Are Chilblains the bane of your existence?

What are chilblains?

Chilblains are small, itchy reddish purple patches, like blisters, on the skin, which can be very painful. Generally, they occur on the extremities – toes, fingers, even ears and noses. When more severe, these patches can swell and sometimes cause splitting and cracking of the skin, leading to infection. If left untreated, these infections can become ulcerated. This condition is sometimes called Pernio, Perniosis or Cold-Induced Vascular Disorder.

A condition related to chilblains is Raynauds Phenomena, which has many similarities to chilblains.

Causes

The main cause for chilblains is cold weather. When we become cold the blood vessels close to the skin constrict to concentrate blood and body heat in the areas of the vital organs. This constriction starves the extremities of blood. When the extremities are later warmed – for instance if we come inside from the cold – the constricted blood vessels expand too quickly. This can cause blood to leak into nearby tissue, creating a chilblain.

Less common causes for chilblains are:

  • Poor circulation. If your circulation is already sluggish or compromised by an underlying condition such as diabetes or lupus, chilblains will commonly arise.
  • Tight or ill fitting shoes. Shoes which constrict the flow of blood to the foot because they are too tight, or pinch in specific places, can cause chilblains to develop.

Anyone can suffer from chilblains, however the people most at risk of chilblains are the elderly, people with underlying medical conditions, smokers, people who are underweight, and those with a sedentary lifestyle. Women are also more prone to the problem than men.

Symptoms

As we said earlier, chilblains are red/purple, itch, painful and sometimes swollen patches on the skin. There is usually itching, and often a burning sensation. Blisters often develop and the skin splits and cracks.

Most often, chilblains occur on the toes and feet. However, your hands, ears and nose may also be affected.

Treatment

  • If you regularly suffer from chilblains, or if the skin has split or cracked, it is important to see a Podiatrist for assessment. They will be able to make recommendations on treatment and prevention, and to manage any underlying or secondary conditions related to the chilblains, like ulcerations. This is especially important if you suffer from diabetes.
  • Soothing lotions will reduce the itch. It is important not to scratch as this will increase the likelihood of the skin cracking. Witch hazel or calamine lotion are often good
  • Keep the affected skin supple with rich lotions like lanolin to avoid cracking
  • Vicks or Antiflamme will increase the circulation in the area
  • Look for wool or cotton socks as the natural fibers will not irritate the skin

Prevention

  • When you are outdoors in very cold weather, make sure both your body and your extremities are kept warm. Warm shoes and socks and gloves are essential as well as hats, coats and scarves. Aim for layers, which will trap the warmth, rather than one bulky layer
  • When you come in from the cold, don’t be tempted to reheat your extremities too quickly. There may be no better feeling than warming your hands over a roaring fire, but aim for a slower warming. Run your hands and feet under warm – not hot – water and allow them to warm slowly. Sudden, extreme changes in temperature will exacerbate the problem
  • Make sure your shoes are comfortable and well fitted to avoid pinching
  • Keep up a routine of exercise to ensure your circulation is good

Raynauds Phenomena

This condition has some similarities to Chilblains in that it is related to restricted blood flow to the extremities. In the case of Raynauds, blood flow to the extremities is restricted or interrupted by a constriction of the blood vessels called a vasospasm. Triggers for this can be cold or emotional stress.

Unlike the red/purple patches of chilblains, when blood flow is constricted in Raynauds Phenomena, the skin turns white, feels icy cold and sometimes even develops a blue tinge.

There are two types of Raynauds:

– Primary, where there is generally little pain. Primary Raynauds exists on its own and has no underlying condition

– Secondary, where the sufferer may experience pain, tingling and numbness for minutes or hours. Secondary Raynauds is related to underlying conditions such as arthritis or an auto-immune disease

When a Raynauds vasospasm is over it may take some time for circulation to be restored, and you may experience throbbing and redness in the area.

Raynauds is caused by a range of conditions and environmental factors such as arthritis, atherosclerosis, lupus, smoking and some medications, such as beta blockers.

Prevention and treatment for Raynauds is much the same as with chilblains. However, if you suffer from Raynauds it is important to keep warm as much as possible and avoid triggers like nicotine and caffeine. It is also important to try and manage emotional stress.

If you are suffering from chilblains, or think you may have Raynauds Phenomena, call our Hills district clinic on 9639 7337 to make an appointment for an assessment and treatment to with our Podiatrist.

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