Small blood vessels in the skin constrict or narrow in response to cold and dilate in warmth. Chilblains, also known as pernio, or perniosis, occurs from exposure to cold temperatures followed by rapid re-warming. Quick or extreme dilation of blood vessels from rapid re-warming can cause some leakage of fluid from the blood vessels into the surrounding tissues, resulting in the symptoms of chilblains: painful inflammation, swelling and itching, and red patches, ulcers or blisters on the affected areas of skin. According to the Mayo Clinic, chilblains usually resolves within about 14 days of treatment.
Corticosteroids
Chilblains typically affects the extremities, including the hands and feet, and nose and earlobes. The small affected areas make topical treatments practical. Corticosteroid creams applied directly to the areas affected by chilblains can reduce itching and swelling because they act to suppress the body's inflammatory response. Corticosteroid creams are available both in over-the-counter and prescription strength.
Nifedipine
Doctors sometimes prescribe the medication nifedipine to treat the root cause of chilblains because it helps dilate blood vessels, making them less reactive to temperature changes. According to the Merck Manuals Online Medical Library, nifedipine blocks calcium channels in cell membranes to relax blood vessels. Primarily prescribed to treat high blood pressure and angina, treatment of chilblains with a 30 to 120 mg tablet once daily is an off-label use for nifedipine. However, the Mayo Clinic notes that nifedipine is only moderately successful in treating chilblains.
Infection Prevention
Treatment with corticosteroid cream should prevent the worst of the itching, but infection of opened sores at the site of chilblains due to scratching, cracked skin or ruptured blisters, remains a concern, especially for people with poor circulation. Keep any open wounds clean, dry and covered and use an antibiotic ointment to reduce the risk of infection.
Recurrence Prevention
Some people are more likely than others to experience chilblains, including those with poor circulation or people who are very sensitive to temperature changes. The Mayo Clinic offers some advice for people who are susceptible to chilblains: when venturing out into cold weather, dress warmly and cover all exposed skin, especially the hands, feet, earlobes and nose that are especially vulnerable to chilblains. Keep your surroundings comfortably warm. After cold exposure, re-warm skin gradually to avoid causing or worsening chilblains; do not use hot water bottles or sit too close to a fire or other heat source.
