WHAT ARE... CHILBLAINS?


First of all – ouch! Chilblains are itchy, painful, swollen, red patches on your hands and feet caused by exposure to the cold. They will go away by themselves, but care should be taken so that they do not blister and ulcerate.

BUT WHY?! The small blood vessels in your fingers and toes (more usually found here than on the fleshier parts of your extremities) do not react quickly enough to changes in temperature (vasospasm) causing release of chemicals that cause inflammation and pain (very layman’s terms; if you want the scientific explanation please redirect yourself to https://www.sciencedirect.com/topics/medicine-and-dentistry/chilblains). In essence, you’ve probably been out in the cold, your toes have become chilled and then you’ve come inside where it’s lovely and warm – but your toes have warmed up too quickly causing the reaction above. Ta-da; chilblain. They’re mainly down to pure bad luck, otherwise everyone would get them. They are more common in individuals who have Raynaud’s syndrome or phenomenon, or other circulatory problems. If you have diabetes or any problems with your circulation it is important your chilblains are reviewed by a clinician, whether that be your doctor or (preferably) your podiatrist, as your ability to heal will be impaired.

WHAT’LL I DO?! There is no quick fix, but chilblains should rectify themselves within a couple of weeks or so. The general protocol is: - - Do not expose your feet to extremes of temperature; so this means avoiding walking on

cold surfaces (read: tiles) without slippers on, if it’s chilly outside, put a decent pair of warm socks on and never put your feet against the radiator to warm them up. - Keep your feet a constant warm temperature, so socks or slippers worn when indoors during winter months. - Do not be tempted to scratch; the skin will be fragile here and you’re likely to cause an injury. - You can dress the toes with a simple gauze dressing to protect them and for comfort whilst you wait out the healing process. - There are some over-the-counter remedies; e.g. Friar’s balsalm, and old wives tales e.g. your own urine (!). I’ve got no experience of these so I can’t make any recommendations or discredit them either. - If you are a repeat offender, the doctor can prescribe a vasodilator (Nifedipine) in some circumstances. - I have found if you are prone to chilblains in the winter, using a preventative cream such as Akileine Winter Cream is a really good idea; it reinforces the natural hydrolipid barrier of the skin to protect against the effects of the cold (https://www.amazon.co.uk/Akileine-Winter-176A-Cream-75ml/product-reviews/B003OCVIRA?pageNumber=2) You can also apply this cream to unbroken chilblains. WHAT IF THE SKIN’S BROKEN?! As in any case where there is broken skin, a) this is going to be super sore and b) it’s at high risk of infection – it needs a dressing on it. Make an appointment with a podiatrist. Why not me? Click here to book an appointment. WHERE DO INFECTIONS COME FROM? Your skin is C O v e R e D in bacteria. The minute there is a breach in your skin, the bacteria are delighted and will swarm to the open wound (colonise) to have a party in your lovely juices. OK. Not exactly, but you get the general gist. A shower is a great place to ensure all the bacteria on your body is driven into any wounds on your feet (gravity, moisture…), so if you do have broken skin ensure you either cover up the chilblains whilst you shower, or saltwater bathe and dress the toes after you’re bathed. If you’re well, you can usually overcome any low-level infection without antibiotics (and saltwater bathing – the saviour of everything - glorious saltwater bathing), but if you’re immunocompromised in any way a low-level infection can take hold and become pretty nasty pretty quickly. Please see my other article to spot the signs and symptoms of an infection. DIFFERENTIAL DIAGNOSES - Skin infection (fungal or bacterial); diagnosis required by clinician - Gout: diagnosis by blood test (NB: excruciatingly painful; the condition not the blood test!) - Fracture; different symptoms but a red, swollen toe could also be a fracture - Ingrowing toenail; diagnosis required by clinician - Blood blister; usually caused by friction (footwear) CONCLUSION So if you think you’ve got a chilblain, do not panic, it will resolve itself but if it’s not getting better do get in touch.

ANY QUESTIONS? Please get in touch.

#chilblain #infection #blister #pernio

Providing Podiatry Home Visits in Oxford

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