What are Chilblains   by Craig Payne

in Health / Diseases and Conditions    (submitted 2010-08-13)

Chilblains are a painful reaction that generally occurs on the toes in response to changes in temperature. While they mostly affect the toes, the can affect the fingers, ears and nose. They are more common in colder climates, but are not really caused by the cold as such. Normally when the we get cold, the blood vessels constrict to conserve body heat. When we get warm, the blood vessels open up to help cool the body. What happens in a chilblain is that the toe gets cold, so the blood vessels constrict, but when the foot warms up, the blood vessels do not open as required. This means that waste products accumulate in the skin as there is no blood supply to remove them. This accumulation of waste products initiate an inflammatory response. Eventually the circulation responds to the warmer temperature, but the inflammatory response has already done some damage. So, the cold is not really the cause, the cause is the poor response of the circulation to the warming after the foot has got cold. Poor circulation is also not the cause as they are relatively common in younger people with great circulation; the cause is how the circulation responds to the changes in temperature.

The classic appearance of a chilblain is a red and itchy patch on the toe. This soon becomes blue/black in colour. Sometimes there may be a break in the skin. The most satisfactory treatment is some gentle rubbing of the area to stimulate the circulation. Antiseptics should be used if the skin is broken. Probably the most important is to keep the foot warm and not let it get cold. If the foot gets cold, then it must be warmed by very slowly. Putting a cold foot in front of a heater to warm it, is going to cause a chilblain in those who are vulnerable. Prevention is by keep the foot foot warm and not letting it get cold.

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