Chilblains, or perniosis, is an inflammatory injury caused by lengthy exposure to extremely cold temperatures and damp conditions. Although the injury doesn’t cause permanent damage, it can cause swollen skin and sometimes painful blisters.
Some people are more prone to chilblains, like women, those who are underweight, and those who have Raynaud’s syndrome. If a person has Raynauld’s, then they may have blood vessels that constrict excessively and decrease blood supply—especially in the extremities. This is a normal body response to conserve heat, but those with Raynaud’s may have an exaggerated response in lower temperatures.
If a person has a mild case of chilblains, he or she may just have swollen skin that is itchy, hot, or red. Longer exposure to cold temperatures can cause the skin to go numb or feel prickly. Bumps can form after a person gets warm again. These bumps can also develop into blisters, and in severe cases, ulcers.
Chilblains occur when the skin is exposed to cold temperatures before being rapidly warmed up again. During low temperatures, tiny blood vessels in the skin begin to constrict in order to help the body to stay warm. When the skin warms up again, the tiny blood vessels suddenly dilate again much faster than the larger blood vessels nearby can cope with. This creates a bottleneck effect and can cause blood to leak into tissues beneath the skin.
The effects of the cold on blood vessels can be exacerbated when clothing is too tight, as this can further restrict circulation. Wearing tightly-fitted clothes in cold or damp weather often leads to chilblains. Damp clothing that sits on the skin for a long period of time can also cause chilblains.
Since chilblains are linked to our circulatory system, individuals with poor circulation tend to develop chilblains more easily than others. It’s also known that people with Raynaud’s disease are more susceptible to chilblains.
To stop chilblains from getting worse, a person should get in a warm, dry environment. He or she then needs to remove any cold, wet, or tight clothing and change into warm loose layers. The injury should be gently washed and dried.
If blisters have formed, then they should be covered with an ointment and bandaged. A person should avoid popping a blister since the fluid keeps the skin underneath clean from infection. However, if the blister is incredibly painful or in an incovenient location (e.g. around thumb), then it can be drained with a sterlized razor blade and needle. Then it should be washed, treated with an antibiotic ointment, and bandaged every day until it gets better. Symptoms for chilblains are usually gone in a few days to a few weeks.
To prevent chilblains, it’s important to protect the extremities of the body from extreme exposure to the cold. Wear gloves to protect the hands and fingers, hats and scarves to protect the head and ears, and thick socks with sturdy, closed-toe shoes to protect the feet.
It is often better to wear multiple loose layers of clothing rather than single, thick items. This is because the air in between layers will trap heat and keep the body warm. Avoid wearing items which fit very close to the body, particularly around the wrists and ankles, as this could further constrict circulation.
Staying dry is incredibly important, so have a change of clothes available if you are likely to get wet. Change wet clothing as soon as possible, making sure to gently dry the skin first.
Avoid plunging cold or damp skin into hot water or applying other sources of intense heat to the skin. Instead, warm the skin gradually to allow blood vessels to dilate at a more gradual rate.