Chilblains
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
Chilblains are patches of inflamed skin that appear when your skin reacts to damp, cold weather. They are red, purple or blue, and they itch, burn or hurt. They usually show up on the toes and fingers. They are not common, and are seen more often in colder climates. Most chilblains settle on their own in 2 to 3 weeks without lasting problems. Simple steps, like warming up slowly, help you look after them. They often come back each winter.
What is it?
Chilblains (also called pernio or perniosis) are patches of sore, inflamed skin. They happen when the small blood vessels in your skin react in an unusual way to cold, damp conditions. The cold is not freezing. It is the chilly, wet kind of weather.
They cause red, purple or blue swellings or patches that can itch, burn or hurt. They most often appear on the toes and fingers. Chilblains are not common, and they are seen more often in colder climates.
Who does it affect?
Chilblains can affect anyone who spends time in damp, cold conditions, but they are seen more often in colder parts of the world. They sometimes run in families, which suggests some people are more prone to them.
Older people, and people with poor circulation or weak leg veins (venous insufficiency), may find that chilblains last longer.
Signs and symptoms
Chilblains usually start as small, itchy, red swellings. They can then become more painful, swollen and sore. They are usually on both sides of the body, for example on the same toes of each foot.
The most common places are:
- the toes, especially the smaller ones
- the fingers
- the heels
- the nose
- the lobes of the ears
- the face and legs, less often
The skin may look red, purple or blue, and may feel hot, swollen or itchy. On brown and black skin, redness can be harder to see, so look for purple or swollen areas as well.
In more severe cases, the skin can blister or break down into a small open sore (an ulcer). Chilblains can also dry out and leave cracks in the skin, which can get infected.
They often start in winter. Each episode lasts 1 to 3 weeks.
What causes it?
Chilblains come from an unusual reaction of the skin to cold. In the cold, the small blood vessels in your fingers and toes tighten and blood flow slows. If the cold skin is then warmed up too quickly, the vessels can't cope with the sudden rush of blood. Blood can leak into the nearby tissue, which causes swelling and itching.
Damp or draughty conditions can make this more likely. Warming chilled hands or feet too fast, for example by a fire, a radiator or a hot water bottle, can trigger chilblains. Diet and hormones may play a part for some people.
Chilblains are generally not linked to illness elsewhere in the body. Rarely, chilblain-like patches can be part of another condition, which is why a doctor should look at patches that are unusual, severe or keep coming back.
How is it diagnosed?
Chilblains are usually recognised from how they look and when they appear. Your podiatrist will ask about the timing, such as whether the patches followed time in the cold, started with the cold season or come back each winter. They will also ask about damp or draughty conditions and how you warm up after being cold.
They will look at which toes or fingers are affected, the colour of the skin, and whether there is blistering, an open sore or any sign of infection.
Other conditions can look similar, such as Raynaud's phenomenon, cold panniculitis and chilblain lupus. If your patches don't fit the usual pattern, your podiatrist will suggest that a doctor takes a closer look.
During the COVID-19 pandemic, some people, especially children, developed chilblain-like patches on their toes. They can look just like chilblains. The link to COVID-19 is uncertain, and a negative test doesn't rule out a link.
Treatment
Most chilblains heal within a few weeks without any permanent problems. Most people don't need medical treatment, and looking after them at home is the main approach.
Looking after it at home
Warm up slowly. Let cold hands and feet come back to normal at room temperature. Don't put them on a radiator, in front of a hot water bottle or under hot water.
Try not to scratch or pick at the skin, even when it is very itchy. Avoid smoking, caffeine and decongestant medicines (some cold and flu medicines), because they can affect blood flow in your fingers and toes.
If a chilblain breaks open into a sore, cover it straight away with a sterile dressing from a pharmacy. Check it every day for signs of infection.
If you have diabetes, check your feet regularly. You may not feel an infected chilblain.
Treatment from your podiatrist
Your podiatrist can check your feet, explain how to warm up safely and reassure you about what to expect. They can also look after any broken skin and tell you if you need to see a doctor.
Other options
If your chilblains are severe, keep coming back or aren't getting better, see your doctor. They can look for other causes and decide whether a medicine is suitable for you. It isn't yet clear how well specific medicines work for chilblains, so this is decided person by person.
Your doctor may consider a steroid cream called betamethasone. It didn't cause skin irritation or thinning when used, but it isn't yet clear whether it helps chilblains.
If a doctor suspects a rare immune condition (a type I interferonopathy), they will refer you to an expert centre. Medicines that calm the immune system may be considered if the skin is involved. They raise the risk of viral infections, and live vaccines are avoided while you take them.
Recovery
Chilblains usually go away on their own in 2 to 3 weeks, and most episodes settle by spring. They don't normally leave lasting damage.
They can take longer if you have poor circulation. They are also more likely to turn into open sores if you don't look after them. Smoking may slow healing. Older people, and people with weak leg veins, may find that chilblains last longer.
It is common for chilblains to return each winter.
Preventing it
The main steps are to avoid sudden heating of cold skin and to warm up slowly after being cold. Keep away from radiators, hot water bottles and hot water when your hands and feet are chilled. Where you can, avoid long spells in damp, draughty conditions. If you smoke, stopping may help.
It isn't yet clear whether these steps reduce how often chilblains come back, but they are sensible and safe to follow.
When to see a podiatrist
Book an appointment if
You have chilblains and would like your podiatrist to check your feet, look after any broken skin or show you how to warm up safely.
Seek prompt assessment if
If you have a chilblain or sore and you also feel very unwell, with confusion or slurred speech, severe shivering or muscle pain, severe breathlessness, mottled or discoloured skin, or little or no urine, this could be sepsis: call your local emergency number.
See your GP or another doctor today if a chilblain shows signs of infection: swelling and pus, feeling generally unwell, a fever of 38°C (100.4°F) or above, or swollen glands. If your GP can't see you today, go to an urgent care clinic or an after-hours GP.
See your GP or podiatrist today if you have diabetes, or are having medical treatment, and a chilblain has broken open into a sore. Cover it with a sterile dressing until you are seen.
See your GP soon if your chilblains are severe, painful or keep coming back, or if they haven't started to improve after 2 to 3 weeks.
See your GP or podiatrist soon if a chilblain blisters or the skin breaks down into a sore. Cover the sore with a sterile dressing and check it daily. See your GP soon too if you get chilblain-like patches without being out in the cold, or if you get them for the first time later in life.
Frequently asked questions
Why do I get chilblains every winter?
Some people's skin reacts strongly to damp cold, so the same pattern can repeat each winter. Chilblains sometimes run in families. Coming back each year is common and doesn't usually mean anything is wrong, but see your GP if they are severe or painful.
Do chilblains mean I have another health problem?
Usually not. Chilblains are generally not linked to illness elsewhere in the body. Your doctor will want to take a closer look if they are severe, keep coming back, happen without cold exposure or first appear later in life.
Are COVID toes the same as chilblains?
They can look the same: itchy or painful pink, red or purple patches on the toes. Some blister. It is uncertain how closely they are linked to COVID-19, and a negative test doesn't rule out a link. If you have patches like this, your podiatrist or GP can look at them.