Occur as a Reaction to Cold

Chilblains are itchy and/or tender red or purple bumps that occur as a reaction to cold. The condition is also known as pernio or perniosis, and is a localised form of vasculitis.

Children and the elderly are most often affected. In children recurrences each winter for a few years are common but complete recovery is usual. Chilblains in elderly people have a tendency to get worse every year unless precipitating factors are avoided.

Severe cold injury can damage the small bones in the digits, leading to microgeodic disease, swelling and sometimes, bone fracture.

Treatment of chilblains

Unfortunately chilblains respond poorly to treatment. The following may be useful:

• Topical corticosteroid cream applied accurately for a few days to relieve itch and swelling
• Antibiotic ointment or oral antibiotics for secondary infection

Prevention of chilblains

The hands and feet must not be allowed to get cold. DO NOT SMOKE! Nicotine constricts the blood vessels.

The following measures may help to keep you warm:

• Insulated and heated home and workplace stop up all draughts
• Warm clothing especially gloves, thick woollen socks and comfortable protective footwear. Keep the head and neck warm with hat and scarf. Have layered clothing on your body.
• Avoid medicines that might constrict blood vessels: these include caffeine, decongestants and diet aids.
• Before going outside, soak hands in warm water for several minutes to warm hands through then dry thoroughly
• Exercise vigorously before going outside
• Wear cotton-lined waterproof gloves for wet work
• Apply sunscreen to exposed skin even on dull days
• Take vasodilator medication such as nifedipine prescribed before the onset of cold weather and taken throughout winter. Side effects may include flushing and headache.

Source: dermnetnz

 
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