Chilblains
(Pernio; perniosis) |
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Information
for health professionals on
vasospastic
conditions |
What are
chilblains (pernio; perniosis): |
Chilblains
are a painful abnormal reaction of the small blood vessels in the
skin when exposed to cold temperatures. Chilblains usually occur
several hours after exposure to the cold in temperate humid climates.
The cold causes constriction of the small blood vessels in the skin
and if rewarming of the skin happens too rapidly, there is leakage
of blood into the tissues as the blood vessels do not respond quickly
enough to this rewarming. Chilblains are not very common in countries
where the cold is more extreme as the air is drier. The living conditions
and clothing used in these climates are protective. Chilblains are
more likely to develop in those with poor
circulation, but chilblains are still common in those with good
circulation. |
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What do
chilblains look and feel like: |
Chilblains appear as
small itchy, red areas on the skin. Chilblains become increasingly
painful as they get congested and take on a dark blue appearance.
They may also become swollen. As they dry out, chilblains leave
cracks in the skin so the risk of getting an infection increases.
Chilblains are common on the toes, but can also affect the fingers
and the face (especially the nose and ears). Chilblains are also
common on areas of the feet exposed to pressure, such as bunions
or where the toes are under pressure from tight shoes or where
there are corns and callus.
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Chilblains
start during the winter (when the weather gets colder) - the initial
symptoms include burning and itching in the area of the developing
chilblain. These symptoms are often intensified when going into
a warm room. There is often some swelling and redness. In many cases,
the skin over the chilblain can break down and becomes a sore (ulcer).
An infection may develop in the chilblain. |
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Chilblains often occur in some
people every year, for the rest of their lives. In other's, chilblains
occur for several years and then just stop occurring. The reason
for these patterns of occurrence of chilblains is not known. As
they are more common in females, there may be a hormonal influence
on the development of chilblains. |
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What causes
chilblains: |
Chilblains
are more common in those that are just more susceptible to them
- the reasons for this are not entirely clear. Factors that contribute
to tendency to chilblains include, a familial tendency, poor circulation,
anemia, poor nutrition, hormonal changes, some connective tissue
disorders and some bone marrow disorders. Damp living conditions
may also increase the risk for chilblains.
As a chilblain
is an abnormal reaction to cold, these factors above increase the
risk that it is going to happen. Chilblains occur when there is
too rapid a change from cold to hot, so the chilblains occur after
the foot is cold. Some people's circulation is so sensitive that
only small changes in temperature may be enough. A typical history
for the development of chilblains is after being outside in the
cold, the foot is placed next to a heat source (eg heater) when
coming back inside. The small blood vessels do not respond quickly
enough to the change in temperature |
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Chilblains
self treatment: |
Prevention
of chilblains:
Keeping
your feet warm is an important way to prevent chilblains - use trousers,
high top boots, tights, leg warmers and long, thick woollen socks.
If your feet do get cold, allow them to warm up slowly - do not
put them straight in front of a source of heat (this gives a chance
for the circulation to respond to the warming skin). Do not let
the feet become exposed to any source of direct heat (eg a heater),
especially if the foot is very cold - this is a common factor causing
chilblains. Use a chilblain cream like Akileine Akilwinter. Smoking also interferes with the circulation in the
small blood vessels and increases the risk of getting chilblains.
Once
a chilblain develops:
* do not
rub or scratch chilblains
* avoid
direct heat (ie do not expose the feet to a heater), but keep the
feet warm by the use of woollen socks and footwear
* use soothing
lotions (eg calamine lotion)
* if the
skin is broken, use an antiseptic dressing to prevent the chilblains
becoming infected
* those
with diabetes or poor
circulation should see a Podiatrist.
The risk of further complications from the chilblains in those with
a foot that is 'at risk' is too high to delay seeking professional
help
* thermal or insulating
insoles can help keep the foot warm to prevent chilblains
*
lanolin or a similar lotion that is rubbed into the feet
will help stimulate the circulation
* there
are a number of natural or homeopathic remedies that are recommended
for the treatment of chilblains. Some of these do appear to help
some people. |
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Podiatric
management of chilblains: |
Podiatrists
see a lot of people with chilblains in cold humid climates and can
give advice beyond what is listed above:
* padding
and pressure relief may give some relief for the chilblain symptoms
* topical
steroids may need to be used in case of very swollen severe chilblains
* corns
and callus are common in the pressure
areas where chilblains can occur, so reduction of these will give
some pain relief
* heparin
ointment may be used in some people to improve the circulation in
the area
* a course
of UV light at the start of winter in those prone to chilblains
has been recommended to help stimulate the circulation in the foot
* a very
rare occasions the chilblains may be a symptom of rare medical problems
(eg connective tissue disease or a bone marrow disorder) |
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Links of
relevance to chilblains: |
Find
a Podiatrist
Poor
circulation
Cold
foot
Foot
health forum
Foot
care products
ePodiatry's
database on vasospatic conditions
Recommended
books on foot care:
The
Little Foot Care Book
101
Foot Care Tips for those with Diabetes
The
Foot Book - Relief for Overused, Abused and Ailing feet
Natural
Foot Care: Herbal Blends and Soothing Treatments to Pamper Your
Feet |
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Buy products
to help chilblains and other foot problems: |
USA & Canada: |
UK & Europe: |
Australia & NZ: |
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ePodiatry
is purely a source of information on chilblains (pernio, perniosis)
and should at no time be considered as replacing the expertise of
a health professional. We recommend seeking professional advice
for chilblains (pernio, perniosis) and any foot problem before embarking
on any form of self treatment or management. Neither the content
or any other service provided through ePodiatry is intended to be
relied on for medical diagnosis or treatment. Do not delay in seeking
health professional advice for chilblains (perniosis) or any other
foot problem because of something seen on ePodiatry. |
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©2003.
The information contained on this page about chilblains (perniosis)
is subject to copyright. No part of the information about chilblains
(pernio, perniosis) contained on this page can be reproduced in
any form without the permission of ePodiatry. |
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Chilblains
(pernio, perniosis)
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