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Chillblains

We're certainly in the heart of Winter, and even though we try to keep warm in our Ugg boots or slippers, our feet still may be cold or feel 'numb'. This may lead to red, itchy, painful spots on our toes. In the world of feet, this is known as Chilblains and is one of the most common conditions we see in Winter. 

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What is a chilblain? 

A chilblain usually appears on the tips of the toes or other extremities, including fingers, ears, and the nose. Chilblains appear as a 'red spot'. It may be itchy or extremely painful. This occurs due to the constriction of vessels in extremities due to extreme temperatures from cold to hot a short period. 

There are four stages of Chilblains:

Stage 1. The initial stage often goes unnoticed and may appear red due to vasoconstriction within the vessels.

Stage 2. Hyperaemic stage – symptoms include Painful, red, hot, burning and itchiness. 

Stage 3. Congestive/cyanotic stage – Swollen and cyanotic. It may resolve or ulcerate at this stage ( Week 2-3).

Stage 4. Ulcerative stage – Skin is broken, may be at risk of infection. 

 

What to look out for? 

  • Discolouration of the skin, small painful red spots 
  • Red, itchy bumps
  • Burning sensation of the affected area 
  • Changes in skin colour – Blue, purple or red. 

Symptoms may last between 1-3 weeks. The bad news is they're painful and annoying. The good news is that they generally resolve on their own and don't result in long-standing conditions. 

 

Can chilblains be prevented? 

Yes, it is preventable; there are numerous ways this Winter to reduce the risk of Chilblains; some may include

  • Avoiding extreme temperatures. Going from a cold environment to a hot environment, e.g. Jumping into a boiling shower when your feet are very cold. 
  • Wearing Merino blend socks or bamboo and thick socks 
  • Ensure feet are dried well after a shower 
  • Wearing appropriate footwear, e.g. not wearing thongs in Winter. Wearing enclosed shoes. 
  • Exercise – encouraging movement to keep blood flowing to the feet
  • Using Akliene (Cold feet crème) helps prevent skin damage from cold weather. It moistens the skin and helps your skin feel hydrated again. Once the Chilblain has healed, a Podiatrist can safely use a sterile blade to clean the hard skin around the toe. 

Tip: If a Chilblain does appear, ensure you rewarm the skin gently. Don't put your feet directly in hot water or in front of a heater to warm up quickly!

 

Who is at risk of Chilblains? 

  • Older adults or people with a sedentary lifestyle 
  • Family history of Chilblains
  • Having feet exposed in colder months with inappropriate footwear
  • Patients with uncontrolled diabetes and compromised blood flow to feet
  • Patients with Peripheral Vascular Disease – Reduced blood flow to feet
  • Underweight females 
  • Smoking 
  • Raynaud's disease 
  • Tight-fitting clothes or footwear which is restricting blood flow 

Treatment options 

Depending on the stage of the Chilblain, your treatment plan may vary. 

  • Initial stages: See your Podiatrist for a professional opinion, and rewarm skin gently. Do not put direct heat on feet, i.e into boiling water or in front of a heater. 
  • Resist the urge to scratch your toe. This will help prevent further damage to the region and prevent skin breakdown. 

If the skin is broken: See your Podiatrist for a professional opinion, and dress with betadine ointment and a waterproof bandaid. Monitor closely for any signs of infection, i.e. swelling, pus, pain on palpation. 

Your podiatrist can also provide a thorough vascular assessment to assess your blood flow to your feet. 

 

Stay safe and warm this Winter. I am looking forward to seeing you in the clinic!

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