prevent moisture buildup.
5. Maintain good circulation through regular exercise and avoiding tight-fitting clothing or accessories that may restrict blood flow.

Conclusion: Chillblains are a common but often misunderstood condition that can cause discomfort during colder months. By understanding the causes, symptoms, and effective treatment options, individuals can better manage and prevent chillblains, ensuring a more comfortable and enjoyable winter season. If symptoms persist or worsen, it's essential to seek medical advice for proper evaluation and treatment. Remember, staying warm and dry is key to keeping chillblains at bay.

If you have any questions or would like a consultation please call 425-391-8666 and make an appointment online.

Dr. Timothy Young

Foot & Ankle Surgeon

Issaquah’s Top Podiatrist