Chilblains (Pernio): Symptoms, Causes, Treatment

What are the symptoms of chilblains (pernio)?

Chilblains, also known as pernio or perniosis, are a skin condition that occurs in response to repeated exposure to cold, damp conditions. The symptoms of chilblains typically include:

1. Redness: The affected area of skin may appear red or purplish.
2. Swelling: The skin may become swollen, especially around the toes, fingers, heels, or other extremities.
3. Itching: The affected skin may itch or burn.
4. Blisters: In severe cases, chilblains can cause blisters or ulcers to form on the skin.
5. Skin changes: The skin may feel hot to the touch and can sometimes become hard or shiny.
6. Pain or tenderness: The affected area may be painful or tender, especially when pressure is applied.

Chilblains typically occur on the extremities, such as the toes, fingers, heels, or ears, and usually develop a few hours after exposure to cold, damp conditions. The symptoms can be uncomfortable but usually improve on their own within a few weeks once the affected skin has warmed up.

In some cases, chilblains can lead to complications such as infection, especially if the skin becomes broken or ulcerated. It’s important to protect the skin from further exposure to cold and damp conditions and to seek medical attention if you experience severe or persistent symptoms.

What are the causes of chilblains?

Chilblains, also known as pernio or perniosis, are caused by an abnormal skin response to cold temperatures. When the skin is exposed to cold and then rapidly warmed, small blood vessels near the surface of the skin may become inflamed, leading to the characteristic symptoms of chilblains.

Several factors can contribute to the development of chilblains:

1. Cold exposure: Chilblains are most common in cold, damp environments. Exposure to cold temperatures, especially when the skin is not properly insulated or protected, can increase the risk of chilblains.
2. Poor circulation: People with poor circulation, such as those with peripheral artery disease or Raynaud’s phenomenon, may be more susceptible to chilblains.
3. Humidity: High humidity levels combined with cold temperatures can increase the risk of chilblains.
4. Tight clothing: Wearing tight or constrictive clothing and shoes can restrict blood flow to the extremities, increasing the risk of chilblains.
5. Individual susceptibility: Some people may be more prone to developing chilblains due to individual differences in skin sensitivity and response to cold.

Chilblains are more common in women, children, and older adults. Certain medical conditions, such as lupus, may also increase the risk of developing chilblains.

What is the treatment for chilblains?

Treatment for chilblains focuses on relieving symptoms and preventing complications. Here are some common approaches:

1. Warming the affected area: Gradually warming the affected skin can help alleviate symptoms. Avoid sudden temperature changes, as this can worsen symptoms.
2. Avoiding further cold exposure: Protect the affected areas from cold and damp conditions to prevent additional irritation.
3. Topical corticosteroids: A mild corticosteroid cream or ointment may be prescribed to reduce inflammation and itching.
4. Calamine lotion: Applying calamine lotion to the affected area can help soothe itching and discomfort.
5. Avoiding tight clothing: Wearing loose, comfortable clothing and shoes can help improve circulation to the affected areas.
6. Elevating the affected area: Keeping the affected area elevated can help reduce swelling and improve circulation.
7. Moisturizing: Regularly moisturizing the skin can help prevent dryness and cracking, which can worsen symptoms.

In severe cases or if complications such as infection occur, a healthcare provider may recommend additional treatments, such as oral corticosteroids, antibiotics (if infection is present), or vasodilator medications to improve blood flow to the affected areas.

It’s important to seek medical advice if you suspect you have chilblains, especially if you have diabetes or a condition that affects circulation, as complications can occur. A healthcare provider can provide guidance on the best treatment approach for your individual situation.

Is chilblains the same as Raynaud’s?

Chilblains and Raynaud’s phenomenon are related conditions, but they are not the same. Both conditions involve abnormal responses to cold temperatures, but they affect the body in different ways.

Chilblains, also known as pernio or perniosis, are small, itchy or painful red or purple bumps that occur on the skin, usually on the fingers, toes, heels, or other areas exposed to cold and damp conditions. Chilblains occur when the skin is exposed to cold and then rapidly warmed, leading to inflammation of the small blood vessels near the surface of the skin.

Raynaud’s phenomenon is a condition in which the blood vessels in the fingers, toes, ears, or nose constrict in response to cold or stress, leading to reduced blood flow to these areas. This can cause the affected areas to turn white or blue, and may be accompanied by numbness, tingling, or pain. Once the affected areas warm up or the stress is relieved, the blood flow typically returns to normal and the skin color returns to normal.

While both chilblains and Raynaud’s phenomenon involve abnormal responses to cold, they are distinct conditions with different symptoms and underlying mechanisms. People with Raynaud’s phenomenon may be more prone to developing chilblains, but not everyone with Raynaud’s will develop chilblains, and vice versa.