Foot health: Chilled feet – preventing problems
Podiatrists (or chiropodists) assess, diagnose and treat people with problems of the feet, ankles and lower limbs. Our aim is to give professional advice to improve the mobility, independence and quality of life for our patients of all ages. There is no difference between a chiropodist and a podiatrist.
The cold, damp weather in the UK can cause problems with our extremities – in particular our feet. Read on to find out more about the prevention and treatment of chilled feet and chilblains and how to get your feet ready for summer.
Many people suffer from cold feet in Winter, but they will not all go on to develop chillblains. Chilblains are caused by the skin having an abnormal reaction to the cold and it may depend on your circulation as to how likely it is you will get them.
- Chilblains are a non-freezing cold injury, which shuts down the peripheral blood vessels leading to localised damaged tissue.
- Frostbite is very different – it is a freezing injury, which leads to death of the tissue.
What are chilblains?
Chilblains are small, itchy swellings on the skin that occur as a reaction to cold temperatures. Chilblains are uncomfortable but are not a serious health issue, and can be prevented.
- Young people may suffer chilled feet but not all of them will develop a chilblain reaction.
- Chilblains occur where chilling is followed by an inflammatory response.
- Chilblains can occur at any age but are more common in children and elderly people.
- The condition affects women more than men.
- Certain people, such as those with poor circulation, are susceptible to chilblains.
- Chilling is more common in the elderly where the circulation is less efficient. This develops tissue damage, which can lead to tissue death and ulceration.
When do they occur?
- Chilling tends to occur most commonly during the winter months when the climate is cold and damp.
- Chilled areas appear on the toes, fingers, ears and nose.
- It is these extremities that cool the quickest.
What causes them?
If the extremities get chilled, the tissue loses its oxygen and becomes damaged. This occurs when the circulation is impaired leading to a black, scabbed area. Where the circulation is better, i.e. with young people, a mild inflammatory response may occur, leading only to a slight discomfort and redness.
Who is most at risk?
- Young women
- People working outdoors such as open markets
- Older people who tend to have an underlying circulatory disorder
- People with anaemia.
What are the signs and symptoms?
- Chilblains can be described as an itchy or burning sensation, which Increases as the area warms up.
- Chilling can be recognised as red blotches, a blue discolouration or blisters, which could break open.
- Older people tend to lose skin sensation with age and may not feel this damage.
- Colour changes that occur:
1st stage: blue discolouration (cynotic)
2nd stage: red blotches (reactive hyperaemia)
3rd stage: white blemishes (congestive)
4th stage black scabs (broken)
‘Prevention is better than cure’.
Prevention
Steps should be taken to prevent the feet from chilling too much. Legs as well as the feet need to be kept warm.
You can help yourself if you avoid extremes of temperature and you wear:
- Trousers
- Long boots
- Thick tights
- Leg warmers
- Cotton or wool socks and tights
- Fur fleece lined shoes and slippers
- Thicker soled shoes
- Thermal insoles
- Thermal socks
Treatment of chilblains
- Chilblains can get better by themselves, but may return in the cold weather.
- If you have a chilblain, do not use a hot water bottle or put your feet directly in front of a fire. Warm up your feet slowly, using massage.
- You can apply Friar's balsam or a chilblain cream to the area. These treatments will help to warm the tissues slowly.
- Witch hazel or calamine lotion will help to reduce the itchiness.
- If the chilblain has broken open, an antiseptic dressing should be applied and medical advice sought. When applying any medication please read the label first.
Chilling in older people
If you have any worries about chilled or cold feet, contact your State Registered Podiatrist or GP who will advise you.
About the author
Neeta Still is a State Registered Podiatrist, registered with the Health Professional Council (number 12661). She has completed three years full time study at the London Foot Hospital, qualifying in 1993 with a diploma in Podiatric medicine. She has worked in the NHS and been established in private practice since 1994. After qualifying she studied foot surgery for a further year and has maintained her own professional development by completing a teaching qualification and a post-graduate diploma in management. She has passed the prescribing exam, which allows her to supply and administer certain prescription-only drugs. This is part of her Masters degree in Podiatry.
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