Medically reviewed by Dr. A.M. van Coevorden, dermatologist, on
ChilblainsRed, painful toes from cold
Chilblains are red to purple, itchy or painful patches on the toes or fingers. They are caused by an abnormal reaction of the small blood vessels to cold and usually clear within a few weeks.
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What are chilblains?
Chilblains (pernio) are inflamed patches on the toes or fingers caused by cold. In the cold, the small blood vessels in the skin narrow. With chilblains they do not open up properly afterwards. The skin gets too little oxygen and becomes inflamed. This gives red to purple-blue, swollen patches that itch, burn or hurt.
The patches usually appear on the toes and fingers. They can also appear on the heels, lower legs, ears and nose. Chilblains on the hands and on the feet are the same condition in a different place.
Chilblains are not contagious. They are a reaction of your own blood vessels to cold, not an infection.
What causes chilblains?
Cold is the trigger. In autumn and winter, especially in chilly, damp weather, the blood vessels in the skin react abnormally. Some people are prone to this: chilblains run in families.
Factors that play a role:
- Cold, and especially rapid changes in temperature, such as warming cold hands up quickly.
- Hereditary predisposition: it runs in families.
- Smoking: nicotine narrows the blood vessels even further.
- Poor nutritional status.
- Sometimes an underlying condition, such as a connective tissue disease.
Chilblains symptoms
You can recognise chilblains by red to purple-blue patches or bumps on one or more toes or fingers. The patches itch, burn or hurt, especially when you come in from the cold into the warmth.
- Red to purple-blue, sometimes slightly shiny patches or bumps under the skin.
- Itching, a burning or glowing feeling.
- Pain and swelling of the toes or fingers.
- In severe cases, blisters or small sores.
Chilblains on the hands cause the same symptoms on the fingers and the back of the hand. Sometimes the patches also appear on the edges of the ears or the nose.
How does the dermatologist make the diagnosis?
The dermatologist usually recognises chilblains from their appearance and from your story: the patches appear after cold exposure and sit in the typical places. No further tests are needed then.
If the picture is unusual, the dermatologist looks for conditions that resemble chilblains. These include Raynaud's phenomenon, a form of lupus that mimics chilblains, and inflammation of the blood vessels. Blood tests or a skin biopsy may then be needed.
With 247dermatologist you upload photos of your toes or fingers and answer a few questions. A registered dermatologist assesses them within 12 to 48 hours.
Chilblains treatment: how it works
Treating chilblains starts with keeping warm. Medication is usually not needed: the patches disappear on their own within a few weeks.
Keep hands and feet warm
Wear thick socks, roomy and well-insulated shoes, gloves and a hat. Avoid cold and especially rapid changes in temperature.
Look after the skin
Do not scratch the patches. Keep any sores clean and covered. Apply a rich moisturiser if the skin is dry.
Stop smoking
Nicotine narrows the blood vessels. Stopping smoking improves circulation.
Medication only for stubborn symptoms
For severe itching or inflammation the dermatologist may advise a corticosteroid cream. For severe, recurring chilblains a doctor may consider a medicine that widens the blood vessels, such as nifedipine. This is only prescribed after weighing up the side effects.
Please note
Do not warm cold hands or feet up quickly under a hot tap, by a heater or with a hot water bottle. Rapid temperature changes make the symptoms worse.
How long do chilblains last?
Chilblains usually clear on their own within one to three weeks. They can come back every winter as long as you are sensitive to cold. In younger people this sensitivity often disappears by itself. In older people the symptoms can last longer.
Preventing chilblains: what you can do yourself
This is how you reduce the chance of chilblains:
- In the cold, wear a hat, gloves and thick socks. Thin liner gloves under your gloves give extra protection.
- Choose waterproof, roomy shoes and socks made of natural materials such as wool or cotton.
- Take off wet clothing, socks and shoes straight away.
- Avoid tight clothing or shoes: they restrict circulation.
- Keep your home warm and stay active.
- Do not scratch the patches.
- Stop smoking.
- Do you take beta blockers? Discuss with your doctor whether they play a role.
When to see a dermatologist or GP?
Contact a doctor if:
- The skin is broken, or there are blisters or sores that do not heal.
- You get the patches without having been in the cold.
- The symptoms continue into spring or summer.
- You also have other symptoms, such as joint pain or mouth ulcers.
Not sure whether it is chilblains? A dermatologist at 247dermatologist assesses your photos and tells you what to do. No referral needed.
Frequently asked questions about chilblains
Not sure whether this needs a look? Have a dermatologist assess it: you get an answer within 12 to 48 hours, no referral needed. In an emergency, contact your GP straight away or call 112.
What is the difference between chilblains on the hands and on the feet?
It is the same condition. On the feet the patches sit on the toes, on the hands on the fingers. The cause and the approach are the same.
Are chilblains dangerous?
No. Chilblains are unpleasant but harmless and usually clear within a few weeks. Only broken skin, blisters or symptoms outside winter need further investigation.
Which cream helps against chilblains?
A cream does not cure chilblains. Keeping warm is the most important thing. For severe itching a dermatologist may advise a corticosteroid cream. Keep the skin supple with a rich moisturiser.
Do chilblains come back?
Yes, they can. As long as you are sensitive to cold they can return every winter. Keeping warm and not smoking reduce the chance.
Can children get chilblains?
Yes. Chilblains also occur in children and young adults. In younger people the sensitivity often disappears by itself.
Is it chilblains or Raynaud's phenomenon?
With Raynaud's phenomenon the fingers or toes first turn white in the cold, then blue and then red. With chilblains you see lasting red to purple, swollen and painful patches. A dermatologist can tell the difference.
Have a dermatologist look at your skin
Upload photos and answer a few questions. A BIG-registered dermatologist replies within 12 to 48 hours, no referral needed, from € 39.
If more is needed, the dermatologist refers you to a medical specialist.
Want to know what a dermatologist does, when you can see one and how quickly that can happen? Read more about the dermatologist.
Sources and more information
- NVDV, patiëntenfolder Wintertenen
- Thuisarts.nl, Ik heb winterhanden of wintertenen
- Huidziekten.nl, patiëntenfolder Wintertenen (perniones)
- Huidziekten.nl, zakboek Perniones
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