Once upon a time there was a man stuck to a nose / Once upon a time there was a superlative nose / (…) Once upon a time there was an infinite narcissistic / Frisian archinariz, caratulera / Purple and fried garrafal Sabañón . The famous satirical sonnet by Francisco de Quevedo, dedicated to Luis de Góngora, is one of the innumerable references of the classics to chilblains. This painful inflammation caused by the effect of cold on the skin most exposed to external aggressions is much less common today and, therefore, its reflection in contemporary literature has diminished.
But the so-called perniosis is not extinct. “Although its incidence is unknown, it has been decreasing over the years thanks to the improvement in warm clothing and the extension of heating and other methods to heat both the home and the workplace,” explains Miguel Sánchez Viera, director of the Institute of Integral Dermatology . The expert emphasizes that “chilblains were a much more frequent pathology a few decades ago, when it was more difficult to maintain body heat because the cold was more intense and there were many more jobs outdoors.”
Antonio Clemente Ruíz de Almirón, member of the Spanish Academy of Dermatology and Venereology (AEDV) and dermatologist of the Clinica Clemente (Murcia), explains that today “they are seen especially in inland areas, but especially in people with a certain predisposition or sensitivity to cold ”.
How are they distinguished?
Chilblains are lesions ” red or bluish in color characterized by pressing on them, they seem to disappear and are always cold,” as described by Sánchez Viera. “In addition, they can present crusts, since patients, suffering from itching and burning , tend to scratch them involuntarily, causing the lesions to open and even become infected,” he adds.
The areas where they appear most frequently are the hands, feet, ears and, more rarely, the nose.
They can occur at any time in life, but tend to affect more, according to Juan Carlos Montero Arroyo, a podiatry professional, “to people between the ages of 20 and 30 and the elderly .” Also more prone are “women, in whom blood pressure is usually lower, or due to hormonal causes.”
Be careful with applying heat
This inflammation is caused by the effect of cold on blood vessels , in which the blood supply is reduced (vasoconstriction). When you return home with very cold hands, a common gesture is to put them on top of the heater to warm them up. Clemente Ruíz de Almirón warns of the risk that could entail: “If the area is heated very quickly, blood flow increases suddenly and also the probability of chilblains appearing.”
How to prevent them?
Avoiding sudden changes in temperature and gradually heating the body are, therefore, very effective preventive measures, although Montero Arroyo considers that the most important is “to avoid exposure to cold for long periods of time”. It also highlights the convenience of using “suitable clothing that protects from the cold and promotes good breathability .” Warm shoes, socks, gloves, hats, scarves and ear muffs are some of the most recommended garments. It is also advisable, as Clemente Ruíz de Almirón comments, “to hydrate the skin well in the areas where it may appear”.
These recommendations should be followed with greater reason by those individuals who are more predisposed to suffering chilblains, such as those affected by lupus , some vasculitis , arthritis or cryoglobulemia. “Of course, also people affected by circulatory problems , “ adds Sánchez Viera.
In general, chilblain outbreaks subside within one to three weeks, especially if temperatures rise. “During the outbreak,” explains Clemente Ruíz de Almirón, “therapy is protection against the cold and topical corticosteroid creams can be used to reduce inflammation and symptoms. In severe cases “it may be necessary to use oral vasodilator drugs.”
Sánchez Viera adds that, if the injuries are not very serious, antibiotic creams may be indicated to “avoid possible infections”. “For itching we will guide antihistamines and, in the event that there is pain, analgesics,” says Montero Arroyo.
The main complication of chilblains not treated in time is the appearance of blisters, which can be associated with infections . The podiatrist explains that “in healthy people they often remit on their own; however, in diabetics , the elderly and individuals with vascular problems, not treating them can lead to a more important vascular problem that, in very extreme situations, can cause the ischemia of a finger ”.
Well-groomed feet against the rigors of winter
The Official College of Podiatrists of the Community of Madrid (Copoma) offers the following tips to protect your feet from the cold:
- Use natural fiber socks, preferably cotton, that will help your feet to sweat.
- Wear suitable footwear, the correct size and that does not tighten so as not to hinder circulation. It is preferable that it be made of natural materials and with a non-slip sole. If they are heeled, try to make them as wide as possible for greater stability.
- Pay special attention to drying the feet after washing and subsequent hydration with creams. We can take advantage to massage them and, thus, stimulate circulation.
- Increase the consumption of water and certain foods. Good hydration helps prevent the feet from getting cold and products such as cayenne, cinnamon or pepper, as well as some vitamins (E, K and C) can promote favorable circulation.
