Chilblains

If your toes are looking red, puffy, or swollen, it does not necessarily mean that you have frostbite or trenchfoot.

What you may have is called chilblains, also known as pernio and perniosis. Chilblains are a tissue injury that happens when a person is exposed to cold and humidity. The cold causes damage to the capillary beds in the skin, which in turn causes inflammation, blisters, redness, and itching. Typically these acral ulcers (ulcers that affect the extremities) are not painful at first but can become painful.

Chilblains is usually idiopathic, but can also be a manifestation of a more serious medical condition. Those with a history of chilblains may have a connective tissue disease. In rare cases, chilblains, along with fevers and severe neurologic disease, in infants is a sign of Aicardi-Goutieres syndrome.

Signs of chilblains include blistering of the affected area, burning and itching sensation in the affected toe, dermatitis, digital ulceration, erythemia (blanchable redness of the skin), pain in affected area, and skin discoloration, from red to blue.

If seen by a podiatrist immediately, chilblains will heal within seven to 14 days. If left untreated, however, there is a risk of complication, including skin ulceration, cracked or broken skin, and infections.

Treatment for chilblains is non-invasive and typically involves keeping the area warm, applying a topical steroid cream, and even taking vitamin D and calcium supplements.

To prevent chilblains from recurring, make sure that when it is cold outside, you are dressed properly, with socks and enclosed shoes. Avoid tight fitting socks and shoes, which constrict the blood vessels. If you are susceptible to the cold, try to avoid going outside. When coming back in from outdoors, expose your feet gradually to the heat. Some people find putting wool between the toes improves their circulation, as does exercise.