Chilblains, or pernio as they are also known a small sometimes painful or itchy lesions that commonly affect the toes. Due to the cause (cold) they are prevalent during winter time. The low temperature cause a constriction to the arterioles supplying blood to the skin, and followed by a rapid warming there is subsequent damage which can lead to a blistering, redness, and sometimes itchy lesion. These lesions can often be painful, and in severe cases can lead to ulceration.

Prevention, as always is better than cure. Keeping feet warm throughout the winter is the best weapon in the fight against chilblains for sufferers. This can be achieved through wearing a well fitting full shoe, natural fibre socks, and a thermal lined insole. Regular soaking of feet in warm water will aid in maintaining temperature too. If feet do get cold, it is important to slowly warm the foot, and not lets its temperature rise too quickly.

There are a number of products available from pharmacies which may help sufferers. They are usually rubefacients, which increase blood flow to the skin by causing an inflammatory response, this can be very helpful in the prevention of these lesions forming. Regular exercise, and a healthy diet have also been shown to reduce the incidence of chilblains, but the most important factor is keeping toes warm for as long as possible.

If the skin does break, applying a dressing is vital to prevent an infection. This is of even more importance in an immunocompromised patient, the elderly and diabetics, as infections of the peripheries can be much more difficult to resolve in these populations.