When you look at your fingers and toes on a cold day with a little rain, do you see small red or blue spots that are slightly swollen and itchy? Sometimes with a little pain. This is actually something that happens to many people. Although it is a little uncomfortable and annoying, it is not something to be afraid of. Today we are talking about this condition. In medicine, we call this Chilblains , or Pernio .
Simply put, what are these Chilblains (Pernio)?
Chilblains are a condition that causes small, red, raised bumps on our skin. They are not caused by exposure to extreme cold, meaning freezing cold. Rather, they are caused by prolonged exposure to humid, slightly cool weather . To be precise, the cold weather in places like Nuwara Eliya in Sri Lanka can be a major factor in this.
These usually appear on the fingers and toes , but can also appear on the ears and nose. These spots can be red, blue, or purple. They can also be itchy, burning, and painful.
Anyone can develop this condition, but people with a low Body Mass Index ( BMI ), meaning they are thin, are at a slightly higher risk. Also, babies can also develop this condition if they are not dressed appropriately for cold weather.
What exactly are the symptoms of this?
You can see a variety of symptoms in chilblains. Sometimes these spots can even look a little shiny. Let's take a look at the main symptoms.
| Symptom | Description |
|---|---|
| Skin discoloration | Red, blue, or purple spots on the skin. This is the most common symptom. |
| Itching | There may be severe itching in the affected areas. |
| Inflammation and pain | You may feel burning and pain in places like the fingertips. |
| Swelling | That area of the skin may become swollen. |
| Blisters | In some cases, if it gets severe, water-filled blisters may form in those areas. |
Why is this happening to us? What is the reason?
Simply put, this is because our body has an abnormal response to cold. When we are exposed to cold, humid weather, the small blood vessels under our skin constrict . Then, when we return to a warmer environment, these blood vessels suddenly dilate rapidly. Unable to cope with this sudden change, blood vessels begin to leak fluid into the surrounding tissues. This is what causes swelling, redness , and pain .
Researchers are still not sure exactly why this response occurs. However, some experts believe it may be due to:
- Genetics
- Hormonal changes
- Other underlying medical conditions in the body (for example, connective tissue diseases )
Who is at higher risk of developing this condition?
Some people are more likely to develop chilblains than others. Let's take a look at what those risk factors are.
| Risk factor | Description |
|---|---|
| Decreased body mass index (BMI) | Thin people are at higher risk because it is a little more difficult for them to maintain body heat. |
| Humid climate | This is more common in people who live in cool, humid climates that are not freezing cold. |
| Smoking | Smoking constricts blood vessels, which hinders blood circulation. |
| Dressing for prison | Wearing tight shoes, socks, gloves, or clothing can impair blood circulation and worsen this condition. |
| Other medical conditions | People with diseases that affect blood circulation are at higher risk. Examples: Lupus , Raynaud's phenomenon , Peripheral Arterial Disease (PAD) . |
How does a doctor recognize this?
In most cases, your doctor can tell if you have chilblains by examining your skin. Asking questions like how you got these symptoms and how long you've had them can give your doctor a good idea of the condition.
However, sometimes there are other conditions that show similar symptoms, so your doctor may recommend some blood tests or a skin biopsy to make sure they are not the same.
What are the treatments for this?
The best news is that most of the time, chilblains heal on their own within two to three weeks, without any treatment.The most important thing to do is to protect yourself from the cold and humidity and keep your body warm.
However, if this condition persists for more than three weeks or if the pain and itching are severe, you should definitely see a doctor. The doctor will then prescribe the appropriate medication for you.
Oral Medications
These medications help to dilate blood vessels and improve blood circulation.
- Nifedipine (Adalat®) : Helps dilate blood vessels.
- Pentoxifylline (Trental®, Pentoxil®) : Improves blood circulation.
Topical Medications
These are medications that are applied directly to the affected skin surface.
- Nitroglycerin (Nitrol®, Nitro-Bid®)
- A cream containing a steroid, such as betamethasone valerate (Beta-Val®, Valisone®) .
What can we do at home?
In addition to the medications your doctor prescribes, there are several things you can do at home to ease these discomforts.
- Keep your hands and feet warm. Wear socks and mittens.
- Wear layers of clothing. Wearing several thin layers of clothing will help keep your body warm rather than one thick layer.
- Wear a hat. Most of the body heat escapes through the head, so wearing a hat helps keep the entire body warm.
- Apply an unscented moisturizer to your skin. Drying your skin can make it itch worse.
- You can take an NSAID for pain and swelling, such as ibuprofen (Advil®, Motrin®) . But it's best to ask your doctor before taking any medication.
- Soak the affected areas in lukewarm water for a while. But remember, don't use hot water. Also, don't rub the skin too hard. Doing so can make the condition worse.
When is it best to see a doctor?
This is usually not a serious condition. However, you should see a doctor immediately in the following cases:
| Opportunity | Why is that important? |
|---|---|
| Not healing for more than three weeks | This could be due to another medical condition, so a proper examination is necessary. |
| If you have diabetes and develop chilblains on your feet | Because diabetics have poor sensation and blood supply to their feet, even a small wound can lead to serious infections. |
| If pus is draining from the skin | This is a sign of a bacterial infection and requires immediate treatment. |
| If you feel feverish or have a cold | This can also be a sign of an infection spreading throughout the body. |
Take-Home Message
- Chilblains are caused by exposure to cool, moist weather, not freezing cold.
- The best way to prevent it is to keep the body, especially the hands and feet, warm and dry.
- In most cases, this condition resolves on its own within 1-3 weeks.
- If the itching and pain are severe, last more than three weeks, or if you see signs of infection (pus, fever), be sure to see your doctor.
- If you have diabetes, seek medical advice immediately about any skin changes on your feet.











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