Chilblains — also called pernio or perniosis — are small, itchy, inflamed patches of skin that develop on the toes (and sometimes fingers, ears, or nose) after exposure to cold, damp conditions. They are uncomfortable but almost always temporary, usually clearing up on their own within two to three weeks with simple home care. Even so, recurring or severe chilblains are worth having a podiatrist look at, especially if you have diabetes or circulation problems.
Utah winters bring plenty of opportunities for cold, wet feet — shoveling snow, walking to the car in slush, or spending a day on the slopes in boots that don't quite keep moisture out. If you've noticed red or purplish patches on your toes that itch, burn, or swell after being out in the cold, you may be dealing with chilblains. Here's what our podiatrists want you to know.
What are chilblains?
Chilblains are an abnormal reaction of the small blood vessels in the skin to cold, damp air. When cold skin warms back up too quickly, the tiny blood vessels near the surface expand faster than the surrounding tissue can accommodate. Fluid leaks out of the vessels into nearby tissue, causing the redness, swelling, and itching that are the hallmark of chilblains. They most often appear on the toes, but can also show up on the fingers, ears, and nose.
What do chilblains feel like?
Chilblains typically appear as small, red or purplish patches that develop within a couple of hours to about half a day after cold or damp exposure. Common symptoms include:
- Small red or purple patches on the toes
- Intense itching, especially as the skin rewarms
- A burning or stinging sensation
- Swelling of the affected toes
- Tenderness or pain to the touch
- Blistering or skin ulceration in more severe cases
Symptoms tend to develop within two to fourteen hours of cold, damp exposure and usually resolve within two to three weeks as long as the skin is protected from further cold.
Who is more likely to get chilblains?
Chilblains can affect anyone, but some people are more prone to them than others. Risk factors include:
- Being female — women are affected more often than men
- Poor circulation in the feet
- Raynaud's disease or other circulatory conditions
- Anemia
- A sedentary lifestyle with little daily movement
- Low body weight or thin skin with little insulating fat
- Smoking, which further restricts blood flow to the extremities
Because poor circulation plays such a central role, chilblains are also worth discussing with your podiatrist if you have diabetes, since diabetic patients need extra vigilance with any changes in foot skin.
How are chilblains treated?
Most chilblains clear up on their own within two to three weeks with basic home care. The most important step is gentle, gradual rewarming — never apply direct heat, hot water, or a heating pad to skin affected by chilblains, as rapid rewarming can make the inflammation worse.
At-home care
- Warm the area gradually at room temperature rather than with direct heat
- Keep the skin dry and change out of damp socks or shoes promptly
- Apply a soothing, anti-itch lotion to calm irritation
- Avoid scratching, which can break the skin and lead to infection
- Elevate the feet to help reduce swelling
When professional care helps
If chilblains keep coming back winter after winter, are unusually painful, or develop blisters or open sores, a podiatrist can evaluate the skin, rule out other causes, and recommend targeted treatment. This is especially important for anyone with diabetes, poor circulation, or a history of slow-healing skin, since what looks like a simple chilblain can become a more serious problem if it is not monitored.
How can you prevent chilblains?
Prevention comes down to keeping your feet warm, dry, and well-circulated through cold weather:
- Dress in warm, layered clothing and insulated, waterproof footwear
- Avoid prolonged exposure to cold, damp conditions when possible
- Change out of wet socks and shoes as soon as you can
- Stay physically active to support healthy circulation
- Avoid smoking, which narrows blood vessels and reduces blood flow to the feet
- Warm up gradually after being outside rather than rushing to a heat source
See a podiatrist if your chilblains are severe, keep recurring each cold season, or if you notice blistering, open skin, or signs of infection such as increasing redness, warmth, or drainage. You can request an appointment at either of our Northern Utah offices.
Medically reviewed by the physicians at Wasatch Foot & Ankle Institute. Our board-certified, fellowship-trained podiatrists provide foot and ankle care in Farmington and South Ogden, Utah. This article is for general education and is not a substitute for an in-person evaluation.