Chilblains (Pernio)

Chilblains

Overview

Chilblains (pernio) are painful, itchy, inflammatory skin lesions that develop on the fingers, toes, ears, or nose in response to repeated exposure to cold but not freezing temperatures. They result from an abnormal vascular response to cold, leading to localized edema, inflammation, and sometimes blistering. Chilblains typically develop hours after cold exposure and resolve over 1-3 weeks with warming.

Key Symptoms

  • Red, purple, or dusky swollen patches on the fingers, toes, heels, or ears
  • Intense itching and burning sensation
  • Tenderness and pain in the affected areas
  • Blistering or ulceration may occur in severe cases
  • Symptoms develop hours after cold exposure, not immediately
  • Lesions typically resolve in 1-3 weeks if further cold exposure is avoided

Affected Areas

Toes, Fingers, Heels, Ears, Nose

Care Instructions

  1. Keep extremities warm — wear insulated gloves, thick socks, and warm footwear.
  2. Avoid rapid rewarming (such as placing cold hands directly on a heater); warm gradually.
  3. Topical corticosteroids can reduce itching and inflammation.
  4. Nifedipine (a calcium channel blocker) may be prescribed for recurrent or severe cases.
  5. Do not rub or massage the affected areas.
  6. See a dermatologist if chilblains are recurrent or if lupus-related chilblains (chilblain lupus) need to be ruled out.

Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified dermatologist for diagnosis and treatment.

Prevalence: Common in cold, damp climates; more frequent in women and in individuals with poor peripheral circulation