Chilblains, also known as perniosis, are a common condition during the colder months. They occur as a reaction to exposure to cold, non-freezing temperatures and are characterised by inflammation and discomfort.

What Are Chilblains?

Chilblains are a localised inflammatory response triggered by exposure to cold and damp conditions. The condition typically develops within 12–24 hours after exposure. Symptoms include:

• Painful, swollen, and itchy patches or nodules.
• Discolouration of the skin, ranging from red to purple or blue.
• Affected areas often include the fingers, toes, ears, and nose, but can occasionally appear on the face or legs.

If left untreated, chilblains can worsen, with prolonged exposure potentially leading to ulceration or infection.

Causes and Risk Factors

Chilblains result from changes in blood flow in response to cold temperatures. Initial vasoconstriction reduces blood flow to the area, followed by delayed vasodilation that can lead to tissue damage and inflammation.

Certain factors increase susceptibility, including:

• Poor circulation or low body mass index (BMI).
• Smoking, as nicotine constricts blood vessels.
• Wearing tight clothing or ill-fitting footwear.
• Living in cold, damp climates.
• Being female, especially during adolescence and early adulthood.

Management of Chilblains

Effective management focuses on prevention and symptom relief:

• Minimise Exposure to Cold: Wear insulated footwear, thermal socks, and warm clothing.
• Avoid Tight Shoes: Ensure shoes allow sufficient space for insulating materials without restricting circulation.
• Keep Skin Dry: Change damp socks promptly and use moisture-wicking materials.
• Topical Treatments: Chilblain creams containing active ingredients like methyl salicylate or capsaicin may help.
• Avoid Trauma: For broken chilblains, protect the area with appropriate padding and dressings to prevent infection and optimise healing.