Many health care providers can diagnosis chilblains just by looking at the affected area. They may want to run a blood test to rule out other conditions with similar symptoms, such as cold urticaria or vasculitis.
Chilblains are triggered by exposure to cold and damp weather. They are itchy, burning red patches that can blister and ulcerate. Treatment involves staying warm and taking certain medicines that soothe pain or itching. The is no quick way to get rid of chilblains, but the symptoms can be easily managed.
Medications
Painful, red, itchy blisters appear on parts of the body that are exposed to cold and damp conditions. They occur mostly on the hands and feet, but can also affect the ears, nose, or fingers. Chilblains are caused by damage to tiny blood vessels that cause leakage of blood into surrounding skin tissue. They can be difficult to treat, but with proper care the condition usually disappears within a week or two when temperatures warm up again.
Medications can help reduce the inflammation and irritation associated with chilblains. These medications include topical creams, prescription steroid lotions, and over-the-counter pain relievers like ibuprofen or acetaminophen. Avoiding exposure to cold and damp conditions, avoiding rapid changes in temperature, and slowly warming up the affected areas (by putting them under a blanket) can help prevent chilblains from occurring.
Some people, especially those with reduced blood circulation, may be at a higher risk for developing chilblains. They include women, children, and the elderly. People with lupus or other chronic inflammatory diseases, and those who suffer from certain genetic predispositions, such as a family history of chilblains, are also at increased risk. It is important to follow up with a healthcare provider if home treatments aren’t effective or if symptoms worsen or become infected. A simple physical exam and questions about recent exposure to cold weather can diagnose the condition. In rare cases, a doctor might want to run tests or take a biopsy of the affected skin in order to rule out other causes.
Topical Creams
A doctor may prescribe topical creams to ease pain, reduce redness, and protect skin. These medications are often formulated with urea or other substances that help improve skin texture and increase blood flow to the affected area. These medications are typically applied several times a day. If chilblains are recurrent, your doctor may prescribe a daily tablet or capsule called nifedipine (Adalat, Nifedical, Vectrol). This medication relaxes the blood vessels and increases circulation. It can also help prevent chilblains from developing.
You can also try emollients (ointments) to help relieve itching, swelling, and dryness. They are often formulated with ingredients such as lanolin, shea butter, and aloe vera. These products can be purchased from your local pharmacy or grocery store. You may find that your chilblains improve within a few days if you use the ointments regularly.
Chilblains are usually a minor health concern, but they can be serious if left untreated or if the area is exposed to cold weather again. You should see a health care provider if your chilblains do not go away after two weeks of home treatment or if they come back repeatedly during the winter.
Chilblains are most likely to occur when a person rapidly warms their hands or feet after exposure to cold temperatures, such as when they quickly move from cool outdoor air into the heat of an indoor space or by placing their hands and feet on a hot water bottle or heater.
Over-the-Counter Pain Relievers
Chilblains are usually easy to diagnose based on the symptoms and appearance of the affected skin. If the symptoms persist or if the skin becomes red, blistered or ulcerated, it is recommended that you see your healthcare professional for further assessment and treatment. Your healthcare provider will examine the affected area and ask you questions about your symptoms. They may also run a blood test or a biopsy to rule out other conditions with similar symptoms such as Raynaud’s phenomenon.
The most effective treatment for chilblains is at home care that includes gradually warming the hands and feet with lukewarm water, using warm clothing like wool socks, wearing protective footwear, and applying a soothing lotion. Over-the-counter pain relievers such as acetaminophen or ibuprofen can be used to help reduce discomfort. It is important to resist the urge to scratch as it can cause further irritation and lead to an infection.
Swelling (edema) occurs in about 80% of cases of chilblains and results from blood leakage from small vessels. It can cause the affected areas to feel tight and uncomfortable and worsens when the affected area is rewarmed or cold. Discoloration of the affected skin ranging from red to purple or blue is common and appears in about 65% of cases. It is caused by inflammation and blood leakage from the small blood vessels, and it typically affects the fingers, toes or ears. Numbness is experienced by about 30% of chilblains patients and occurs when the swelling compresses nerves.
Warming the Area
The itching that accompanies chilblains can be reduced by slowly warming up the extremities after exposure to cold. However, sudden temperature changes — such as immediately going inside after being outside in cold weather — can exacerbate the symptoms. Slowly warming the hands and feet by dipping them in warm, but not hot, water or placing them near a heater can help reduce itching. A light massage of the affected areas can also improve circulation and relieve itching. Moisturizing creams should be applied often to keep the skin hydrated and prevent dryness, which can worsen chilblains.
In most cases, chilblains will clear up within a few weeks without the need for medical care. However, if the skin breaks open and becomes infected, antibiotics may be needed. In rare instances, minor surgical interventions may be needed to drain fluid or remove damaged tissue.
Chilblains can be prevented by limiting time spent in cold environments and wearing loose-fitting clothes that cover the hands and feet. The use of mittens, a scarf and hat and warm footwear that fits well can also help. Adding omega-3 fatty acids (found in fish and chia seeds) to the diet may also support healthy blood vessels, potentially reducing the risk of developing chilblains. Seeing a healthcare provider for an evaluation is recommended if chilblains appear, especially in people who have underlying conditions that increase the risk of developing them.