Chilblains of the Foot (Pernio)

Chilblains, also called pernio, are painful or itchy skin changes that can develop on the toes or feet after being exposed to cold, damp weather. They are not frostbite, but they can be uncomfortable and may come back each winter if not managed properly.

What Do Chilblains Look and Feel Like?

Chilblains usually appear a few hours after your feet warm up following cold exposure.

Common symptoms include:

• Red, purple, or bluish patches on the toes

• Swelling of the toes or forefoot

• Itching, burning, or tenderness

• Pain that worsens when feet warm up

• Dry, cracked skin

• Occasionally blisters or open sores

What Causes Chilblains on the Feet?

Chilblains happen when the small blood vessels in your feet react poorly to cold temperatures. When feet get cold, blood vessels tighten. If they warm up too quickly, the vessels may leak and cause inflammation.

Common risk factors include:

• Cold, wet weather exposure

• Poor circulation

• Wearing thin socks or shoes

• Tight footwear

• Smoking or nicotine use

• Sudden temperature changes

• Conditions like Raynaud’s disease

How Are Chilblains Treated?

Most cases improve with simple care and protection from the cold.

Treatment options include:

• Keeping feet warm and dry

• Gradually warming feet (avoid heaters or hot water)

• Moisturizing dry or cracked skin

• Topical creams to reduce itching or inflammation

• Medications to improve circulation in severe or recurring cases

If sores become open or infected, medical treatment is important.

How Can You Prevent Chilblains?

Prevention is the best treatment, especially if you get chilblains every winter.

Prevention tips:

• Wear warm, insulated shoes and boots

• Use moisture-wicking or wool socks

• Avoid tight shoes and socks

• Change wet socks promptly

• Warm feet slowly after being outdoors

• Avoid smoking

• Stay active to improve circulation

Start prevention before cold weather begins for best results.

When Should You See a Podiatrist?

You should seek medical care if:

• Symptoms last more than 2–3 weeks

• You develop open sores or ulcers

• Pain is severe or worsening

• Chilblains keep coming back

• You have diabetes or circulation problems

Key Takeaway

Chilblains of the foot are a common cold-weather condition that causes painful, itchy toe lesions. With proper foot protection, early treatment, and good circulation habits, most people can prevent chilblains or manage symptoms effectively.

If you have ongoing foot pain, toe discoloration, or sores during cold weather, a podiatrist can help determine the cause and recommend the right treatment.