Painful inflammation of small blood vessels of the skin is called chilblains. Sudden warming up of body from cold temperature results in chilblains.
A chilblain is also known as pernio. It is characterized by itching, red patches, swelling and blistering on toes, fingers, ears and nose.
Commonly chilblains affect the following parts of body: Fingers and toes, legs, heels and ears.

Due to cold exposure or in humid or damp conditions there is abnormal vascular response. Minor trauma may aggravate the condition.
Chilblains are a common occurrence. The abnormal reaction of skin to cold results in chilblains. Chilblains commonly occur on extremities as it easily becomes cold.
When the skin becomes cold the blood vessels under the skin become narrow resulting in slow supply of blood to that area of skin. On warming up of the skin there is some leakage of fluid from blood vessels into the surrounding tissues. This results in inflammation and hence chilblain develops.
Age / Sex prevalance of chilblains

It is more common among young and middle-aged women and in children.

Causes of chilblains

Chilblains occur as a result of an abnormal reaction of the body to cold. Chilblains develop on the skin that has been exposed to sudden cold and warm temperatures e.g. sudden warming of cold hands directly in front of fire that result in expansion of small blood vessels under the skin causing leakage of blood into nearby tissues.

Chilblains may be a result of various systemic diseases as follows:
• Anorexia nervosa.
• Dysproteinemias.
• Chronic myelomonocytic leukemia.
• Raynauds disease.
• Macroglobulinemia.
• Cryoglobulinemia, cryofibrinogenemia, cold agglutinins.
• Antiphospholipid antibody syndrome.
• Celiac disease.

Signs and Symptoms of chilblains

Chilblains show following signs and symptoms:
• Small, itchy red areas on your skin, often on the feet or hands.
• Formation of sores or blisters.
• Swelling of the skin.
• Burning sensation.
• Color changes in skin from red to dark blue, accompanied by pain.
• Ulceration may occur.

Differential diagnosis of chilblains

Diagnosis is made by physical examination. Appearance of symptoms after exposure to cold and particular look of the skin helps in diagnosing the condition.

Treatment of chilblains

Treatment options for chilblains include:
• Corticosteroid creams to relieve itching and swelling.
• Blood pressure lowering drugs.
• If the skin is cracked, treatment also includes cleaning and protecting the wounds to prevent infection.

Prognosis of chilblains

Condition can recur in cold weather. If the exposure to cold is avoided the symptoms will disappear in 1-3 weeks.

Complications of chilblains

• Skin ulcers.
• Infections.

Diet / management of chilblains

• If pain and itching occurs on visit your doctor.
• Bate the affected part in alternating cold and warm water, this will help in circulation.
• Apply antiseptic lotion on broken skin.

Vitamin A and vitamin C rich food are extremely good for chilblain patient e.g. coriander, tomatoes, spinach, carrots, banana, oranges, watermelon, lemon, etc.

Homeopathic treatment for chilblains

• Severe itching.
• Skin becomes loose and flabby.
• Purplish appearance of skin after suppression of eruptions.
• Worse by cold air and wet weather.

Agaricus muscarius
• Burning, itching, redness.
• On scratching the part itching changes place.
• Pricking sensation as from needles.
• Worse after alcohol.

Carbo animalis
• Occurrence of itching in bed.
• Burning pain becomes worse at night.
• Chilblains accompanied by glandular enlargement.
• Formation of ulcers with chilblains which bleed very easily.

Hepar sulphur
• The skin is sensitive to cold air.
• Deep cracks develop with chilblain.
• Chilblains can suppurate.

Lachesis mutus
• Ulcers leading to gangrene develop with chilblains.
• Severe burning sensation worse at night.
• Sensitive to touch.
• Bleeding in lesions.
• Excoriation of the affected part.

Nitricum acidum
• Skin becomes dry.
• Burning pain with pricking sensation.
• Worse open air, cold application and cold weather.
• Formation of multiple cracks that are very sensitive to touch.

• Moist appearance of skin.
• Burning and itching.
• Tips of the fingers are cracked.

• Intense itching and burning.
• Worse from scratching and washing.
• Itching from warmth, in evening.

Rhus tox
• Redness and swelling with intense itching.
• Worse in wet, rainy weather.

• Intense itching with pulsating pains.
• Aching soreness.

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