With the cold of winter, some people develop reddish or purplish lesions on their fingers that itch, sting and sometimes hurt. These are chilblains, and although they are uncomfortable, in most cases they are harmless and can be prevented.
What chilblains are
Chilblains (or pernio) are small inflamed areas of skin that appear after exposure to cold and damp, mainly on the fingers and toes, but also on the nose or ears. They look like reddish-purple patches.
They appear after cold exposure followed by sudden warming. The typical presentation is local redness or purplish-toned patches on the skin, localised swelling, itching and a burning sensation.
Why they appear
They are caused by an exaggerated reaction of the small blood vessels in the skin to cold: they first contract and, when the area is warmed suddenly, they widen abruptly. That change inflames the tissue. This is why warming the fingers quickly (for example, with a heater) can encourage them.
They are more common in cold, damp climates and in young women.
The best treatment for a chilblain is not letting it appear in the first place: protect against cold and, very importantly, do not warm your hands or feet suddenly. When they recur often, it is worth reviewing the circulation.
How to prevent them
Prevention is the most effective approach. These measures help keep them from appearing:
- Keep hands and feet well wrapped up, with warm gloves and socks.
- Warm up gradually, without placing your fingers near direct heat sources.
- Keep the skin dry and moisturised; avoid prolonged damp.
- Stop smoking, because tobacco narrows the arteries and worsens circulation to the skin.
When to see a doctor
Most chilblains heal on their own if the area is protected. An assessment is worthwhile if:
- They recur very frequently or last longer than expected.
- They appear outside winter or with no relation to cold.
- They are accompanied by wounds that will not heal or by other general symptoms.
In these cases, it is worth ruling out an underlying cause, such as a circulatory problem or an associated condition.
In summary
Chilblains are an uncomfortable but almost always harmless reaction of the skin to cold and damp. Keeping warm, avoiding sudden warming of the fingers and looking after circulation prevents most of them. If they recur often or do not heal, a vascular assessment helps rule out an underlying problem.