Chilblains — also known as pernio and chill burns[2] is a medical condition that occurs when a predisposed individual is exposed to cold and humidity, causing tissue damage. It is often confused with frostbite and trench foot. Damage to capillary beds in the skin causes redness, itching, inflammation, and sometimes blisters.[3] Chilblains can be reduced by keeping the feet and hands warm in cold weather, and avoiding extreme temperature changes.

Other namesPernio, chill burn, perniones, perniosis[1]
Toes inflamed by chilblains
  • /ˈɪlblnz/
SpecialtyEmergency medicine

Chilblains can be idiopathic (spontaneous and unrelated to another disease), but may also be a manifestation of another serious medical condition that must be investigated. A history of chilblains suggests a connective tissue disease (such as lupus). Chilblains may also be caused by Raynaud's disease.

In infants, chilblains together with severe neurologic disease and unexplained fevers occurs in Aicardi–Goutières syndrome, a rare inherited condition. Ulcerated chilblains are referred to as kibes.

Signs and symptoms

The areas most affected are the toes, fingers, earlobes, nose.

Chilblains usually heal within 7–14 days.



  • Avoid rapid changes in temperature (including from cold to hot).[4]
  • Wear warm shoes, socks and gloves.[4]
  • Wear a hat and a scarf to protect the ears and the nose.[4]
  • Avoid tight fitting socks/shoes.


  • Exercise at least four times a week to improve circulation[4]


  • A course of vitamin B, especially nicotinic acid, helps improve circulation and may completely treat the chilblains.
  • Soaking in warm water with Epsom salts for 15–20 minutes, 3–4 times a day.
  • Keep affected area warm, and avoiding any extreme temperature changes (including very hot water).
  • Keep affected area dry.[5]
  • Use a topical steroid cream to relieve itch.
  • Nifedipine, a vasodilator, may help in more severe or recurrent cases.[6] Vasodilation helps reduce pain, facilitate healing and prevent recurrences.[7] It is typically available in an oral pill but can be compounded into a topical formula.
  • Diltiazem, a vasodilator, may also help.[8]
  • Apply a mixture of friar's balsam and a weak iodine solution.[4]
  • Avoid restricting the affected area.[9]


The medieval Bald's Leechbook recommended treating chilblains with a mix of eggs, wine, and fennel root.[10]

A common tradition of Hispanic America recommends warm garlic on the chilblains.[11]

See also


  1. James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
  2. SJ; et al. SJ'.
  3. Cold Stress: Chilblains. National Institute for Occupational Safety and Health. Retrieved January 6, 2009.
  4. "What are chilblains (pernio)? What causes chilblains?". Medical News Today.
  5. " - #1 Online Source for Treatments, Prevention, Relief Advice".
  6. Rustin, M.H.A.; Newton, Julia A.; Smith, N.P.; Dowd, Pauline M. (2006). "The treatment of chilblains with nifedipine: the results of a pilot study, a double-blind placebo-controlled randomized study and a long-term open trial". British Journal of Dermatology. 120 (2): 267–75. doi:10.1111/j.1365-2133.1989.tb07792.x. PMID 2647123.
  7. Simon, T. D.; Soep, JB; Hollister, JR (2005). "Pernio in Pediatrics". Pediatrics. 116 (3): e472–5. doi:10.1542/peds.2004-2681. PMID 16140694.
  8. Patra, AK; Das, AL; Ramadasan, P (2003). "Diltiazem vs. nifedipine in chilblains: A clinical trial". Indian Journal of Dermatology, Venereology and Leprology. 69 (3): 209–11. PMID 17642888.
  9. " - Information, Treatment and Prevention". Archived from the original on 2016-03-05. Retrieved 2019-11-06.
  10. Robert Lacey and Danny Danziger August: The Year 1000: What Life Was Like at the Turn of the First Millennium Little, Brown, 2000 ISBN 0316511579
  11. "Remedios caseros para sabañones". (in Spanish). Retrieved 29 December 2016.
External resources
  • Cold stress, National Institute for Occupational Safety and Health
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