Compleet Feet treat chilblains. This is a priority at the moment during the pandemic. A sore and broken chilblain can be a misery and stop individuals enjoying their daily get out and keep fit during lockdown. This is the time of year when the incidence of getting a painful chilblain goes up. The cold winter months can play havoc with feet and chilblains can effect any age.
So what are chilblains? A chilblain is a superficial skin vascular condition caused by cold exposure. It is a vasospastic problem whereby the small blood vessels constrict as a direct response to cold, but don’t dilate back to normal when the temperatures warm up. The result is a build-up of circulatory waste products in the tissues and reduced oxygen and nutrition. There is leakage of fluid into surrounding tissues. The tissues become inflammed, and there can be a burning sensation. The affected area can become painfully swollen and itchy. Visible signs are red, blue to purple mottled patches of discoloration. Not all chilblains are itchy and can just be tender and sore. These are often misdiagnosed.
The main areas to be affected are extremities like toes and fingers, but the soles of the feet can be affected too. The skin on the sole of the feet is insulating, so plantar chilblains are less common, but seen more in the elderly or in individuals with a circulatory deficiency. It is thought about 1 in 10 individuals will get a chilblain at some point in their lives.
Chilblains generally can go away in 7 – 14 days with little to no complications, but they can blister and breakdown. A broken chilblain can ulcerate and lead to infection, a particular worry in individuals who have peripheral vascular disease or diabetic. Chilblains are not to be ignored in vulnerable individuals.
Chilblain Treatments
Once an individual has a chilblain the advice is to apply a rubefacient cream daily, and liberally to the affected area. A rubefacient is a cream which when applied to the chilblain will help to increase peripheral blood flow by causing the blood vessels to dilate. Chilblain creams are relatively cheap to buy over the counter. Examples are Balmosa and Nelsons Chilblain Ointment. If the chilblain is unbroken a 1% Hydrocortisone cream can be sparring applied to reduce the pain associated with the inflammation. Broken chilblains are dressed with antiseptic dressings e.g. Inadine. Inadine is a Povidine Iodine dressing which has a rubefacient action. Neat Iodine is no longer, as in the past, applied to broken chilblains. Far too ouchy!
Prevention is the main cure and treatment for chilblains:
- Keep feet warm at a steady temperature e.g. don’t allow to chill or get damp for long periods of time
- Don’t warm up feet too rapidly. This can cause tissue damage and exacerbate condition
- Insulate feet with warm socks. Choose Merino wool, mohair. Avoid cotton . Choose materials which don’t hold water content. Purchase thermoregulatory socks e.g. Carnation Silversocks . These socks have a high silver thread content which actively regulates temperature through heat transfer.
- Don’t wear tight constrictive socks or tights
- Wear slippers at home, don’t go barefoot
- Warm feet up before going out
- Place feet on cushion when sitting
- Dry feet well after washing
- Wear good fitting footwear, choose shoes/ boots with a good thick insulating sole
- Exercise regularly and eat a good balanced diet
- Take vitamin B as it is a vasodilator
- Stop smoking as nictotine is a vasoconstrictor
- Medication? If taking beta blockers these could be contributing to your chilblains? Talk to your GP.
- A doctor can prescribe vasodilating drugs e.g. nifedipine for longstanding conditions
Cold Not The Only Cause of Chilblains – COVID TOE
There are other contributing factors causing chilblains other than cold temperatures. A common one seen in youngsters is hormonal changes. Once they go through puberty this can subside as hormonal balance is normalised, but could recur with hormonal changes during pregnancy. There is little written on this phenomena related to chilblains, but more recently there has been much written about the new Covid Toe syndrome. This is a pseudo chilblain with all the appearances at first of a simple chilblain. A good consultation with a podiatrist will help to identify if the mottled blue purple discoloration is a covid symptom. A podiatrist will also be able to identify if the chilblain is connected with other conditions affecting circulation e.g. Raynaulds Syndrome.
In summary, if you or a loved one is struggling with painful toes and feet which are chilled and discoloured, consider booking an appointment with a podiatrist. Compleet Feet treat chilblains. They can identify and diagnose what is the problem; treat and give you the correct advice on future management and prevention. You may not have a chilblain, but a totally different problem, or think you have a corn or infection, when it is in fact a chilblain. Chilblains are not something from the past when are ancestors lived in cold unheated houses, but are a modern problem occurring in warm central heated homes.
