Do You Know What a Chilblain Is?

A rough guide for Americans in the UK this winter.

By Rose Ernst

Photo by Ray Hennessy on Unsplash

Do you think it’s Covid?” I asked.

“How could it be? Is that a symptom of it?” my partner asked.

I flashed a graphic image at him from my phone.

“It’s called Covid toes.”

We stared at his swollen, shiny, pink-purple toes.

“It must be something else.”

“I’m sure we can make it go away,” I said. 

Little did I know, he had passed a time-honored hazing ritual of living in the UK: chilblains.

“Tuppenny was a short-haired guinea-pig of dilapidated appearance. He suffered from toothache and chilblains; and he had never had much hair, not even of the shortest. It was thin and patchy. Whether this was the result of chilblains or of ill-treatment is uncertain.”—The Fairy Caravan, by Beatrix Potter

Tuppenny and his poor chilblains. Beatrix Potter, 1929 (public domain).

Although I’d grown up in Alaska and lived for 25 years in the wet and mild climate of the Pacific Northwest, I’d only ever read about “chilblains” in British children’s literature.

Beatrix Potter’s book, The Fairy Caravan, is about a poor guinea pig with chilblains all over his body. Though she never described them, it was clear they were a dreadful affliction.

But because these books were old, I thought “chilblains” were just a euphemism for a general ailment, much like a “bilious attack” meant that you’d been a glutton at supper.

So what are they, and why do we not talk about them in the United States?

No Graphic Pictures

Photo by Craig Cooper on Unsplash

According to the Mayo Clinic, chilblains “are the painful inflammation of small blood vessels in your skin that occur in response to repeated exposure to cold but not freezing air. Also known as pernio, chilblains can cause itching, red patches, swelling and blistering on your hands and feet.”

Here’s where the conflict between the United States and the United Kingdom arises:

US-based medical researchers claim that chilblains are “a rare inflammatory condition,” while Scleroderma & Raynaud’s UK says that “Chilblains are common. It is thought that about 1 in 10 people in the UK get chilblains at some stage in their life.

Perhaps the US researchers should have claimed that chilblains were “rare” in the United States. 

When I mentioned the topic at the local shop in Cornwall, the sleepy mid-winter shopkeepers perked up. “Chilblains?” They’d say, happily launching into a miserable story of their own or that of a relative.

Chilblains often appear on your extremities, and if you’re unfortunate enough to get them on your feet — as my partner did — you simply cannot walk. And this isn’t like recovering from an insect bite. They take at least two to three weeks to heal, and even then they can return. 

Here’s the list of symptoms

chilblains appear as small itchy, red areas on the skin

in some cases, the skin over a chilblain may blister which may delay healing 

sometimes the skin breaks down to leave a small ulcer which is prone to infection

possible secondary infection finger skin inflammation

the chilblain may become ulcerated chilblains become increasingly painful as they get congested and take on a dark blue appearance

toe skin inflammation — the affected area is swollen

a burning sensation on the skin

How to Avoid Chilblains

Photo by George Hiles on Unsplash

Though chilblains can appear unexpectedly, you can take steps to avoid them. 

I grew up in ice and snow, but the closest ailment I’d ever heard of was frostbite, an entirely different condition. My partner also grew up with Ukrainian winters, and he’d never heard of them either.

The NHS has several recommendations for avoiding chilblains, but here are the two most important:

Warm your shoes on the radiator before you put them on — make sure damp shoes are dry before you wear them; if your feet are already cold, make sure your shoes aren’t too hot to avoid causing chilblains.

Warm your hands before going outdoors — soak them in warm water for several minutes and dry thoroughly, and wear cotton-lined waterproof gloves if necessary; if your hands are already cold, make sure not to warm them up too quickly to avoid causing chilblains.

I wish my partner and I had read this before we went into a UK winter lockdown. 

We went on a long walk in the rain and his feet became wet. When we returned, he took a hot shower

That’s what caused the chilblains: “When the skin is cold, blood vessels near its surface get narrower. If the skin is then exposed to heat, the blood vessels become wider.

Avoid exposing cold, damp skin to immediate heat, and vice versa. Let your body adjust slowly. 

After my partner’s toe incident, I committed the same crime: I returned from my walk with cold, damp hands. I ran them under hot water to warm them up. Sure enough, this gave me small chilblains on my fingers as well.

The Silver Lining

Photo by Jonny Clow on Unsplash

After spending a long winter in lockdown in the UK, we have a better appreciation for why the British are famous for escaping their winters.

Though I secretly like them.

One small silver lining was that my partner’s chilblains became our badge of honor. One tiny step out of tourist mode.

Every time I’d walk the four miles to the tiny shop on the Lizard in Cornwall — no matter who was on duty — the question would be the same. “How are your husband’s chilblains?”

And while my poor partner was at home nursing his toes, I had a little glow of satisfaction at our induction into a truly British ailment.

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