With winter’s cold bite comes a surge in foot & ankle issues, especially Raynaud’s, chilblains & toe pain—common conditions we’ve been treating more often.
Both of these tend to flare up during colder weather, causing reduced blood flow, discomfort, and skin irritation. Raynaud’s results in numb, cold feet, while chilblains cause itching, swelling, and redness due to poor circulation in cold weather.
Raynaud’s disease is a systemic condition, while chilblains are a physical response to cold. While chilblains can often be prevented with proper care and protection from the cold, Raynaud’s cannot be prevented. Though Raynaud’s can sometimes be an underlying cause of chilblains, the two are not always linked. Understanding both conditions is essential for managing their symptoms effectively.
What Is the Difference Between Chilblains and Raynaud’s?
Chilblains are localised, painful, itchy lesions that form when the skin is exposed to cold, wet conditions and then warm up too quickly. The sudden change in temperature causes blood vessels to constrict, and when they reopen, they can leak fluid into the surrounding tissue. This leads to redness, swelling, and sometimes blisters.
Raynaud’s syndrome, on the other hand, is a systemic condition where smaller blood vessels, usually in the fingers and toes, constrict in response to cold or stress, limiting blood flow to those areas. This can cause the toes to feel cold and numb, change colour (usually from white or blue to red), and sometimes cause pain when the blood flow returns.
Both conditions are marked by a few common symptoms:
- Extreme temperatures in the toes (either feeling burning hot or freezing cold)
- Numbness, itching, pain, and
- Noticeable colour changes
When circulation is disrupted, you may notice your toes turning from a fiery red to a bruised, almost purple or blue colour.
If you’re experiencing any of these symptoms, it’s important to get checked out, as they can worsen, resulting in ulceration without proper care. There are simple measures to help manage the symptoms, like staying warm, wearing moisture-wicking socks, and using enclosed footwear. In some cases, a Podiatrist may recommend treatments like topical medication application, wax baths or lifestyle changes to improve circulation.
So, if you feel your feet are always cold or experience any of these changes, don’t hesitate to visit the clinic. It’s better to catch it early and prevent complications!
Raynaud’s Disorder, Syndrome or Phenomenon?
Raynaud’s Disorder, Syndrome, and Phenomenon all refer to conditions involving reduced blood flow, but they differ in causes and severity:
- Raynaud’s Phenomenon is the general term for temporarily reduced blood flow to the extremities (often fingers or toes), usually in response to cold or stress. It’s often not linked to any underlying disease.
- Raynaud’s Disease (or Disorder): This is a primary form of Raynaud’s, meaning it occurs by itself without any other medical conditions. It’s the most common type and is often triggered by cold temperatures or emotional stress.
- Raynaud’s Syndrome: This refers to secondary Raynaud’s, which occurs as a result of another underlying condition, such as autoimmune diseases like lupus or scleroderma. It’s generally more serious and can lead to long-term complications.
In short, phenomenon is the broadest term, while disease/ disorder is primary and syndrome is secondary, usually linked to other health issues. Raynaud’s is triggered by cold exposure or emotional stress, which can further reduce blood circulation. People with autoimmune disorders, connective tissue disorders, or a family history of blood supply problems are at higher risk. Raynaud’s can be primary (without an underlying condition) or secondary (linked to another health issue like systemic sclerosis).
What About Chilblains?
Toes or fingers that turn pink or red, often accompanied by a hot, burning, or itchy sensation, along with swelling, are typical signs of chilblains. When cold weather restricts blood flow to the toes, followed by a return to warmth, the sudden rush of blood can overwhelm the area, triggering a reaction to the cold sensation with redness, swelling, itching, and pain on the affected skin.
In severe cases, blisters, peeling, or skin breakdown may occur as the skin becomes fragile due to ongoing inflammation and swelling. Chilblains are caused when cold temperatures constrict blood vessels, reducing blood flow. As the area warms up, blood rushes back in, sometimes resulting in an exaggerated inflammatory response. Chilblains are more common in damp, freezing conditions or when skin is suddenly exposed to heat after being cold.
Risk factors for chilblains include:
- Family history
- Raynaud’s phenomenon
- Circulatory issues and
- Lifestyle factors like smoking or prolonged inactivity
- People who originate from warmer climates and have moved to an area with a colder climate
- People with autoimmune diseases or blood disorders may also be at higher risk
If symptoms are recurrent or very painful, a thorough medical evaluation can help diagnose the condition, often through a physical examination and sometimes blood tests to rule out underlying causes.
How Can You Tell The Difference Between Chilblains & Raynaud’s?
Chilblains and Raynaud’s share similar symptoms, but chilblains occur after exposure to cold and cause skin swelling, itching, and colour changes, while Raynaud’s symptoms are triggered by cold or stress, causing fingers and toes to turn white/blue. A cold stimulation test can help distinguish between the two.
The Role of Blood Vessels, Blood Flow & Circulation in Managing Raynaud’s and Chilblains
Understanding the importance of blood vessels, blood flow and circulation is essential when addressing Raynaud’s and chilblains. Both conditions involve restricted blood flow to extremities, leading to discomfort, swelling, and skin damage after exposure to cold or emotional stress. Proper treatment aims to improve circulation, alleviate symptoms, and prevent further complications. By focusing on restoring healthy blood flow, treatments help minimise the risk of tissue damage and long-term effects.
To manage Raynaud’s, it’s key to keep your skin warm, avoid damp conditions, and wear warm clothes to increase blood flow. In some cases, medications like calcium channel blockers are prescribed to help dilate blood vessels. If symptoms persist or worsen, a medical evaluation is essential to rule out underlying causes and prevent complications like tissue damage.
Do Chilblains Mean I Have Poor Circulation?
Chilblains may indicate issues with blood circulation, especially when cold exposure leads to restricted blood flow. While not always linked to poor circulation, they can be a sign of compromised blood vessel walls or conditions like Raynaud’s phenomenon. Recurrent episodes may suggest underlying circulation problems.
What Autoimmune Diseases Can Cause Chilblains?
Chilblains can occur with autoimmune diseases like systemic sclerosis, lupus, and rheumatoid arthritis. In these cases, secondary Raynaud’s may also be present, where cold exposure exacerbates symptoms. These diseases can affect blood vessels, making chilblains more common. Blood tests help identify autoimmune causes.
How Do You Prevent & Manage Chilblains?
Since chilblains and Raynaud’s often go hand-in-hand (or toe-in-toe?), the treatments for them are mostly the same.
Preventing chilblains involves taking steps to avoid cold exposure and improving blood circulation, which is crucial for both chilblains and Raynaud’s disease. Since these conditions often occur together, the treatments overlap.
- Avoid Cold Exposure: Protect your skin from extreme cold by dressing warmly and wearing insulated gloves, socks, and shoes. It’s important to cover exposed areas, particularly on hands and feet.
- Keep Warm: Ensure your home is warm, and use heating pads or electric blankets if necessary. Avoid sudden temperature changes, as rapid warming of cold extremities can trigger chilblains.
- Improve Circulation: Regular physical activity promotes blood flow, which can help prevent both chilblains and Raynaud’s attacks. Avoid sitting or standing still for long periods, as it may restrict blood flow.
- Avoid Damp Clothing & Shoes: Wet or damp clothes can exacerbate chilblains. Ensure shoes and socks are dry and insulated to protect your feet.
- Topical Treatments & Medications: In more severe cases, your doctor may recommend topical creams to reduce inflammation or medications like calcium channel blockers, which help dilate blood vessels and improve circulation.
- Lifestyle Modifications: Quitting smoking is essential, as nicotine constricts blood vessels, worsening circulation problems. Eating a balanced diet and staying hydrated also support vascular health.
Focusing on warmth, circulation, and protection from cold can significantly reduce the risk of developing chilblains and effectively manage existing symptoms.
Getting On Top Of The Problem – How Your Podiatrist Can Help!
It’s crucial to address the cause and treatment of Raynaud’s and chilblains as soon as possible to prevent them from worsening. The earlier you manage them, the better the long-term outcome! Untreated symptoms, like fluid-filled bumps or painful swelling, can lead to potential complications.
By coming in to see us, we can help you manage these conditions with tailored treatments and expert advice. Our podiatrists will assess your symptoms, help improve circulation, and provide strategies to protect your exposed skin from cold temperatures. We’ll guide you on how to keep your feet warm and dry, advise on appropriate footwear to prevent damp shoes, and offer tips to improve overall circulation.
If needed, we can explore advanced treatment options to manage Raynaud’s chilblains and toe pain, reducing inflammation, easing discomfort, and preventing complications. Don’t wait for the pain to get worse—schedule an appointment today, and we’ll help you take control of your condition and get you back on your feet.
Until next time, have fun and keep on walking!
Caelin Ling
Podiatrist
Holistic Foot Clinic
https://www.sruk.co.uk/raynauds/chilblains/
https://www.mayoclinic.org/diseases-conditions/chilblains/symptoms-causes/syc-20351097
https://www.medicalnewstoday.com/articles/176713.php