Chilblains by David Webby

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Chilblains occur when an individual is exposed to cold fingers or toes, that may result in capillary bed damage in the skin causing redness, itching, inflammation, and sometimes blisters.

 

They may be related to circulation issues such as Raynaud’s syndrome, Polycythaemia, Ischemia, or Connective tissues diseases such as Lupus.

Smoking can also cause restriction of blood vessels in the extremities.

 

Chilblains can be spontaneous, particularly during the winter when the autonomic nervous system can shunt blood away from the extremities, thus reducing the blow flow to the tissues on the toes.

 

Left untreated, Chilblains can result in skin infections and ulcerations.

 

 

Treatments

 

Vitamin B, especially Nicotinamide, helps improve circulation

 

Keep areas warm and dry. 

Avoid extremes of temperature, such hot water bottles, heat packs.

Use wool socks, or ‘All day’ socks that don’t restrict circulation or are tight fitting.

 

Warm water foot baths with Epsom salts (15-20 minutes 2-3 x a day) is said to be beneficial.

 

Hiradoid cream or similar can reduce bruising and relieve itch

 

Medication used as a vasodilator, eg Adalat, can help with severe or recurrent cases.

 

 

How can we help?

 

Podiatrists often see people with poor circulation, ulcers, and chilblains.

As professionals, Podiatrist under take circulation assessments to help determine the blood flow and pressure of the smaller arteries and sometimes the smaller blood vessels of the feet to help determine healing ability of one to infections or potential problems.

 

At Dan Lewis Podiatry people with a suspect circulation condition or Diabetes, are offered a thorough circulation assessment, which may include a Doppler assessment of the arterial blood flow in the foot.

Other devices can measure the blood pressure of the smaller blood vessels in the big toe.

An Ankle or Toe Brachial Index can indicate whether there is some form of plague build up in the walls of the arteries, that may impede blood flow, and thus slow healing.

 

Assessment of the whole foot can indicate areas that need to be addressed to ensure better foot care.

Good foot care is an important aspect of maintaining integrity of the feet.

 

With the experience and trained eye of the Podiatrist, we can quickly assess areas that need to be attended. 

Red patches or rubbing of the skin may indicate tight or short shoes.  

Padding may be used to help avoid pressure and facilitate healing.

 

Advise on footwear and socks may help keep the feet warm, and aid recovery.

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