Chilblains: Treatment, Relief, and Prevention

Chilblains (pernio) are inflammatory skin lesions from cold, damp exposure—not freezing. They cause itchy, red/purple swellings on fingers, toes, ears, nose.

Symptomatic Treatment

1. Don’t scratch—prevents infection; keep nails short, wear loose clothing.
2. Cold compress: 15–20 min, several times daily (reduces swelling/itch).
3. Calamine lotion: Soothes itch/inflammation.
4. Oral antihistamines: Cetirizine, loratadine, fexofenadine (less sedating); diphenhydramine at night.
5. Oatmeal baths: Colloidal oatmeal 15–20 min.
6. Topical corticosteroids (mild): Hydrocortisone 1% for inflammation if needed.
7. Aloe vera / witch hazel / dilute tea tree oil: Adjunctive soothing.

Prevention

• Keep extremities warm/dry (gloves, socks, insulated boots).
• Avoid rapid rewarming (no hot water immersion).
• Smoking cessation (vasoconstriction worsens chilblains).
• Calcium channel blockers (nifedipine) for recurrent/severe cases.

When to See a Doctor

• Ulceration, infection signs, persistent >2–3 weeks.
• Underlying connective tissue disease (lupus, scleroderma) screening if recurrent.