Have you noticed dark red to purple, painful skin patches on one or more of your toes? You may have a condition called Chilblains. Typically, these skin patches develop after exposure to damp cold but not freezing air. In normal circumstances, blood vessels dilate when warm and constrict when cold. Chilblains occur with repeated cold exposure, and the blood vessel do not shrink or enlarge with the change in environmental temperature. With rapid rewarming, blood rushes to the toes. The excess blood seeps out of narrow capillaries into the skin, causing inflammation. Increased blood in the skin leads to redness, itching, burning, swelling, and bumps on the skin. The patches start as red to purple bumps, and in some cases, they can blister and crust over. They usually last for 3 to 4 weeks or longer and resolve in warmer months. We see patients with the condition starting in early November to late April. Chilblains occur mainly on the toes, fingers and can even happen on the nose and ears. Anyone can get chilblains, but it is most common in women. Diagnosis involves a physical exam, and generally, a biopsy will not be required.
Risk Factors for Chilblains
Low body mass index, low body fat
Cold, damp environment, think Maine in the late fall and early spring
Smokers
Peripheral artery disease, poor circulation
Connective tissue diseases
To avoid Chilblains, always keep your feet warm and avoid going barefoot at home, especially in the winter months. Wear wool socks and avoid tight-fitting shoes in cold, damp environments. Drink hot herbal tea instead of coffee and mocktails instead of alcoholic beverages. Consider using foot warmers in your winter boots. If your feet get cold and damp, warm your feet gradually and avoid jumping into a hot shower.
Treating Chilblains at Home
If you are experiencing intense itching and burning, try these home remedies
Tylenol or ibuprofen for the pain
Moisturize with shea butter and L-arginine like Neuro-eze twice a day
Eat hot meals, drink hot tea
Light exercise to increase circulation
Invest in warm socks like Smart Wool hikers.
In severe cases, your primary care doctor may prescribe a calcium channel blocker like Nifedipine
If you are suffering from symptoms of Chilblains or have questions, Dr. Michele Kurlanski is here to help. We can evaluate your feet and recommend how to manage these symptoms. Same-day appointments are now available! Call us today at (207) 774-0028 to schedule your next appointment at our location in Scarborough, Maine!
