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Chilblains (pernio) are small, itchy, painful, red or blue patches of inflammation that occur on the skin, typically on the toes, fingers, nose, or ears. They are an abnormal reaction to cold exposure.
read more about chilblains ...The mechanism is abnormal blood vessel response. When cold skin is suddenly warmed, the small blood vessels near the surface widen too quickly. This sudden expansion causes blood to leak into the surrounding tissue, leading to inflammation and swelling.
Symptoms begin with itching or burning on exposed skin areas, followed by red, swollen, or bluish patches. The affected skin can feel tender, warm, or even painful to touch. Small blisters or ulcers may form in more severe cases. The irritation usually appears several hours after exposure to cold and may last for days. Repeated exposure can cause the same spots to flare up each winter season.
Diagnosis is usually made based on the appearance of the lesions and the history of cold exposure. Treatment involves keeping the affected area warm, avoiding scratching, and sometimes using topical corticosteroids or pain relievers to manage symptoms.
Chilblains rarely impact vision. In extremely rare, severe cases associated with systemic conditions, lesions may appear on the eyelids, causing local swelling or discomfort. However, for most individuals, the condition is confined to the extremities.
Necessary prevention strategies involve keeping the extremities warm. This means wearing warm gloves, socks, and hats, and avoiding sudden changes in temperature, such as going from very cold air directly into very hot water.
No, chilblains are a vascular reaction to cold and are not contagious.
No, chilblains are usually mild and resolve naturally within two to three weeks, but they can be very painful.
No, rubbing or massaging the affected skin should be avoided, as this can worsen the inflammation.
If you have chilblains that recur frequently or do not heal within three weeks, see a doctor to rule out underlying connective tissue disorders like Lupus. If the area develops ulcers or signs of infection (pus, increasing redness), medical treatment is necessary to prevent skin necrosis.
NHS. Chilblains (nhs.uk). 2022.
DermNet NZ. Chilblains (dermnetnz.org). 2021.
StatPearls. Pernio (ncbi.nlm.nih.gov). 2025.
Merck Manual. Tissue Cold Injuries (merckmanuals.com). 2024.