# Chilblains > Chilblains (pernio) are red or purple, itchy or painful patches on the toes and fingers, caused by the skin reacting to cold and damp. Most settle on their own within a few weeks. Rewarming slowly, avoiding direct heat and not scratching is the main thing to try. Guide in [Skin and nails](https://footanklelowerlimb.com.au/learn/topics/skin-and-nails), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/chilblains Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **A reaction to cold and damp:** chilblains are red or purple, itchy or painful patches, usually on the toes and fingers. - **Most settle by themselves** in a few weeks, and most people don't need medical treatment. - **Rewarm slowly:** keep cold hands and feet away from radiators and hot water, and try not to scratch. - **Some need checking:** blistered or broken skin, signs of infection, or chilblains that keep coming back. ## What are chilblains, and how common are they? Chilblains (also called pernio or perniosis) are an abnormal reaction of the skin's small blood vessels to cold, damp conditions [1]. They cause red or purple swellings that itch or hurt, usually on the toes and fingers, though they can appear on other areas [1]. They happen after exposure to cold but non-freezing wet weather, and they usually settle on their own [2]. Chilblains are described as an uncommon condition [3]. ## What causes chilblains, and who gets them? Chilblains come from the skin's abnormal reaction to cold [4]. Cold makes the small blood vessels in your fingers and toes tighten for too long, which reduces blood flow, and damp and windy conditions can make this worse [1]. Damp or draughty living conditions may also play a part, and so can chilling followed by warming up too quickly, for example in front of a fire or hot water bottle [5]. They're seen more often in colder climates [4]. ## What do chilblains look and feel like, and how are they diagnosed? Chilblains typically show as itchy or painful red, purple or blue patches or swellings on the toes and fingers, often on both sides of the body, and less often on the heels, nose or ears [4]. They often start in winter [4]. The smaller toes are common spots [5]. The skin can swell and then dry out and crack, which raises the risk of infection [5]. On brown and black skin, redness can be harder to see, so look for purple or swollen areas as well [6]. A podiatrist or GP will usually ask when the patches appeared, whether they followed the cold and whether they return each winter, and will look closely at the skin. Occasionally other conditions look similar [4], which is one reason patches that appear without cold, or for the first time later in life, are worth getting checked [1]. ## What can I do first? Most people don't need medical advice for chilblains [7]. The main step is to rewarm slowly after being cold [8]. Warming up too fast with a radiator, hot water bottle or hot water is best avoided [9]. Try not to scratch or pick at itchy chilblains [9]. > [!tip] Try this > When you come in from the cold, take off any damp socks or gloves and put on dry, loose ones. Let your hands and feet warm up gradually at room temperature. If a chilblain has broken open (ulcerated), cover it straight away with a sterile dressing, which you can buy at a pharmacy, and check it daily for signs of infection [10]. A podiatrist or GP can look at it and advise on care. ## What helps if that isn't enough? If self-care isn't enough, a GP can look for other causes and decide whether a medicine is suitable for you. Medicines for chilblains should be prescribed and reviewed by a doctor, who weighs up the benefits and harms for each person. It isn't clear yet how well any particular medicine works. While you arrange a review, keep up slow rewarming and avoid scratching. ## How long do chilblains last, and how can I stop them coming back? Chilblains usually go away on their own in 2–3 weeks [6]. They often start with winter, settle by spring and commonly return each year [4]. Older people, and people with venous insufficiency (poorly working leg veins), may have a longer course [4]. If your circulation is poor, chilblains may last several weeks and are more likely to become open wounds if you don't look after them [9]. To lower the chance of them coming back, try to rewarm slowly after the cold rather than using direct heat [8]. Smoking and caffeine can affect blood flow in the fingers and toes [6], and smoking may slow healing [9], so cutting back is worth considering. It isn't clear yet how much any of these steps reduces how often chilblains return. ## When to see a podiatrist See a podiatrist or your GP if your chilblains are severe, haven't improved after 2–3 weeks, or keep coming back; if they blister, break down or are painful; if they happen without cold exposure; or if they first appear later in life [1][6]. See your GP or a podiatrist the same day if you notice swelling and pus around a chilblain, a fever of 38°C or above, swollen glands, or feeling generally unwell [7]. See your GP or a podiatrist the same day too if a chilblain has broken open and you have diabetes or are having medical treatment, or if you have diabetes and notice any new sore, blister or colour change on your foot [9]. People with diabetes may not feel an infected chilblain, so check your feet regularly [7]. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. ## Common questions ### Are COVID toes the same as chilblains? They can look very alike. During the pandemic, many children developed chilblain-like patches on their toes, and whether the virus causes them is still unsettled. Most children tested didn't have COVID-19, and some cases may have been ordinary chilblains. A negative test doesn't completely rule out a link. A GP can help if patches appear. ### Do chilblains mean I have an underlying health problem? Usually not. Chilblains are generally not linked to illness elsewhere in the body. Occasionally chilblain-like patches can go with other conditions, so a GP can check if your patches don't seem typical. Mention any other symptoms you've noticed, such as feeling unwell, when you book your appointment. ### Why do I get chilblains every winter? Chilblains are set off by cold, damp weather, so they often return when the cold season starts. Some people also seem more prone to them, as chilblains can cluster in families. Rewarming slowly after being cold is worth keeping up each winter, and a podiatrist can talk through your situation if they keep coming back. ## Further reading - [Chilblains on Clindice](https://clindice.com/chilblains) - [Chilblains](https://www.oxfordhealth.nhs.uk/wp-content/uploads/sites/44/2024/02/OH-003.24-Podiatry-Chilblains.pdf), NHS - [Chilblains (perniosis) - symptoms and treatment](https://www.healthdirect.gov.au/conditions/skin-conditions/chilblains), healthdirect - [Chilblains](https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/chilblains), Better Health Channel - [Chilblains – Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH)](https://www.rdash.nhs.uk/services/podiatry-foot-protection/general-foot-care/chilblains/), NHS - [Chilblains - The Dudley Group NHS Foundation Trust](https://www.dgft.nhs.uk/pil/chilblains/), NHS ## Sources 1. Chilblains (perniosis) - symptoms and treatment · Healthdirect Australia. https://www.healthdirect.gov.au/conditions/skin-conditions/chilblains 2. Chilblains · Nyssen A, Benhadou F, Magnée M et al. · VASA · 2020. https://doi.org/10.1024/0301-1526/a000838 3. An Evidence-Based Review of Perniosis (Chilblains): Therapeutic Strategies and Integration With Raynaud's Syndrome Management · Sharifzadeh A, Smith GP · International Journal of Dermatology · 2025. https://doi.org/10.1111/ijd.17812 4. Pharmacologic Treatment of Idiopathic Chilblains (Pernio): A Systematic Review · Pratt M, Mahmood F, Kirchhof MG · Journal of Cutaneous Medicine and Surgery · 2021. https://doi.org/10.1177/1203475421995130 5. Chilblains · NHS. https://www.dbth.nhs.uk/wp-content/uploads/2025/12/Chilblains-leaflet.pdf 6. Chilblains · NHS · 2017. https://www.nhs.uk/conditions/chilblains/ 7. Chilblains · nidirect. https://www.nidirect.gov.uk/conditions/chilblains 8. Chilblains · NHS. https://www.oxfordhealth.nhs.uk/wp-content/uploads/sites/44/2024/02/OH-003.24-Podiatry-Chilblains.pdf 9. Chilblains · NHS. https://publicdocuments.sth.nhs.uk/pil5718.pdf 10. Chilblains · NHS. https://www.somersetft.nhs.uk/podiatry/wp-content/uploads/sites/135/2022/06/Chilblains-FINAL-v2-140622-.pdf --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.