Are you perhaps suffering from very regularly distributed chilblains?
The peripheral distribution, swelling and pain, association with cold
and moist weather,and relief under warmer dryer conditions all match.
A doctor should check for underlying conditions that may be a cause
such as diabetes, peripheral vascular disease, connective tissue
but the majority of cases are idiopathic (of unknown cause).
"Chilblains are a painful abnormal reaction of the small blood vessels
in the skin when exposed to cold temperatures. Chilblains usually
occur several hours after exposure to the cold in temperate humid
climates. The cold causes constriction of the small blood vessels in
the skin and if rewarming of the skin happens too rapidly, there is
leakage of blood into the tissues as the blood vessels do not respond
quickly enough to this rewarming. Chilblains are not very common in
countries where the cold is more extreme as the air is drier. The
living conditions and clothing used in these climates are protective.
Chilblains are more likely to develop in those with poor circulation,
but chilblains are still common in those with good circulation.
What do chilblains look and feel like:
Chilblains appear as small itchy, red areas on the skin. Chilblains
become increasingly painful as they get congested and take on a dark
blue appearance. They may also become swollen. As they dry out,
chilblains leave cracks in the skin so the risk of getting an
infection increases. Chilblains are common on the toes, but can also
affect the fingers and the face (especially the nose and ears).
Chilblains are also common on areas of the feet exposed to pressure,
such as bunions or where the toes are under pressure from tight shoes
or where there are corns and callus.
Chilblains start during the winter (when the weather gets colder) -
the initial symptoms include burning and itching in the area of the
developing chilblain. These symptoms are often intensified when going
into a warm room. There is often some swelling and redness. In many
cases, the skin over the chilblain can break down and becomes a sore
(ulcer). An infection may develop in the chilblain.
Chilblains often occur in some people every year, for the rest of
their lives. In other's, chilblains occur for several years and then
just stop occurring. The reason for these patterns of occurrence of
chilblains is not known. As they are more common in females, there may
be a hormonal influence on the development of chilblains.
What causes chilblains:
Chilblains are more common in those that are just more susceptible to
them - the reasons for this are not entirely clear. Factors that
contribute to tendency to chilblains include, a familial tendency,
poor circulation, anemia, poor nutrition, hormonal changes, some
connective tissue disorders and some bone marrow disorders. Damp
living conditions may also increase the risk for chilblains.
As a chilblain is an abnormal reaction to cold, these factors above
increase the risk that it is going to happen. Chilblains occur when
there is too rapid a change from cold to hot, so the chilblains occur
after the foot is cold. Some people's circulation is so sensitive that
only small changes in temperature may be enough. A typical history for
the development of chilblains is after being outside in the cold, the
foot is placed next to a heat source (eg heater) when coming back
inside. The small blood vessels do not respond quickly enough to the
change in temperature
Chilblains self treatment:
Prevention of chilblains:
Keeping your feet warm is an important way to prevent chilblains - use
trousers, high top boots, tights, leg warmers and long, thick woollen
socks. If your feet do get cold, allow them to warm up slowly - do not
put them straight in front of a source of heat (this gives a chance
for the circulation to respond to the warming skin). Do not let the
feet become exposed to any source of direct heat (eg a heater),
especially if the foot is very cold - this is a common factor causing
chilblains. Smoking also interferes with the circulation in the small
blood vessels and increases the risk of getting chilblains.
Once a chilblain develops:
* do not rub or scratch chilblains
* avoid direct heat (ie do not expose the feet to a heater), but keep
the feet warm by the use of woollen socks and footwear
* use soothing lotions (eg calamine lotion)
* if the skin is broken, use an antiseptic dressing to prevent the
chilblains becoming infected
* those with diabetes or poor circulation should see a Podiatrist. The
risk of further complications from the chilblains in those with a foot
that is 'at risk' is too high to delay seeking professional help
* thermal or insulating insoles can help keep the foot warm to prevent chilblains
* lanolin or a similar lotion that is rubbed into the feet will help
stimulate the circulation
* there are a number of natural or homeopathic remedies that are
recommended for the treatment of chilblains. Some of these do appear
to help some people.
Podiatric management of chilblains:
Podiatrists see a lot of people with chilblains in cold humid climates
and can give advice beyond what is listed above:
* padding and pressure relief may give some relief for the chilblain symptoms
* topical steroids may need to be used in case of very swollen severe chilblains
* corns and callus are common in the pressure areas where chilblains
can occur, so reduction of these will give some pain relief
* heparin ointment may be used in some people to improve the
circulation in the area
* a course of UV light at the start of winter in those prone to
chilblains has been recommended to help stimulate the circulation in
* a very rare occasions the chilblains may be a symptom of rare
medical problems (eg connective tissue disease or a bone marrow