Chilblains – Symptoms and causes

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chilblains definition

We know that chilblains are small lesions which are caused by the inflammation of tiny blood vessels after the exposure of cold air. In many cases, they are painful and they tend to affect the skin on your hands and feet. Chilblains are also known as pernio. It can cause itchy and red patches, swelling and blistering on hands and feet. Usually, chilblains clear up within 1 – 3 weeks, especially if the weather gets warmer. Also you can have recurrence of chilblains seasonally for years. The treatment of chilblains includes using lotions to ease the symptoms and protecting yourself from the cold. Usually, chilblains are not resulting in permanent injury. The best way to avoid the development of chilblains is to cover the exposed skin, dress warmly and limit your exposure to cold. You should avoid or limit your exposure to cold in order to prevent chilblains [1]. When you are going outside in cold weather, you should cover all exposed skin as completely as possible. You should dress in layers of loose clothing and you should wear mittens and warm, water – resistant footwear. If your skin was exposed to cold, then you can re-warm it gradually because if you re-warm your cold skin suddenly can worsen chilblains.

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Symptoms

Here are the signs and symptoms of chilblains [2]:

  • Changes in skin color from red to dark blue, accompanied by pain
  • Burning sensation on your skin
  • Swelling of your skin
  • Possible blistering or skin ulcers
  • You can have small and itchy red areas on your skin, often on your feet or hands

In the most cases, chilblains will get better on their own. If your symptoms are not improving in a period of one to two weeks, if you suspect an infection or if the pain is unusually severe, then you should talk with your doctor as soon as possible. Also you should visit your doctor if the symptoms of chilblains extend into the warm season. If you have poor circulation or diabetes, then the healing may be impaired. This is a reason why you should be cautious and seek medical care.

Causes

It is not known the cause for chilblains. Chilblains can be an abnormal reaction of the body to cold exposure which is followed by re-warming. You should know that the re-warming of the cold skin can cause the small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle. This will result in a bottleneck effect and your blood will leak into the nearby tissues.

Risk factors

Here are some factors which can increase your risk of chilblains:

  • Having been diagnosed with Raynaud’s disease: It is known that those people are having Raynaud’s disease have increased risk of getting chilblains [2]. This condition can result in sores but the Raynaud’s disease is causing different types of color changes on the skin.
  • People with poor circulation: It is known that that those people who have poor circulation tend to be more sensitive to changes in temperature which is making them more susceptible to chilblains.
  • Environment and season: It is known fact that chilblains are less likely in colder and drier areas because the clothing and living conditions in these areas which are more protective against cold [1]. If you live in an area with high humidity and cold, but not freezing temperatures, then you have more chances of getting chilblains. Chilblains are most commonly happening from November to April.
  • Your sex and weight: It is known that women are having more chances of getting chilblains than males and children [3]. Also those people, who weight about 20% less than is expected for their height, are having increased risk of getting chilblains.
  • Clothing that is tight or exposes skin to the cold: If you are wearing tight – fitting clothes and shoes in cold and damp weather, then you have more chances of getting chilblains [4]. The skin which is exposed to cold and damp conditions is having more chances of getting chilblains.

Complications

If your skin blisters, then chilblains can cause complications. If this happens, then you can develop infections and ulcers [5]. Infections are painful and if they are left untreated, then they are potentially life – threatening. If you suspect an infection, then you should visit a doctor.

References:

[1] Singh GK, Datta A, Grewal RS, et al. Pattern of chilblains in a high altitude region of Ladakh, India. Medical Journal Armed Forces India. 2015;71(3):265–9.

[2] Padeh S, Gerstein M, Greenberger S, Berkun Y. Chronic chilblains: The clinical presentation and disease course in a large paediatric series. Clinical and Experimental Rheumatology. 2013;31(3).

[3] Winner AL, Cooper-Willis ES. Chillblains in servicewomen. The Lancet. 1946;248(6428):663-7.

[4] Gönül M, Keseroğlu HO, Kurmuş GI, et al. A case of pernio associated with cold agglutinin positivity in an unusual location. Journal of Dermatological Research and Therapy. 2016;1(2).

[5] Sedhu PA, Sugathan S, Pushpakaran A, Kurian C. Bacterial and fungal profile of infectious keratitis: A prospective study. International Journal of Scientific Study. 2017;5(8):128-32.

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