What is Chilblains?
Chilblains, also known as perniosis, pernio and blain when they occur in your feet, are a painful and abnormal reaction of your skin to the cold and humidity. They’re considered as acral ulcers, which are ulcers that happen to your extremities, which include your hands, feet and earlobes.
There is a common misconception that chilblains only happen to the elderly, and although the elderly are more prone to developing chilblains, they can happen to anyone at any age, and is in fact very common. It’s been reported that 1 in 10 people in the United Kingdom develop chilblains during colder weathers. It’s also often confused with other cold-related medical conditions such as trench foot and frostbite. While there are many factors that may cause chilblains, its exact cause is unknown.
Symptoms and Causes
Chilblains are itchy, painful, red swellings on your skin. You may also feel a burning sensation on these areas, and they may become sensitive and tender. They usually appear hours after your exposure to above-cold freezing temperatures. They become increasingly painful and eventually turn from red to a dark blue or purple color. They usually happen in groups, so expect to find chilblains spread out in more than one place.
Chilblains usually occur in your feet usually on the areas exposed to the most pressure , but you may also find them in your earlobes, hands, nose and other extremities. In some cases, chilblains may occur in your thighs, heel and lower legs.
While the exact cause of chilblains is unknown as it is mostly considered an abnormal reaction to the cold. It is generally agreed that chilblains are caused by the constricting effect of cold temperatures to your skin, which causes blood flow to your skin areas to slow down. When your skin warms up, some fluid from your blood vessels (which have not responded quickly enough to this change of temperature) leak to your skin tissue, which somehow causes your skin to be irritated and inflamed. Some medications may also have the side effect of constricting your blood vessels, which may also cause chilblains.
Chilblains are also thought to be caused by poor circulation in our bodies, although they still occur in otherwise very healthy people. Sudden changes in temperature are also thought to cause chilblains. For example, going to warm yourself by a fire immediately after coming in from the cold outdoors.
There are also some factors for people to be more susceptible to chilblains than others. Those with poor nutrition, anemia, connective tissue disorders and bone marrow disorders may develop chilblains as a direct or indirect result of their condition. Hormonal changes, diabetes, smoking, or hereditary factors may also play a part in your susceptibility in developing chilblains. Some people have reported to regularly develop chilblains during the colder months of the year.
Chilblains usually lasts around four to seventeen days. Other than the irritation and pain that comes along with them, they can be very inconvenient and may get in the way in your everyday activities, especially if chilblains appear in your feet and hands.
If not treated properly, chilblains can cause breaks in your skin which may develop into sores or ulcers, which in turn may become infected.
How to Get Rid of It
Keep them warm. Once you’ve observed that you have developed chilblains, your first step is to keep the affected parts, padding them with thick gloves, muffs or socks, whatever is appropriate. However, keep in mind that you should not expose the affected parts to extreme and direct heat, such as pressing affected feet onto a hot-water bottle, or sitting too close to a fire without any socks or insulation on. Chilblains make your skin extremely sensitive and irritable, so putting on padding to act as insulation is the best thing you can do to keep them warm and protecting them from shifting temperatures. Keep indoors and stay away from cold weather if you can.
If you do come in from a cold environment, warm up your extremities slowly by alternately putting them in warm water and then in cold water. You can also try rubbing your wrists together to encourage stimulation in your hands.
Avoid scratching. Scratching may cause your skin to break and it may cause infection. The more you resist scratching your chilblains, the sooner it will go away.
Soothing creams. You may use cooling and astringent solutions such as calamine, burrows and witch hazel in the early stages of chilblains, when it is pink in color. When your chilblains has progressed to a blue or purple color, you may use rubefacients such as Hiduroid and Lasonil, but do not use these when the skin is broken. If the skin has been broken, make sure to consult with a podiatrist or physician before taking any sort of medication
Steroid creams can also help reduce the itch and soreness of your chilblains. Lanolin or similar lotions and heparin or Zambuk ointment may also be applied to help the circulation throughout the area.
Padding and thermal insoles. Remember that chilblains usually develop on areas that are exposed to the most pressure, especially in your feet. Padding and other forms of pressure relief may be given to you to help cope with chilblain’s symptoms.
Dressings. If your chilblains have broken your skin, make sure to apply antiseptic dressings on the area to ensure that it doesn’t get infected.
For recurring cases, certain medications are used to prevent chilblains. A drug called nifedipine dilates small blood vessels which helps prevent chilblains from developing. Diltiazem, a calcium channel blocker. Like nifedipine, it is a vasodilator, which means that it contains a chemical that relaxes the smooth muscles in our bodies.
If chilblains are caused by diabetes, or the more serious tissue or bone marrow disorders should consult with their doctor for treatment options open for these conditions.
Natural treatments. You can also opt for herbal remedies that have been reported to be effective in treating chilblains. Gingko biloba, an herb used in traditional Chinese medicine improves blood flow and the functioning of the circulatory system. Ginger also acts as a circulatory stimulant and has anti-inflammatory properties. Rosemary is known to dilate and strengthen our body’s blood vessels.
Prevention
Chilblains is relatively easy to prevent, and to save yourself from days of unnecessary pain, here are some tips:
Keep yourself insulated. Wear proper clothing to keep you warm and insulated when you are going out in cold weather. Extra jackets, wool socks, scarves and muffs are your best friend, so keep them at hand in chilly weather!
Exercise. Traditional advice is to exercise before going out in the cold. Supposedly this will encourage circulation throughout your body. There is no clear evidence if this is true, but it doesn’t hurt to try. Exercise is good for your body’s circulatory system, and will be helpful in the long run.
Gradually warm up. Chilblains occur when you change from a cold environment to a warm one too quickly. Try the alternating cold and hot water treatment mentioned above. You can also dip your hands and feet in warm water and then drying them before going out in cold weather. Before going in baths, check with your elbows if the temperature is not extremely hot or extremely cold.
Drug side effect. Some drugs, like heart medicine beta-blockers, may have a side effect of constricting tiny blood vessels, which may cause chilblains. Consult with your doctor if you have observed developing chilblains since taking any particular medication.
Quit smoking! Smoking has been shown to cause your blood vessels to constrict, making you more likely to get chilblains. Not only will quitting smoking lessen the likelihood of developing chilblains, it has other health benefits as well.
Healthy, low-fat diet will help your body’s circulation, as well as high doses of Vitamin K, which is important for healthy blood. Food that will help with your body’s circulation is also recommended in preventing chilblains.
Get good-fitting shoes. Wearing ill-fitting shoes may cause your feet to be always sore. Damaged skin may make you more vulnerable to developing chilblains.
Remember, it is not merely cold weather that causes chilblains. Your body needs enough time to get used from one temperature to another. Doing this as well as wearing the appropriate clothing in cold weather will help you in the long run from avoiding chilblains.
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