Chilblains are areas of erythema (red inflamed skin that blanches when squeezed) found on body extremities in predisposed individuals. Chilblains can swell and then dry out leaving cracks in the skin which expose the foot to the risk of infection. They occur on the toes, particularly the smaller ones, fingers, the face, especially on the nose, and the lobes of ears. They often occur on areas of the feet exposed to pressure, e.g. on bunions or where the toes are squeezed by tight shoes. Their appearance can vary from red when recently formed, to a blue/purple discoloration. The affected areas will often itch, burn, and become painful. On occasions the chilblain may become ulcerated.

Chilblains occur in predisposed individuals where the capillary beds react abnormally to cold temperatures particularly where forceful friction and pressure has been applied via ill fitting footwear.

Once a chilblain(s) has developed it is essential that you should favour warmer footwear, keep the foot warm, and avoid tight fitting shoes & socks. Eventually, if these criteria are adhered to, the skin will recover. If the itching is intense and there is no ulceration, then applications of a mild steroid cream can help, although this should be applied sparingly for only short periods of time.

Soaking the feet in warm (not hot) water footbaths for 15 minutes several times daily is effective in warming the feet, however the feet must be dried thoroughly, and thick ‘fluffy’ loose fitting ski socks should be worn immediately after drying.

There is no ‘magic’ cream or medication that will produce instant relief of symptoms. The use of creams that dilate peripheral arterioles (Rubefacients) are often used e.g. Deep Heat, however their efficacy is open to debate. For individuals who are particularly affected by persistent & significant chilblains then the tablet Nifedipine could be considered. In extreme cases where persistent chilblains occur in combination with poor peripheral circulation then a Lumbar Sympathectomy could be considered.