Posted by Jenn F. on Friday, December 2nd, 2016
You’ve been outside in the cold, and as you’re on your way in the house, you can’t wait to get your boots off. It feels like someone’s rubbed sandpaper on the tops of your toes—ouch! Upon closer inspection, you notice your toes are red, inflamed, and sore. They throb and itch uncontrollably. Is it a blister? Frostbite? Trench foot? It could actually be a common winter condition called chilblains (or pernio). Today, NYC podiatrists from The Center for Podiatric Care and Sports Medicine share important facts about this cold weather affliction and how to treat it.
What Causes Chilblains?
Essentially, chilblains are caused by an inflammatory response. “Chilblain flare-ups occur when the tiny blood vessels in your toes shut down to conserve heat,” explains Dr. Josef Geldwert, a board-certified foot surgeon in Manhattan. “Normally, these capillaries open up again when we go inside and warm up, but with chilblains sufferers, there is a 30-minute delay.” Without sufficient circulation and blood supply to gradually warm us, the skin becomes overheated and damaged. The hot, red, itchy inflammatory response occurs once the blood runs across the injured soft tissue.
Who Is At Risk?
We have seen chilblains in old people. We have seen them in children as young as six—often hours after they play in the snow. We have seen them in people who are otherwise completely healthy. Little is known about the precise cause of chilblains, but we believe there is an undiscovered genetic link. Approximately 1 out of 10 people are affected by chilblains, and there are certain risk factors that may predispose a person to get chilblains in the winter:
- Autoimmune diseases like lupus
- Blood disorders like viral hepatitis
- Tight clothing in damp, cold weather
- Female gender
- Poor circulation
- Raynaud’s Syndrome
- Being sedentary
- Working outside in the cold
- Wearing ill-fitting boots
- Being underweight (by about 20%)
- A location that has high humidity and cold temperatures but is not freezing
Treatments and Preventative Measures
You may be able to prevent chilblains by doing foot exercises to increase circulation. Make sure you are wearing loose wool socks (ideally two pairs of socks) and waterproof boots that have been professionally sized to fit your feet. Avoid a hot shower right away after coming inside. Instead, allow the feet time to gradually warm up or put them into a basin of warm water. Before you go outside, put on a moisturizing cream or a menthol ointment like Zambuk that is specially formulated to open up the blood vessels. Avoid smoking, eat a healthy diet, and be sure you are getting enough calcium, vitamin D, and B vitamins!
If you have chilblains, avoid scratching the site. Instead, you can apply calamine lotion to reduce itching and use lanolin to bring down the swelling. Although it may seem tempting, do not apply heat packs to the affected area. The best course of home treatment is to soak your feet in Epsom salt and lukewarm water for 20 minutes. The chilblains should heal completely on their own within 7-14 days, and, in most cases, they do not cause long-term damage. However, serious cases may turn into weepy ulcers. If you are diabetic, you should see your doctor immediately, as any small sore on the foot runs the risk of becoming a non-healing, infected ulcer. Infections can threaten life or limb, so if you are not seeing progress within two weeks or if the situation seems to be worsening with every passing day, seek medical attention from a NYC podiatrist.
A Podiatrist Can Help
One of the main reasons people seek a doctor’s opinion is to rule out something more serious like Raynaud’s Syndrome or lupus. Even if it is just a particularly severe case of chilblains, your doctor can prescribe a medicine such as nifedipine to dilate blood vessels or a topical steroid to expedite healing. UV light therapy or ultrasound may also increase circulation and natural healing factors while alleviating some of the pain. Additionally, we have special dressings to treat ulcers or broken skin and prevent infection. Whatever your exact situation, we’re happy to help you come up with a strategy to prevent recurring chilblains. Don’t suffer this winter; contact Manhattan podiatrists here.