Chilblains: An Annoying Winter Woe

A painful inflammation of small blood vessels in your skin – chilblains – is a distressing winter woe that can happen year after year.

The word chilblain comes from old English. Chill refers to a lower temperature and blain is a superficial area of inflammatory swelling or a sore.

Chilblains and frostnip are the two most common cold-weather injuries, the difference between the two being – the presence or absence of moisture.

Also called pernio, chilblains can occur in response to repeated exposure to cold but not freezing air in the presence of moisture (think damp, cold British castle). These can cause itching, red patches and swelling over the exposed parts, usually your hands and feet, accompanied by pain and burning sensation. The lesions can also involve your ears, the tip of your nose, cheeks or chin. The skin may change color from red to dark blue to purple. In severe cases, the surface of your skin may break, causing you to develop sores or blisters.

Frostnip, on the other hand, occurs in a dry environment where the very superficial tissue actually freezes, resulting in dehydration of the cells and consequent cell death. Thankfully our skin, unlike nerves, has great regenerative capacity. So new cells take up the place of the damaged cells once treated.

Chilblains don’t usually result in permanent injury and generally clear up within 1-3 weeks, especially if the weather gets warmer.

One may have recurrences seasonally for years.

Treatment involves protecting yourself from the cold and using topical lotions to ease the symptoms.

It’s important not to scratch the skin as it can break easily and become infected. When infected, it may cause severe damage if left untreated.

Causes

As the name suggests, you get chilblains when it’s cold. The cold makes the tiny blood vessels or capillaries in your fingers/toes to get smaller or constricted. Chilblains happen as an abnormal reaction of the body (in some people) to cold exposure while rewarming. Rewarming of the skin too quickly can cause the constricted capillaries under the skin to expand faster than nearby larger blood vessels can handle. This causes a bottleneck effect and stops blood from moving about as fluidly, resulting in tissue damage. Blood leaks into the nearby tissues causing pain, swelling and discoloration.

The external cause of chilblains is exposure to cold. Apart from this, poor health conditions and weak peripheral circulation can also trigger the disease. In most cases, the condition worsens with a change in the weather.

Risk Factors

Factors that may increase your risk of chilblains include:

Clothing that is tight or exposes your skin to the cold. Wearing tight-fitting clothes/shoes in cold and damp weather or direct exposure of the skin to cold interferes with peripheral blood circulation making you more susceptible to chilblains.
Your gender. Women are more likely to get chilblains than men.
You are underweight. If you weigh about 20 percent less than is expected for your height, you have an increased risk of chilblains owing to a lesser fat/muscle insulation.
Environment and season. Chilblains are less likely in colder and drier areas because the living conditions and clothing are more protective against the cold. Your risk of getting a chilblain is higher if you live in areas with high humidity and colder but not freezing temperatures.
You suffer from poor circulation. People with poor circulation tend to be more sensitive to changes in temperature, making them more susceptible to chilblains.
You have Raynaud’s disease. People with Raynaud’s disease are more susceptible to chilblains. Either condition can result in skin sores, but Raynaud’s causes different types of color changes on the skin.
You suffer from an autoimmune disorder. Lupus (an autoimmune connective tissue disease) is the most common concurrence with chilblains.

Complications

Chilblains may cause complications if your skin blisters. If that happens, you may develop ulcers and infections. Besides being painful, an infection can get potentially life-threatening if left untreated. See a doctor if you suspect one. Be cautious and seek medical advice to check for complications if you are experiencing:

severe or recurring chilblains
chilblains that don’t improve within a few weeks
if you think your skin may have become infected, is swollen with pus forming in the affected area
you are running fever 38 °C (100.4 °F) or above
swollen glands
if your symptoms extend into the warm season

If you have diabetes or suffer from poor circulation, healing can get impaired. Be cautious and seek immediate care since foot issues can turn serious in diabetics.

Prevention

To prevent chilblains:

Avoid or limit your exposure to cold.
Dress in layers of loose clothing and wear mittens and warm, water-resistant footwear.
Cover all exposed skin as completely as possible when going out in cold weather.
Keep your hands, feet and face dry and warm.
Keep your home and workplace comfortably warm.
Don’t smoke. It can constrict your blood vessels and slow down wound healing.
Avoid caffeine, as it can affect the blood flow in your fingers and toes.
Do not scratch or pick at your skin.
Putting your feet or hands direct on a radiator or under hot water to warm them up is an absolute NO.

If your skin gets exposed to cold, it’s helpful to rewarm it gradually because sudden rewarming of cold skin may break your capillaries and worsen chilblains.

Lifestyle And Home Remedies

The best approach to chilblains is to avoid developing them. Chilblains usually clear up in one to three weeks after cold exposure. In the meantime, you can take steps to ease your signs and symptoms.

Rewarm affected skin gently, without massaging, rubbing or applying direct heat.
Avoid cold exposure whenever possible.
Keep the affected skin dry and warm but away from sources of heat.
Apply medicated lotions rich in vitamin E to alleviate itching.
Make sure to clean the affected skin with an antiseptic and gently bandage to prevent infection.
Avoid scratching.

Homoeopathic Treatment

Other than offering quick and gentle relief in the acute symptoms, long-term constitutional treatment with homoeopathic remedies can help completely resolve the tendency to have chilblains year after year. Once treated, patients report no recurrence.

Here are seven remedies that top my list of bringing a complete cure to many a cases of chilblains:

Agaricus – Helps in chilblains affecting feet, especially toes that feel frozen with a lot of itching and burning.
Petroleum – I’ve found it best for chilblains on hands and feet that burn, along with purple discoloration of your skin. The skin may be rough and cracked and feel dry, leathery, constricted and sensitive. Eruptions may ooze out a watery discharge.
Pulsatilla – Most indicated in chilblains affecting upper extremities. There is a lot of itching, swelling and pain over the hands and fingers. Symptoms get worse on heating up or when near a fire or a hot place. The skin becomes bluish in color. The remedy helps reduce inflammation and is most often indicated in young girls when the occurrence usually starts after puberty. Some menstrual disturbance may present along with the symptoms of chilblains.
Nitric Acid – Toes of the feet are primarily affected every time. Itching, swelling and painful inflammation tend to worsen at night/evening. Feet are prone to damp offensive sweat.
Rhus Tox – Mainly, I have used this remedy for chilblains with redness, swelling, vesication or blistering and painful itching. Symptoms are worse from getting wet and from cold.
Graphites – Eruptions that exude a thick, gooey and sticky fluid. Itching and roughness of the skin over the face, nose, ears and chin besides extremities. The remedy takes care of the enlarged and indurated lymph glands draining the area.
Lachesis: It works well on chilblains which tend to develop ulcers with a bluish-black or bluish-red discoloration on the skin. There is intense itching and burning sensation, more so during sleep.

Topically applying Calendula, Echinacea, Graphites or Petroleum ointments or adding a few drops of their Mother tincture in your favorite moisturizer or vaseline or vitamin E oil as per your physician’s advice can help speed up your recovery time.

Don’t let the cold and frosty winter dampen your skin health. Take care and welcome the New Year with healthy, supple and blain-free skin.