Treatment

There’s huge differences in opinion here. The main issue is keeping the problematic body parts at a constant temperature, avoid any sudden temperature changes (easier said than done if commuting to work during the winter), and keep any developing chillblains dry but moisturised. The last thing you want is for the skin to split.   Some doctors may prescribe hydrocortisone cream (its available over the counter in the UK without prescription) which does have a quick positive effect (reducing swelling and irritation) but should be used sparingly as this thins the skin;  potentially aggravating the condition if used long term.

Chillblain creams do exist which moisturise in addition to containing an irritant which brings blood to the surface and cause a warming effect. These may help, or at least bring some relief although I believe the warming effect is just that – an effect. The only way to encourage blood into a problem area is exercise (and to a lesser extent massage – massage also helping with fluid removal).

I’ve also used Geranium oil in the past, but I think the benefit is due to the moisturising properties rather than the plant extract. Anything moisturising massaged in to the affected area may help, keep the skin supple and increasing circulation.

Socks containing high silver content
Socks containing high silver content

There’s quite a few comments online regarding ‘heated socks’. I’ve tried several brands but all are too bulky to wear with shoes. Any socks you do wear should be natural fibres; cotton or wool. These insulate and also ‘wick’ better – carrying sweat away from the affected area. I often wear two pairs, one pair of cotton next to my skin and an outer pair of wool. The double layer traps air and insulates well. Others have suggested ‘silver socks’ as the silver helps heat transfer from feet to toes but I’ve been unable to find these locally.

Update:  I’ve today worn a pair of 12% silver socks.  They do make a small but noticeable difference, aiding heat transfer between the sole of the foot and extremities.  I now see these available online via specialist Reynaud and diabetes retailers.  It is also advisable to use ‘seamless’ socks as many traditional seamed socks may rub already irritated skin.  

Moisture is our enemy, if your feet are affected consider changing socks two or more times daily; keep your feet warm (but not hot) and dry at all times.

When cold, the worst thing we can do is rapidly heat our affected parts as this may provide temporary comfort but will only aggravate the problem in the long term. Some people recommend gently warming the affected area in a warm (but not hot) water bath. I’ve not tried this – but I imagine there’s a fine line between helping and aggravating.

Heated Foot Massager
Heated Foot Massager

Update:  I have started to use a warmed foot massager;  I find the gentle heating combined with massage effect to be very beneficial.

Whatever you do – never rest your hands/feet on a radiator. It feels great but 20 minutes later you’ll be regretting it, guaranteed!

When my condition is at its worst, I often gently bind my toes with strips of plasters. I do this so swellings protected but not so tight as to reduce circulation. This does seem to help.  Occasionally I may also apply a gentle moisturising cream first.

I do this for anywhere between a few days and a week or more;  I have to be careful not to over-do the moisturing as too much seems to over-soften and make worse rather than better.  Once the swellings have reduced and any splits healed I’ll then try and ‘dry them out’; remove plasters, considerably reduce moisturising, keep dry, and expose them to air as much as possible.

Woman walking dog.
Any exercise can be beneficial.

I haven’t mentioned perhaps the most important part of all yet though; exercise. If you can manage it, do it. The one year I didn’t suffer at all despite a hard winter and a long commute on foot was the same year I was in the gym 5 days a week. Initially I started with cardio, but later moved to lifting weights; the type of exercise didn’t seem to matter – just get that heart working!

In summary, keep well insulated, don’t over-heat or over-cool, keep dry, consider moisturising, massage and exercise.  I should also mention smoking; this is bad for many reasons but specifically your circulation.

Finally, if like me you suffer from chillblains on the toes, good fitting shoes are essential. Only of course it’s not that simple. Great fitting shoes may not be so great fitting once your toes have swollen to twice their size and the slightest pressure is agony.  I find a size shoe larger than I’d normally take helps; I simply fit an insole which moves my foot position upwards enabling me to lace up snugly. The insert then adds to the cushioning and also the insulation. Thin work shoes on cold pavements is just asking for trouble – the more insulation the better.

Update:  I have not covered medication.  In the UK, Nifedipine (click to see wikipedia article) can be prescribed to widen blood vessels and increase blood flow.  It does not cure the condition but may reduce symptoms.  However, there are also side effects and my doctor suggested this should always be a last resort.

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