Chilblains in winter: taking steps to prevent these itchy sore patches
At this time of year, our Ontario weather can be changeable, veering from above freezing and wet to serious cold and deep snow. So whilst you may be aware of the need to be covered up from the severe cold to avoid frostbite, it’s worth keeping covered up in milder conditions too, to prevent chilblains.
Chilblains are caused by skin being exposed to damp air that is cold but not freezing. Chilblains (perniosis) often show up hours after you’ve come in out of the cold air as swollen, inflamed patches of skin on your hands, feet and sometimes nose and ears. These patches are often itchy, and may blister. Your toes may also swell, and be painful or stinging, and even change colour.
The good news is that chilblains usually fade away in a couple of weeks. If they don’t or you have any concerns, or have diabetes, always consult your doctor.
Chilblains: from cold to hot
The exact trigger for chilblains isn’t known, but they are a reaction to your body being cold and then rewarmed. Cold air makes small blood vessels near your skin surface to constrict, reducing the flow of oxygenated blood to your feet and toes. The reverse happens when you rewarm your feet. If your feet are warmed too quickly, the smaller blood vessels rapidly expand, which the larger blood vessels may not be able to adjust to, causing pain and swelling.
That’s why you should never warm hands and feet on a heater or run them under hot water when you get back inside. (Similar advice applies if you think you might have frostbite – see our frostbite prevention article here). Also avoid caffeinated drinks after coming inside, as these can affect your blood flow. (3)
Chilblain risk factors
Risk factors in developing chilblains include wearing shoes that are tight on your foot when it is both cold and damp. Your risk is also higher if you have a low Body Mass Index (BMI), are female and aged 15-30, smoke, or have certain medical conditions. Getting chilblains are more problematic if you have diabetes, as any sores and blisters that may develop make your skin more vulnerable to infection.
Chilblain prevention
As with so many foot conditions, prevention is based on keeping your feet warm, dry and wearing comfortable, well-fitted shoes or boots. Shoes or boots that are too tight can cause many problems, chilblains being just one.
Dry feet are usually more healthy feet. As we have said many times before, always swap soggy / sweaty socks for a new clean, dry pair as soon as possible, and also wash and carefully dry your feet. Your outside shoes or boots need to have room for a warm pair of shoes and still not be too tight.
If you find your footwear is the right size but is not comfortable to actually walk in, you may have a problem with your gait (walking). Our team specialise in helping people walk better by creating custom moulded orthotics. This simply slip into shoes and boots, to restore the correct balance and gait. For more details, see our orthotics page (link) or contact us for an appointment.
Chilblains and Raynaud’s Phenomenon
Raynaud’s Phenomenon is a circulation disorder that affects fingers and toes. Both chilblains and Raynaud’s may cause toes and fingers to change colour, but:
“When a person has Raynaud’s phenomenon, exposure to cold abnormally reduces blood circulation, causing the skin to become pale, waxy-white or purple. The disorder is sometimes called “white finger,” “wax finger,” or “dead finger.” (4)
Raynaud’s in the hands is also associated with workplace exposures including vibration, and the resulting “hand-arm vibration syndrome.” It can also occur in professional who experienced repeated finger stress, from pianists to dentists. For more details, see this government site. If you think you have Raynaud’s, consult your doctor as soon as possible.
Expert care at one of our three Ontario foot clinics
if you have any concerns about the health of your foot or ankle, have foot pain, or have a sports injury, make an appointment at one of our three Hunt Footcare clinics.
About the author
J.Craig Hunt D.Ch. is founder of Hunt Footcare, one of Southwestern Ontario’s longest providers of professional footcare and foot surgery consultation services. He is Past President of both the College of Chiropodists of Ontario and the Ontario Society of Chiropodists. Read more about Craig here:
SOURCES:
(1) Mayo Clinic. (n.d.). Chilblains. https://www.mayoclinic.org/diseases-conditions/chilblains/symptoms-causes/syc-20351097
(2) Cleveland Clinic. (n.d.). Chilblains (pernio). https://my.clevelandclinic.org/health/diseases/21817-chilblains-pernio
(3) NHS. (n.d.). Chilblains. https://www.nhs.uk/conditions/chilblains/
(4) Canadian Centre for Occupational Health and Safety. (n.d.). Raynaud’s phenomenon. https://www.ccohs.ca/oshanswers/diseases/raynaud.html
