Chilblains: Everything You Need to Know

Chilblains (also known as perniosis) are small bumps or patches of skin that can become inflamed, red, or itchy after you've been exposed to the cold. Unlike skin damage from frostbite, chilblains are a rare inflammatory vascular condition that don't usually cause permanent damage or discoloration.

Not everyone develops chilblains in the cold. This article will review what you can expect if you develop chilblains, what they feel like, how to treat them, and how long it will take them to go away.

Symptoms

The primary symptoms of chilblains are red, bluish, or purple skin lesions that appear after exposure to cold, damp environments. These patches form because of an abnormal small blood vessel reaction to the cold.

Beyond discoloration, you may experience symptoms like:

• Pain or tenderness
• Intense itching
• Burning or stinging
• Swelling
• Blistering

Symptoms usually appear 12–24 hours after exposure to the cold and affect the lower legs, toes, feet, hands, and face. Lesions typically resolve in a few weeks but could cause scarring or thickening of the skin that remains for several years.

Risk Factors

There are some known risk factors for developing chilblains, but the causes are sometimes unknown. More women develop chilblains than men, and they usually develop in young adults or middle-aged people, while children and older adults are rarely affected. The most common risk factors are:

• Poor nutrition
• Low body weight
• Tight-fitting clothing (which decreases blood flow)
• Circulatory or cardiovascular disease
• Infection
• Hormonal changes
• Genetics

Chilblains can develop as a standalone condition or as a secondary symptom of another disease. Lesions associated with chilblains are often confused for symptoms of different diseases, including:

• Raynaud's disease
• Celiac disease
• Viral hepatitis
• Autoimmune diseases
• Vasculitis
• Cellulitis
• COVID-19

Complications

Chilblains usually resolve on their own but may develop again with exposure to cold temperatures. In most cases, chilblain lesions fade or disappear within weeks, but in rare cases, they can linger for years.

Blister-like lesions that are rubbed or irritated may scab over, form ulcers, or become infected. Chilblains can also cause scarring in people who heal slowly or are continually exposed to the cold.

Treatment

Chilblains typically go away on their own within two to three weeks, and treatment is not usually necessary. Here are some steps you can take to find relief while you wait for them to clear:

• Stay out of the cold when possible.
• Warm the affected area.
• Keep skin clean and dry.
• Avoid scratching and apply lotion or cream to alleviate itching.

In severe or complicated cases, a healthcare provider may recommend treatment with medications such as:

• Afeditab (nifedipine): A blood pressure medication used to improve circulation
• Topical steroids: Creams applied directly to the affected area, used to treat inflammation
• Tylenol (acetaminophen)
• Advil or Motrin (ibuprofen)

Prevention

Wearing warm clothing that keeps your skin dry can help prevent chilblains. Quitting smoking and avoiding caffeine can help too since both can impair your circulation and increase your risk of developing chilblains.

Summary

"Chilblains" is the common name for perniosis, a condition in which red, itchy, or inflamed lesions form when you are exposed to cold, damp environments. You may develop chilblains independently or as part of another condition. Treatment isn't usually necessary for chilblains, and they will go away on their own in time. You can prevent these lesions from forming by avoiding the cold and by keeping your skin warm and dry.

A Word From Verywell

Chilblains can be an uncomfortable side effect of cold, damp weather, but they are not usually permanent and rarely require any treatment. If you or someone in your family has developed red or bluish patches after being in the cold, take extra care to dress in waterproof, warm clothing if you plan to be in the cold again.