/ Ever heard of Raynauds Syndrome?/chilblains

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hilblains 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

http://www.epodiatry.com/poor-circulation.htm>, but chilblains are

still common in those with good circulation.

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

http://www.epodiatry.com/bunion.htm> or where the toes are under

pressure from tight shoes or where there are corns

http://www.epodiatry.com/corns-callus.htm> and callus

http://www.epodiatry.com/corns-callus.htm>.

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.

chilblains pernio perniosis picture

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.

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

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.

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 http://www.epodiatry.com/diabetic-foot.htm> or

poor circulation http://www.epodiatry.com/poor-circulation.htm> should

see a Podiatrist http://www.epodiatry.com/clinics.htm>. 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.

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 http://www.epodiatry.com/corns-callus.htm> and callus

http://www.epodiatry.com/corns-callus.htm> 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)

Links of relevance to chilblains:

Find a Podiatrist http://www.epodiatry.com/clinics.htm>

Poor circulation http://www.epodiatry.com/poor-circulation.htm>

Cold foot http://www.epodiatry.com/cold-feet.htm>

Foot health forum

http://boardserver.superstats.com/list.html?u=epodiatry&f=1>

Foot care products http://www.epodiatry.com/purchase.htm>

ePodiatry's database on vasospatic conditions

http://www.epodiatry.com/education_sub3.asp?topic=Peripheral%20vascular%20disea\

se&sub1=Learning%20resources&sub2=Vasospastic%20conditions>

*Recommended books on foot care:*

The Little Foot Care Book

http://www.epodiatry.com/little-foot-care-book.asp>

101 Foot Care Tips for those with Diabetes

http://www.epodiatry.com/101-footcare-tips-diabetes.asp>

The Foot Book - Relief for Overused, Abused and Ailing feet

http://www.epodiatry.com/the-foot-book.asp>

Natural Foot Care: Herbal Blends and Soothing Treatments to Pamper Your

Feet http://www.epodiatry.com/ePodiatry-NaturalFootCare.asp>

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