DermNet NZ

Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Chilblains are itchy and/or tender red or purple bumps that occur as a reaction to cold. The condition is also known as pernio or perniosis, and is a localised form of vasculitis.

Children and the elderly are most often affected. In children recurrences each winter for a few years are common but complete recovery is usual. Chilblains in elderly people have a tendency to get worse every year unless precipitating factors are avoided.

Severe cold injury can damage the small bones in the digits, leading to microgeodic disease, swelling and sometimes, bone fracture.

Perniosis Perniosis Perniosis
Perniosis Perniosis Perniosis

What is the cause of chilblains?

Chilblains are due to blood vessel shut-down in cold conditions. They occur several hours after exposure to the cold in temperate humid climates. They are sometimes aggravated by sun exposure. Cold causes constriction of the small arteries and veins in the skin and rewarming results in leakage of blood into the tissues and swelling of the skin.

Chilblains are less common in countries where the cold is more extreme because the air is drier and people have specially designed living conditions and clothing.

Chilblains are more likely to develop in those with poor peripheral circulation i.e. blue-red mottled skin on the limbs. In some cases they are due to connective tissue disease, particularly lupus erythematosus.

Contributing factors include:

What do chilblains look like?

Each chilblain comes up over a few hours as an itchy red swelling and subsides over the next 7-14 days. In severe cases blistering, pustules, scabs and ulceration can occur. Occasionally the lesions may be ring-shaped. They may become thickened and persist for months.

Common sites for chilblains are:

Treatment of chilblains

Unfortunately chilblains respond poorly to treatment. The following may be useful:

Prevention of chilblains

The hands and feet must not be allowed to get cold. DO NOT SMOKE! Nicotine constricts the blood vessels.

The following measures may help to keep you warm:

Related information

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If you have any concerns with your skin or its treatment, see a dermatologist for advice.