Also known as pernio or perniosis, chilblains are a condition concerning the skin and connective tissue. Because of the skin’s colour of redness to dark blue, this condition is often confused with frostbite, trench foot or Reynaud’s disease.
Chilblains are caused by repeated exposure to cold dampness constricting the capillaries, the tiny blood vessels in the skin, which is followed by the affected extremity warming back up too quickly. This damages the capillary walls and causes the swelling of and the leakage of blood into the skin tissue. If left alone or unbroken, the blisters should go away within a week to three weeks; however, if they are aggravated, it could lead to lengthy healing, permanent scarring and severe infection when the blisters are broken or dry out.
Who Gets Chilblains and Why?
Although it is still unclear why chilblains occur (why the capillaries do not dilate as fast as the blood flowing to them does), there are several suggested risk factors as to who is more likely to get them. These factors include:
- poor circulation or being underweight making a person more sensitive to temperature changes
- a familial tendency
- anemia
- hormonal changes, especially in women
- where a person lives and whether it gets damp-cold or dry-cold and the protective clothing (scarves, hats, gloves, boots) used
- the time of the year – they are more likely to occur November through April
- wearing ill-fitting clothing or shoes causing pressure to the skin
- certain drugs such a beta blockers
- disorders of the connective tissue or bone marrow
- stress or repetitive trauma
- smoking, which decreases blood flow to peripheral extremities
- Reynaud’s phenomenon, which is another cold-related condition causing the skin colour to change from blue or white to red
Coping With Chilblains
Exposure of the skin to cold damp conditions should be avoided and if not, warm non-constrictive garments should be worn – a scarf for the face, nose and ears, a hat for the ears, gloves for the hands, and cotton/wool blend socks with waterproof high cut boots for the feet. Also avoid warming of the extremities too quickly. Do not expose them directly to a heat source. The burning itch of chilblains occurs more often by warming extremities this way.
Itching the affected area although very difficult not to, is definitely not recommended. It only makes the skin itchier and risks rupturing any formed ulcers. Instead apply pressure or padding until the itchiness subsides. Broken or dry blisters need to be treated with an antiseptic and bandaged to prevent infection.
Medical and Homeopathic Treatments
A doctor may prescribe blood pressure medication such as nifedipine or diltiazem to increase blood circulation. However, these medications lower blood pressure and cannot be used by persons with low blood pressure. A prescribed topical corticosteroid cream reduces inflammation, but overuse of this cream results in thinning skin and infections if applied to open sores or broken skin.
There are many homeopathic remedies which can improve circulation and warm the affected extremities. Mustard baths encourage blood flow to the extremity by adding one tablespoon of mustard powder to a large bowl of hot water and soaking the affected area for 10 to 15 minutes.
Teas such as rosemary or ginger with a pinch of cinnamon, and chili, heparin, arnica and ginger ointments, creams or oils improve circulation as well. Caution should be used with arnica as it irritates broken skin causing contact dermatitis. Also, high dosages of chili, cinnamon and rosemary should be avoided during pregnancy.
For controlling chilblain inflammation and to soothe the itching, cold aloe vera gel, packaged or from the plant leaf, can be applied to the affected area including broken ulcers. Beet lotion (yes, those vegetables that are usually pickled) can cool and reduce inflammation also. It was used in ancient Greece to relieve fever and control body temperature. Other creams , ointments, oils or lotions that may prove helpful include marigold or “calendula”, calamine and lanolin.
As always in situations such as these, it is best to consult a licensed health professional to discuss diagnosis of this condition and treatment options.
Chilblains (Pernio; Peniosis) - ePodiatry - Accessed September 2010
Chilblains - Mayo Clinic - Accessed September 2010
Corticosteroids - Topical Index - MedicineNet - Accessed September 2010
Ajl, Stephen Ira, Parents Magazine's Mother's Encyclopedia and Everyday Guide to Family Health, ""Chilblain"" (New York: Parents Magazine Enterprises, 1980), 170.
Miller, Sigmund Stephen, Funk & Wagnalls Family Medical Guide, ""Chilblains"", (Funk & Wagnalls, Inc., 1976), 466 - 467.
Ody, Penelope, Essential Guide to Natural Home Remedies, (London: Kyle Cathie Limited, 2002).
Schull, Patricia Dwyer, 2008 Nursing Spectrum Drug Handbook, (The McGraw-Hill Companies, 2008).
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Amy Gillies - I have had a variety of jobs in retail, food services and at one time, I worked as an Illussionist's Assistant with large exotic cats. I ...
