Chilblains

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of the small blood vessels in the skin. Thermal damage to the capillaries induces a skin response that manifests itself as redness, itching, swelling and blistering on the extremities of the body, such as the nose, ears, toes and hands. Chilblains can be idiopathic or associated with serious medical conditions, which need to be investigated. For example, recurring episodes can be indicative of connective tissue diseases or circulation disorders. Treatment of chilblains typically involves the use of topical remedies and anti-inflammatory drugs. The patient usually recovers within a couple of weeks. If the condition is neglected, however, there is a risk of complications, such as skin ulcers, scars and infections, which can delay healing.

they cause vascular constriction, while hot ones induce vasodilation. If the transition from cold to hot is abrupt, dilation of the capillaries may occur faster than that of the large blood vessels; this can lead to the leakage of blood components into surrounding tissues. The phenomenon determines the onset of skin inflammation in the affected area, which in turn is associated with the typical symptoms of chilblains.

Symptoms of chilblains generally appear shortly after exposure to cold. First of all a burning and itching sensation usually occurs in the extremities of the body: earlobes, nose, heels, toes and hands. Later, symptoms worsen if the individual enters a warm environment.
Signs and symptoms of chilblains can include:

Localized redness, swelling, and itching on the skin, often in the feet or hands
Burning sensation
Changes in skin color, from red to dark blue, accompanied by pain;
Possible formation of blisters and ulcers.

Lesions can be single or multiple, that is, multiple chilblains may remain circumscribed or join together to form an extensive erythematous area. If the patient avoids further exposure to cold, chilblains usually disappear within 1-3 weeks, although these can recur seasonally for years.
Some people don't need to see a doctor. However, if the pain becomes intense and the skin in the affected area shows signs of an infection, referral to a specialist can help treat the disorder more effectively.

o poor nutrition (example: anorexia nervosa).

Family trend.

Some groups of people are more sensitive to temperature changes and chilblains when exposed to the cold:

Female individuals;
Smoking (nicotine constricts blood vessels);
Patients with peripheral vascular disease, due to diabetes or hyperlipidemia;
Patients with connective tissue diseases, especially lupus erythematosus, systemic sclerosis or in association with Raynaud's phenomenon (excessive vasospasm of the small blood vessels in the fingers).

Side effects of some medications can cause small blood vessels to constrict. This may be enough to make the patient prone to developing recurrent chilblains. Beta blockers, for example, can produce this effect.

. Topical application of corticosteroids can help relieve itching and swelling.

Pharmacological therapy. Nifedipine can be prescribed to treat more severe or recurrent cases. This drug lowers blood pressure and causes vasodilation by reducing pain, facilitating healing and preventing recurrence. Side effects can include hot flashes and headaches.

Infection prevention. If the skin is damaged, treatment includes cleaning with an antiseptic and protecting the wounds. If an infection occurs, your doctor may prescribe antibiotics.

During the healing process, some measures can be taken to relieve the symptoms of chilblains, including:

Avoid or limit exposure to cold whenever possible;
Keep the area warm and dry, but away from heat sources (for example, do not directly overheat the chilblains using hot water);
Do not scratch or rub the area.