Chilblains are lesions which develop on the skin as a result of cold conditions. The fingers, toes and face are usually affected. They take the form of red or purple nodules and can be painful to touch, as well as itchy.
- Caused by exposure to cold weather
- Poor circulation can exacerbate chilblains
- Treated by keeping the area warm
If you would like to speak to a doctor about chilblains, you can use our online video consultation service. Our GMC-registered clinicians can issue advice about how to manage and tackle symptoms, as well as provide prescriptions, referrals to specialists and information about treatment. They are available between 9.30am-4.30pm, Monday to Friday.
What causes chilblains?
Chilblains are an abnormal reaction to cold conditions; this is why the extremities are usually the most affected areas. The ears, nose, fingers and toes are more likely to develop chilblains, but it’s also possible to develop them on the heels, lower legs and thighs.
Why some people are more prone to developing chilblains than others isn’t clear, but there are some known risk factors, such as a family history of the condition, malnutrition and peripheral vascular disease (a blood circulation disorder where the vessels near the heart narrow).
Chilblains happen when blood vessels beneath the skin narrow due to the cold, which in turn slows blood supply to the extremities. Once the warmth returns to these areas, fluid from the vessels is then leaked into the tissues, which is thought to cause the characteristic inflammation and swelling. The speed at which warmth returns to the extremities also appears to have an impact on the process; for example, warming cold hands by the fire.
In most cases, chilblains do not occur as a result of another condition, but sometimes there may be an underlying secondary condition that causes them. Lupus can sometimes lead to chilblains, as can haematological conditions such as malignancy.
Diagnosing the cause of chilblains
In order to diagnose the cause of chilblains, doctors typically take into account your medical history, and conduct a simple examination before taking some tests (although this is uncommon).
A doctor will ask how recently you have been exposed to the cold, and the length of the exposure. You might be asked to describe the symptoms, in terms of how quickly the nodules formed and where on the body they formed. Aside from the chilblain symptoms, a doctor will also want to know whether any other symptoms have occurred concurrently, such as a rash or weight loss. Questions about your family history, and whether you have previously had episodes of lesions on the skin, are usually posed.
Following questions about the condition, a doctor will look at the chilblains, and clinically assess whether the nodules on the skin are the right colour and shape. They will then try to identify any indications of an underlying cause, such as peripheral vascular disease, which involves a simple pulse check. Indications of lupus or diabetes may also factor into their assessment.
Further investigation is not necessary, in most cases. If a doctor remains uncertain having completed their review, you may be referred to a dermatologist.
If you have symptoms of chilblains and would like to speak to a doctor about a possible diagnosis, you can use our online video consultation service. Our clinicians are available for consultation between 9.30am-4.30pm, five days a week.
How are chilblains treated?
Chilblains do not usually require any pharmacological treatment, provided that they are idiopathic, which means they are not caused by any other underlying condition.
If this is the case, there are only simple self-care measures that can be taken in order to allow the chilblains to go by themselves. It usually takes between 2-3 weeks for them to disappear, during which period it is advisable to try and keep the affected areas warm and gradually apply heat if they get cold. It may also help to stop smoking, as this can make chilblains worse.
It was previously thought to be beneficial to take steroid creams or other lotions, but this has since been disproven. Other drug treatments that can cause the blood vessels to narrow should also be avoided.
There is a medication called nifedipine that can be used to open small blood vessels to allow the blood to pass more easily, if the chilblains are taking a long time to heal. However, it is not usually recommended as it may come with side effects, and the chilblains will disappear without the need for taking this treatment.
It’s important to keep your extremities warm whenever possible if you are being exposed to cold weather. If chilblains become a recurrent problem, it may be advisable to get specially heated gloves or a sock. Keeping the chilblains dry will also prevent further pain or itchiness.
Chilblains can be uncomfortable, and may cause some distress if they are particularly painful or itchy, but they will usually pass on their own. If you are worried about symptoms of chilblains, you can use our online video consultation service. One of our GPhC-registered clinicians will be able to speak with you between 9.30am-4.30pm, five days a week. They can advise you on your symptoms and treatment, and issue referrals to specialists and prescriptions, where appropriate.
How long is it normal to have chilblains for?
If they are idiopathic, acute chilblains usually last for around 2-3 weeks. If there is an underlying condition, this needs to be treated first before they will clear up.
Are chilblains serious?
Chilblains are not usually serious, and do not last for longer than 2-3 weeks, but it is possible to have chronic chilblains that are more long-term. In this case, a doctor will refer you to a specialist if no underlying cause can be identified. You may also be prescribed nifedipine.
Can I get treatment for chilblains?
In most cases, there is no pharmacological treatment for chilblains, and they pass without any need for medication. However, a doctor may decide to prescribe nifedipine if the symptoms persist and having not determined what the underlying cause is.
How can I prevent chilblains?
There are several self-care measures that can be taken to help prevent chilblains.
You should aim to keep your extremities warm during cold weather by wearing thick gloves and socks. It’s also important not to subject the skin to heat soon after having been out in the cold. Warm the skin more gradually.
Can I speak to a doctor about chilblains?
If you have symptoms of chilblains and have been exposed to cold conditions, you may want to speak to a clinician via our online video consultation service between 9.30am-4.30pm, Monday to Friday. Our clinicians can discuss treatment options, and provide referrals to specialists and prescriptions, where required.