Chilblains are patches of red, swollen and itchy skin often caused by cold weather and sometimes exacerbated by poor circulation. Extremities such as the toes, fingers, nose and ear lobes are most at risk. Prevention strategies include keeping the whole body warm, and exercising regularly to improve peripheral circulation.

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Chilblains

Chilblains are patches of red, swollen and itchy skin believed to be caused by a combination of cold weather and poor circulation. The toes are particularly vulnerable, but other extremities that can develop chilblains include fingers, ear lobes and the nose. Tight shoes can also contribute by irritating and pressing on the skin of the toes, especially the little toe. Despite the discomfort, chilblains don’t cause any permanent damage to tissue. Not everyone exposed to cold and damp conditions will develop chilblains, which leads some researchers to believe that those who do to be overly sensitive to changes in weather and temperature. The elderly, sedentary, teenagers and people with medical conditions such as anaemia are most susceptible.

Symptoms

The little toe is more likely to develop chilblains than the other toes. Common symptoms include:

·         A burning sensation on the skin
·         Red, swollen patches
·         Intense itching
·         Dry skin, leading to splits and cracks
·         Possible secondary infection
·         Ulceration, in severe cases.

The circulation responds to temperature

Although the exact cause of chilblains remains unknown, it is thought to be associated with the body’s reaction to cold weather. The body’s circulatory system comprises arteries, veins and capillaries that shunt blood to every cell. The circulatory system is sensitive to temperature. In hot conditions, the body expands blood vessels close to the skin so that excess heat can be lost to the air, cooling the body. In cold weather, these blood vessels constrict to conserve body heat. This constriction can starve extremities, such as the toes, of blood and warmth if your peripheral circulation is sluggish. 

Abrupt temperature changes 

The symptoms of chilblains are intensified with sudden temperature changes, for example, entering a warm house after being outside in the cold. Similarly, heating cold feet too quickly, such as propping them next to a heater or using a hot water bottle, will also exacerbate the condition. It is better to concentrate on warming your whole body instead.

Treating chilblains at home

Suggestions for treating chilblains at home include:

·         Resist the urge to scratch, as this will further damage the skin
·         Use calamine lotion or witch hazel to soothe the itching
·         Lasonil (Heparin ointment) to improve the circulation in the area
·         Lanolin or similar rubbed into the feet will help retain body heat
·         Wear woolen or cotton socks
·         Keep your whole body warm
·         Gentle exercise will improve circulation to your feet.

Prevention tips

Keeping your entire body warm at all times is the key to preventing chilblains. Suggestions include:

·         Avoid long periods of exposure to cold or damp weather.
·         Wear several layers of clothing, which trap body heat more efficiently than one bulky layer.
·         Wear tights under trousers.
·         Make sure your shoes are comfortable and don’t squeeze your toes.
·         Dry feet thoroughly after showering or bathing.
·         Use woolen or cotton socks to allow your feet to ‘breathe’.
·         Have some gentle exercise like walking every day to improve peripheral circulation.
·         Regularly pamper and condition the skin of your feet with home pedicures.
·         See a podiatrist for regular professional treatments.

Professional treatment

Severe, ulcerating or recurring chilblains need professional attention. A qualified podiatrist can treat your chilblains and offer advice on prevention. If you have a pre-existing condition such as diabetes, see your doctor if your chilblains ulcerate.

Where to get help

·         A Podiatrist
·         Your doctor

Things to remember

·         Chilblains are patches of red, swollen and itchy skin that are thought to be caused by a combination of cold weather and poor circulation.
·         Extremities such as the toes, fingers, nose and ear lobes are most at risk.
·         Elderly or sedentary people, and those with conditions such as anaemia, are most susceptible to developing chilblains.

URLs

Australian Podiatry Assoc
http://www.apodc.com.au
Feet for Life
http://www.feetforlife.org/chilblai.htm

References

The Merck Manual http://www.merck.com/pubs/mmanual/section20/chapter280/280f.htm

OnLine Pharmacy http://www.pharmlink.com.au/fullife/AilmentsandDiseases/chilblains.htm