Your Guide to Chilblains on Toes and Hands: Causes, Treatment, and More

Fact checked by Olga Sadouskaya, MD
Clinical Pharmacologist, Chief Medical Officer

If you’ve ever had chilblains, you know how painful and frustrating they can be. Chilblains are sore, itchy, red, or blistering skin that occurs when it’s exposed to cold temperatures. They usually happen on your extremities, such as your toes, fingers, or ears.

Although chilblains can be painful and uncomfortable, they usually resolve on their own within a few weeks. However, in some cases, they can lead to more serious problems, such as skin infections.

There are a number of things you can do to prevent and treat chilblains. Keep reading to learn how to treat chilblains on your toes and hands.

What are chilblains?

Chilblains are skin lesions brought on by the irritation of microscopic blood vessels. A lot of people get them on their hands and feet, and they can be painful.

This illness goes by many other names, including pernio chilblains, perniosis, and cold-induced vascular dysfunction.

A common skin irritation, chilblains (or pernio) are little red areas of skin. They usually appear in chilly or moist environments, but not below freezing.

Chilblains often appear on the feet and toes, although they may also appear on the legs and ears.

Chilblains are often red or blue in color and can be itchy and painful. Although their exact cause is still unknown, research has pointed to a localized type of vasculopathy triggered by a susceptible person’s exposure to cold.

Capillaries, the microscopic blood vessels that carry blood to the skin, may be damaged by the cold and wet and cause redness, blistering, itching, and inflammation. Red spots that itch, swell, and sometimes blister may appear anywhere on the body, including the toes, fingers, ears, and nose.

A pair of mittens on a radiator as a metaphor for preventing chilblains on hands

Women, young children, and the elderly are more likely to get chilblains. Chilblains are also more common in people who are underweight.

Wrapping up warmly or avoiding the cold as much as possible greatly reduces the risk of chilblains in vulnerable people.

Causes and risk factors for chilblains

When exposed to cold temperatures, capillaries close to the skin’s surface may constrict. Those tiny blood vessels could swell too fast once you warm up. The outcome might be localized swelling as blood flows into the surrounding tissue. Once the swelling has reached a certain point, it can irritate the nerves in the region, resulting in discomfort.

A peculiar response to cold and subsequent rewarming may be involved, but doctors aren’t sure.

You’re more likely to get chilblains if you:

  • Wear tight clothes or shoes that leave skin exposed in the cold
  • Are exposed to cold, wet conditions
  • Lack body fat
  • Live in chilly and damp climates
  • Have an underlying condition like Raynaud’s, connective tissue disease, or SARS-CoV-2 (COVID-19)

Can a vitamin deficiency cause chilblains?

It’s possible. For example, if you have low levels of vitamin B12, the blood supply to your feet may be reduced or halted, leaving you with extremely cold feet that never warm up, altered skin tone (your feet may appear white or purple), chilblains, muscular cramps, and numbness.

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Vitamin B12 deficiency has been linked to reversible megaloblastic anemia and demyelinating diseases. Simply put, this is when the body’s red blood cells are too big to circulate effectively.

There is also evidence that a B12 deficiency may disrupt normal blood flow to the foot, causing inflammation, damage to blood vessels, oxidative stress, and chilblains. Vitamin deficiency is seen in many people with chilblains, so the condition may be improved by including a sufficient amount of vitamins in your diet.

How to treat chilblains on toes and hands

Chilblains tend to heal on their own within a week to three weeks. As you begin to feel warmer, you may notice a decrease in your symptoms. However, chilblains may not heal properly for those with diabetes or poor circulation.

You can try these at-home remedies to treat chilblains on your toes and hands:

  • Use calamine lotion or witch hazel to relieve the itchiness.
  • Massage your feet with heating gel to increase blood flow.
  • Wear socks and gloves made of wool or cotton.
  • Keep your feet and hands warm.
Close-up of shoes covered in snow as a risk factor for developing pernio chilblains

If your symptoms persist for more than three weeks, the pain is severe, or you don’t appear to be improving, you should consult a doctor. They may recommend a topical corticosteroid cream for persistent itching if inflammation is a contributing factor. Sometimes, your doctor may additionally prescribe blood pressure medicine to assist in dilating the capillaries close to the skin’s surface.

Ways to prevent chilblains

If you are sensitive to chilblains, try these steps to prevent getting them in the first place:

  • Avoid unnecessary contact with the cold.
  • Keep your feet and hands warm when you’re outside.
  • Stay active to increase blood flow to your extremities.
  • Avoid wearing shoes that are too snug. They might cut off your toes’ circulation.
  • Warm your footwear in front of the heater before putting them on to make sure they’re not damp.
  • Make sure your home is toasty. And keep an eye on the humidity level, too.
  • Quit smoking. Nicotine can constrict your blood vessels, which may exacerbate chilblains.
  • Keep your skin moisturized. You can use a special chilblains cream for that.

Final thoughts

Chilblains are a skin condition that can cause itching, redness, and blistering. You can avoid chilblains by staying warm and staying inside. If you have chilblains that don’t heal in a few weeks or if they become infected, it’s best to consult your doctor. They may prescribe some medications to alleviate symptoms and speed up recovery. Doctors may also be able to provide advice on how to avoid getting chilblains in the first place. Following these measures may reduce your risk of developing chilblains altogether.

March 8, 2023