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Writer's pictureJoana Jorge
Jan 113 min read

Understanding chilblains: our skin against the cold weather

Introduction

As the winter chill sets in, some people may experience a skin condition appearing on the body extremities characterized by lesions and discomfort. This condition is called “chilblain” or, more scientifically, described as perniosis, and appears as a response to the cold temperatures.


What are chilblains?

Chilblains are a skin condition characterized by the inflammation of small blood vessels (vasculitis) triggered by exposure to cold and humid conditions. The symptoms chart includes pain, itchiness, swelling, and lesions on the extremities of the body (normally fingers and toes). These symptoms start to manifest 12 to 24 hours after exposure to cold temperatures and usually last for two to three weeks. Usually, individuals experience complete or partial resolution as the warmer weather sets in.




Causes of chilblains

1.      Cold temperatures

The cold weather leads to a constriction of the small blood vessels close to the skin, and then, once the tissues are rewarmed, the blood leaks into the tissue. This occurrence causes the skin to swell, which will irritate the nerves and cause pain.

2.      Humid conditions

Skin wetness significantly increases the skin’s heat loss, resulting in lower temperatures in the skin, which contributes to the development of chilblains.

3.      Poor circulation

People with circulatory dysfunctions (such as peripheral vascular disease due to diabetes, smoking, or high blood pressure) usually don’t manage well the temperature fluctuations which makes them more prone to manifest symptoms of perniosis.

4.      Clothing choices

Wearing clothes that expose skin to the cold as well as wearing tight clothes that limit the blood flow, will cause a decrease in the skin’s temperature.

5.      Health conditions

People with a lower body fat percentage are more susceptible to rapid temperature variations and, therefore, to chilblains. Other medical conditions such as lupus or anemia also increase the chance of developing chilblains.

 

Management of chilblains

Preventive measures can delay or soften the onset of chilblains, but only to a certain extent, as there are external causing factors that cannot be controlled. Therefore, conservative measures may be useful, but sometimes pharmacological interventions are essential.

 

Conservative measures

  1. Avoid exposure to cold temperatures: when going out, always dress in layers, especially covering extremities, using thermal socks and gloves.

  2. Avoid humidity: keep your skin, clothes, and shoes dry to prevent humidity from worsening the condition.

  3. Avoid abrupt temperature changes: after being in the cold, don't warm the cold areas of your body directly in the heating system or hot water; instead, gradually raise the overall body temperature.

  4. Keep the skin well hydrated: ensure an adequate fluid intake and moisturize with nourishing creams or lotions, especially the hands and feet.

  5. Reduce or quit smoking: patients are encouraged to stop smoking because nicotine constricts blood vessels, decreasing the blood flow and contributing to the worsening of this condition.

 

Pharmacological measures

When chilblains have already installed, some measures can help ease the pain and discomfort.

  1. Non-prescription topical creams

    1. Calendula cream: calendula presents anti-inflammatory properties that soothe the irritated skin, alleviating discomfort and providing healing.

    2. Aloe vera gel: provides relief from itching and soreness because of the cooling and moisturizing effects of aloe vera.

  2. Non-prescription supplements

    1. Ginkgo biloba: supplementation with Ginkgo biloba can improve blood flow and provide an anti-inflammatory action, which can help reduce symptoms and speed up the healing process.

If chilblain lesions are recurrent, severe, appear infected, or if you have diabetes or another concerning chronic disease, medical help should be sought.

Treatment with medications is second-line but if the condition doesn’t respond to conservative measures, doctors may prescribe treatments to help manage it.

 

  1. Prescription medicines

    1. Topical corticosteroids, such as mometasone or betamethasone, applied for a few days may relieve itching and swelling.

    2. Oral intake medicines as vasodilators and hemorrheologic agents may be considered, as they will increase the blood flow.

 

Conclusion

Chilblains can be a discomforting consequence of winter's cold embrace, but their impact can be minimized. Adequate protection from the cold is key to avoiding this condition!


References


Assessed and Endorsed by the MedReport Medical Review Board


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