October 2018

Foot Focus The chill factor

As the nights draw in and the temperature drops, we know that winter will soon be upon us. Whilst we romanticise about toasting our toes in front of the log fire, it is worth remembering the common seasonal complaint of chilblains. More women than men are affected.

Characteristically presenting itself as painful, often itchy and burning, red, swollen areas on the toes, fingers, and ears. For most, this is a mild discomfort which readily resolves, however in some cases, the areas blister and become open wounds and may require professional assistance.

The underlying cause is one of a circulatory nature, where the tiny blood vessels of the area have not responded appropriately to changes in temperature. People, particularly at risk, are those with family history, poor circulation, exposure to cold and damp conditions, poor nutrition or low body weight and smokers (nicotine having a constricting effect on blood vessels).

For many, chilblains are seen as an old-fashioned ailment, and there is some truth in that. In the days before central heating, when the population was more likely to be underweight, footwear was more basic, smoking was a common pastime, employment was physical and in poor conditions, often outside or on hard cold floors, chilblains would have been a common blight.

As a result, there are many historical references, folklore and old wives tales regarding their treatment, varying from rubbing the areas with raw onion, to soaking the feet in wee – but in these enlightened times, these are not recommended nor do they help.

In mild to moderate cases the discomfort can be alleviated by the application of calamine and witch-hazel, this may help with the associated itching. Foot warming creams and balms available from your podiatrist may prove beneficial.

In instances where the skin has become broken or where the condition seems ongoing, a podiatrist will be able to treat and advise.

In stubborn cases, Nifedipine, a prescription-only medication, may be indicated.

Prevention is better than cure!

It is surprising how much of an impact such a potentially minor ailment can have, ask anyone who has suffered from chilblains, it is miserable!

* Avoid exposure to cold, when cold, allow warming in a natural way – not toasting your feet in front of an open fire! Pre-warm footwear. Good hosiery (thermal fibers)

* Promote healthy circulation – exercise, smoking cessation, healthy diet.

* Good skincare – checking feet for early signs, applying the cream to improve skin quality, rubbing/ massage will also stimulate the microcirculation.

* Good ambient temperature – not a direct heat source, no draughts.

* Well fitting footwear – and fit for purpose. Chafing or tight areas can give rise to chilblains too.

If in doubt make an appointment to see your podiatrist!