Condition Spotlight: Chilblains

close up of toes that have chilblains

Winter is well and truly upon us – and unfortunately, chilblains tend to tag along for the ride.

Though we tend to keep our feet rugged up and protected during the colder months, as we dive deeper into the winter months in Melbourne, it’s important that we must continue to look after our feet.

Many people would have heard of chilblains but are unsure of what they actually are and assume they are associated with frostbite.  During COVID, people were not as active as usual or did not have the same amount of incidental activity as they, like walking to meetings or the printer.

 

What are chilblains?

Chilblains can be defined as a vasospastic condition – ‘vaso’ meaning blood vessel and ‘spastic’ meaning erratic and inconsistent.

The peripheries, known as our fingers and toes, are the areas affected by chilblains.  This is because they are the furthest structures from the heart.  Chilblains are less common on the nose and earlobes.

Chilblains are discoloured patches on the skin on the tips of the toes or the fingers.

The patches will appear white during the initial stages due to the constriction of the blood vessels (vasoconstriction).

Next, they will appear red or purple, as the vessels return blood to the area (vasodilation) at a delayed rate.

Finally, the patches may become a blue colour due to an extended period of vasodilation.  In some cases, these patches may form sores or blisters, which can become quite painful or itchy, and take a while to heal.

 

What do chilblains feel like?

Someone suffering from chilblains will often state that their toes feel extremely cold or numb initially.

They may become itchy or painful, as the blood vessels begin to dilate, and the sensation may change to more of a burning feeling.

 

Who do chilblains affect?

Usually, children and the elderly are at risk of chilblains, which are essentially a cold injury.

Chilblains can also affect those who are constantly exposed to cooler temperatures.  This is because they tend to try to warm themselves up quickly.

People with poor circulation or a family history of chilblains are also at risk.

Conditions such as Lupus and Raynaud’s Phenomenon can also predispose a person to developing chilblains.

 

How are chilblains diagnosed?

Chilblains are diagnosed based on history taking and visual assessment of the painful site.

Further testing is generally not required, however, we may perform a basic vascular assessment to determine whether this could be causing chilblains.  This includes feelings for the pulses in your feet and assessing them using a doppler ultrasound machine.

 

How can chilblains be treated?

There are lots of different treatment options available for chilblains.

In most cases, management of chilblains focuses on keeping your feet and hands warm and avoiding dramatic changes in temperature so as not to disturb blood flow too much.

Some of these treatments include:

  • Topical preparations such as witch hazel, peppermint oil, Vick’s vaporub and McGloin’s chilblains cream can be applied to the affected areas
  • Wearing warm socks and gloves whilst outside during winter
  • Making sure that socks are quite thick when walking out in the cold and ensuring the shoes do not get wet on the inside. Ensure that your feet still fit well into your shoes when wearing thicker socks. If your shoes are too small for your socks, the blood flow to your feet could be further constricted and make the problem much worse.
  • Putting on socks or slippers when getting up in the middle of the night.
  • Wearing socks when going to bed.
  • Avoid putting your feet and hands close to the fire or the central heating vent to warm them up.
  • If the chilblain lesions do blister and break open, it is extremely important to prevent infection by appropriate dressing and ensuring the area is clean. Keeping them protected with a bandaid until you come and see us will help to avoid infection and further pain. 

If you’re suffering from chilblains or experiencing any pain or discomfort in your feet or lower limbs, book in to see us at Watsonia Podiatry.  We can help get your feet working properly! Call 03 9432 2689 or book online here.

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