November 9, 2020: Red, itchy toes? Could it be chilblains?
Do you have chilblains?
Cold weather always brings an increase in enquiries prompted by cherry red, itchy and sometimes, weepy toe tips. With temperatures due to dip below -7degreesC this week we have already seen an increase in concerned callers.
Our Podiatrists at Maidenhead Podiatry understand many people suffer from cold feet in winter, but not all develop chilblains. A question regularly asked is ‘why do I have chilblains? What have I done wrong?’ But is isn’t a matter of doing anything ‘wrong’, some people are simply prone to them due to genetics or poor peripheral circulation.
Of course, not everyone with poor circulation develops chilblains but it can make you more susceptible.
What do chilblains look like?
Following exposure to the cold chilblains appear as small itchy, red swellings on the skin of the tips of the toes and/or fingers. They can appear in a little as a couple of hours and can become increasingly painful. They normally start as small cherry red dots or patches which can slowly increase in size with a slight feel of firmness. It is possible that they will swell, form small blisters, and may weep before drying out leaving cracks in the skin, exposing the foot to the risk of infection.
They normally occur on tips of toes, particularly the smaller ones, but can also appear anywhere on the foot, on fingers, face, especially the nose, and the lobes of the ears. They can also occur on areas of the feet exposed to pressure, for example, on a bunion, heel or where the second toe is squeezed by tight shoes.
Chilblains are usually caused by the skin’s abnormal reaction to cold although exposure, damp or drafty conditions, dietary factors and hormonal imbalance can contribute.
If the skin is chilled, and is then followed by too rapid warming next to a fire or hot water bottle, shower or bath, chilblains may result.
Who is most at risk?
This condition mainly affects young adults working outdoors, in cold places, or people who do not wear socks or tights during .colder weather. Too often, even in cold weather, patients attend Clinic wearing light footwear with no socks leaving their feet vulnerable to extremes of temperature.
Also susceptible are elderly people, and those whose circulation is less efficient that it used to be, people who don’t take enough exercise, and those suffering from anaemia.
Chilblains can develop at any age and frequently skip a few years before reappearing predictably in cold weather.
What causes chilblains?
When the toe and skin is cold, blood vessels near the surface vaso-constrict or get narrower. If the skin is then exposed to heat, or experiences a rapid change in temperature, the blood vessels become wider or dilate.
If this happens too quickly, blood vessels near the surface of the skin can’t always handle the increased blood flow and this can cause blood to leak into the surrounding tissue, which causes the swelling and itchiness associated with chilblains.
What are the symptoms?
With the onset of the cold weather, chilblains will be experienced as burning and itching on their hands and feet. On entering a warm room, the itching and burning is intensified. There can be swelling or redness, and in extreme cases, the surface of the skin may break, with sores (ulcers) developing.
If in doubt – seek professional advice and visit your Podiatrist.
How long do chilblains last?
Some come and go over a few days, others can persist for a couple of months at a time, only disappearing with warmer weather. Chilblains are virtually unknown in warmer climates but Britain’s cold damp winters are ideal for encouraging their appearance.
How do I prevent chilblains
This isn’t as easy but try to keep your body, feet and legs at an even temperature. This is especially important if your circulation is poor and you have limited mobility. Your whole body, rather the just the feet, needs to be kept warm. No matter how it might look, trousers, long johns, long boots, long socks tights and leg warmers all help.
Do chilblain creams help?
Most chilblain creams work by counter-irritation. This means they use a different sensation, such as heat, to distract the brain from the itching and pain. Generally though, although they can bring relief they aren’t treating the underlying condition and have little influence on the length of time the chilblain is experienced.
If chilblains have developed what can I do?
Whatever you do, don’t scratch them. Soothing lotions such as witch hazel or calamine, which can be bought from your local pharmacy, will take away most of the discomfort.
Cover them with a loose, dry plaster and wear warm socks.
If the chilblain has ulcerated, apply an antiseptic dressing. If you have diabetes or undergoing medical treatment, have the ulcer assessed by your GP or Chiropodist/Podiatrist.
Ultimately, time and warmer weather will bring lasting relief, and in the worst cases, a move to warmer climes will provide permanent relief.
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