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Condition - Chilblains

(aka pernio / perniosis)

By Faye Butler BSc (Hons)

What are chilblains?

Chilblains, sometimes referred to as pernio or perniosis, are often characterised by sore, and sometimes itchy red bumps or patches on the skin’s surface, usually present in areas such as the toes, fingers, ears or nose, otherwise known as the extremities. These uncomfortable and rather painful, red swellings develop as a result of exposure to cold and humid conditions. 

When skin cools, tiny blood vessels (capillaries) narrow. They then expand again when returning to warmth. The change from cold to warm can sometimes cause blood to leak out of the capillaries, which, in turn, can lead to inflammation and chilblains, especially if the change in temperature is sudden.   

Who is at risk?

Chilblains commonly affect children and the elderly, and generally tend to affect females more than males. People who suffer with poor circulation, commonly those with diabetes, or Raynaud’s phenomenon (extreme sensitivity to cold where fingers/toes turn white or blue due to limited circulation) tend to be more vulnerable to chilblains. In these circumstances, the extremities undergo such intense temperature changes from cold to warm, that the risk of blood leaking from the capillaries, and thus the development of chilblains, is heightened. 

Furthermore, people with lupus, a condition where the body’s immune system attacks healthy tissue, are more susceptible to chilblains, as blood vessels are more vulnerable to inflammation. 

Dietary Recommendations

Poor dietary and lifestyle habits can greatly influence the risk of developing chilblains. 

Try to avoid…

Smoking – nicotine constricts blood vessels and can cause circulatory problems, particularly in the extremities.

Caffeine and alcohol – drinking either or both in excess can have a very negative impact on circulation and chilblains. They both work in a similar way to nicotine, constricting blood vessels and decreasing circulation.

Sugary foods – foods high in refined sugar, such as chocolate, sweets and biscuits, can hinder the anti-inflammatory systems of the body, which may induce the development or prolong the existence of chilblains. Similarly, saturated fat is pro-inflammatory and also increases cholesterol. Try to avoid fatty cuts of meat, high-fat dairy products, pastries/cakes and crisps.

Salt – a high-salt diet may increase the chances of developing high blood pressure. This makes the blood more viscous, which makes it harder to transport around the body. The majority of processed foods have a tendency to be high in salt for preservation and flavour, and so it is advisable to avoid them and try not to add salt to food while cooking or at the dinner table. 

Try to include…

Oily fish – increasing the levels of essential fatty acids, particularly the omega 3 series, in the diet can reduce the stickiness of blood and help it to flow more easily around the body. Furthermore, it can help to manage inflammation. Try to include a portion of salmon, sardines, mackerel or anchovies in the diet once to twice a week.

Nuts and seeds – nuts, such as almonds, are high in niacin (vitamin B3), which can widen blood vessels and help to pump blood into the smaller capillaries. Seeds, including pumpkin and sunflower seeds, are a good source of vitamin E, which, research has shown, can increase circulation. Snacking on a variety of nuts, particularly walnuts, and seeds will also further boost omega 3 essential fatty acids in the blood.

Oranges –rich in vitamin C and bioflavonoids, oranges help the flow of blood through the body by strengthening the capillary walls and reducing cholesterol. 

Garlic and onions – components of both can help prevent blood from clotting, thus supporting healthy blood flow.

Ginger – research indicates that ginger may stimulate circulation by widening blood vessels. Try incorporating ginger into meals or sip hot water and ginger for a circulatory boost.

Green tea – Warm up with a green cuppa! Studies have shown that green tea, particularly the catechins within it, have great vasodilating effects, boosting circulation. Alternatively, research also suggests that cat’s claw tea may be helpful.

Useful Supplements and Topical Creams

Useful Supplements:

Vitamin Cand bioflavanoids together help build strong capillaries and aid skin renewal.

Essential fatty acids – both omega 3 and omega 6 essential fatty acids help to aid blood flow and manage inflammation. Fish and flax seed oils are good sources of omega 3, while starflower (borage) oil is highly concentrated in the active form of omega 6, GLA.

MSM (methylsulphonylmethane) aids skin renewal.

Vitamin E is a powerful antioxidant that helps to maintain healthy arteries.

Bromelain, an enzyme derived from pineapple, has been shown to encourage healthy circulation.

Coenzyme Q10 is an antioxidant that optimises oxygen transport into the cells.

Calcium and magnesium are important minerals for the proper functioning of the cardiovascular system. 

Topical Creams:

Creams or gels containing Aloe vera (which has natural anti-inflammatory properties) or MSM may help to soothe the inflammation and discomfort of chilblains. Furthermore, the motion of applying something to the area may help increase circulation to these parts. 

Lifestyle Advice

  • Keep areas such as toes, fingers and ears covered and warm with thick socks, scarves, hats and gloves during colder weather.
  • It is important not to expose the skin to extreme temperatures, i.e., do not put very cold feet into a very hot bath. Although this may seem the quickest way to regain warmth, the abrupt change in temperature can increase the chances of developing chilblains, or making existing chilblains worse. Always try to make the change in temperature gradual.
  • Regular exercise increases blood flow around the body, including the extremities, such as fingers and toes. The body’s core temperature is also raised as a result of physical activity.
  • Skin brushing can help to stimulate and increase blood circulation. With a natural bristle brush, try to brush in circular movements towards the heart, prior to a bath or shower.  

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