The name frostbite or perniones is misleading because they have nothing to do with true frostbite, nor do they form a true bump. Rather, they tend to occur in cold, damp weather, such as in spring and fall. They cause dark red patches and doughy soft tissue compaction, located mainly on the protruding parts of the body. The nose, ears, fingers, toes and the outer edges of the hands and soles of the feet are preferentially affected.
What are chilblains?
The first aid for hypothermia is heat preservation, i.e., cover or wrap patients with a wool blanket. Never put a rescue blanket directly on the skin, it will be useless due to lack of insulating effect. Click to enlarge. The good news up front is that even though frostbite is uncomfortable, unlike frostbite, it is quite harmless at first. Frostbites, medically called perniones, are itchy to painful swellings under the human skin that result from repeated exposure to environmental stimuli such as cold and wet. Basically, chilblains fall under the clinical picture of circulatory disorders. After all, as with frostbite, frostbite mostly affects the parts of the body with the least blood supply, such as the toes, fingers, ears and nose. The front and outer sides of the lower legs can also be affected by frostbite, as can the dorsal sides of the hands and feet, i.e. the backs of the hands and feet. Frostbite is caused by extreme constriction or occlusion of peripheral arteries and arterioles when exposed to severe cold, with consecutive tissue damage.
Causes
The primary cause of chilblains is cold, humid weather coupled with inadequate blood flow or circulatory function. Although chilblains usually heal on their own within about three weeks, they are uncomfortable to say the least. The area around the chilblain is reduced in sensation, and a vague, dull pressure is felt. To prevent frostbite, the first thing to do is to stimulate the circulation. For example, if you know that you will be outdoors for many hours during a winter hike, you should make sure that your blood circulation is not impeded. Constricting stockings, shoes, belts, a waistband that is too tight, a watch that cuts into the skin or a tight ring, even constricting gloves – all of these impede the blood supply to the parts of the body that are already less well supplied with blood and are located furthest away from the heart. Adequate protection against cold and wetness is also advised to prevent frostbite. In addition, you can train your vascular system, for example with classic alternating showers. If you pinch your nose, which is decorated with chilblains, you will feel only a dull, indefinite pressure, so the feeling is reduced in such a district. It is well known the violent itching and burning when one suddenly enters a well-heated room with a chilblain. Frostbite, as already mentioned, is caused by insufficient functioning of blood circulation. Therefore, when preventing frostbite, one must be careful to increase the function of the circulatory system. In no case should the blood circulation be obstructed from the outside. What happens if the blood cannot flow through the endangered parts of the body in sufficient quantity due to an external obstacle? Too tight stockings or shoes, for example, restrict the blood supply to the toes because the blood flow cannot fully overcome the constricting obstacle. Thus, not enough fresh blood can flow into the small vessels at the end of the foot and the toes, so that the resistance of the tissue is reduced as a result of the poor nutrition. If this poorly nourished tissue is exposed to external factors, such as cold and wet weather, the appearance of chilblains can be expected on an almost regular basis. So it is not so much a matter of putting on as much as possible, but rather of making sure that the garments are sufficiently loose.
Symptoms, complaints and signs
If frostbite has formed, it can be recognized by the characteristic discomfort on the skin. In addition, there is a general feeling of cold and a blue discoloration of the affected area. Toes, fingers, ears and nose are affected. In these areas, the skin feels cold and moist, and appears numb to the touch. The skin may also feel furry or swollen. In addition, the skin tends to sweat profusely.The chilblains themselves can be recognized by their distinct appearance. They are manifested by clearly demarcated skin lesions, which are usually round, doughy and bluish-pale. Sometimes blisters form or a skin defect develops, which is called an ulcer. If the affected areas of the body are heated, itchy, burning swellings occur. If not treated, the chilblains can become inflamed. As a result, redness and severe itching appear. In individual cases, bleeding may occur. Furthermore, chilblains can cause circulatory disorders and lead to severe inflammation of the tissue. Accompanying chilblains are usually the typical cold symptoms, i.e. cold, severe cough and fever. If these symptoms are noticed, the family doctor or a dermatologist should be consulted.
Complications
Of course, chilblains can also cause various complications, but they can be effectively counteracted with the help of appropriate treatment and the right medications. Since frostbite is an inflammation of the skin, complications can occur especially during the healing process. In many cases, the inflammation does not subside properly, so it is necessary to resort to taking anti-inflammatory medications. If chilblains do not completely resolve within a few days, there is a very high probability that there is a circulation problem. If this complication remains without any treatment, the affected tissue can become severely inflamed or, in the worst case, even die. However, if the affected person seeks treatment in time, this complication can also be treated effectively with the help of drugs that promote blood circulation. It is not uncommon for chilblains to also exhibit various cold symptoms, such as a cold, severe cough and fever. If it is a flu-like infection, one should definitely resort to taking appropriate medication. If this is not done at all, there is a risk of further complications. In the worst case, it comes to pneumonia or even a real flu, which makes a visit to the doctor essential. One thing is certain: The possible complications of frostbite are very diverse and wide-ranging, so that an accurate prognosis is very difficult to make.
When should you go to the doctor?
Frostbite is not a reason to consult a doctor for most people affected. Under normal circumstances, relief of symptoms occurs within a few days. The skin lesions heal and the usual skin appearance reappears. If no further complaints are present, no doctor is needed. The self-healing process independently takes over the regression of the chilblains and no further support is needed for this. It is helpful to wear loose clothing. This avoids unnecessary friction of the clothing on the changed skin areas. If the affected person suffers from further complaints, he needs medical assistance. In case of circulatory disorders, regularly occurring chilblains or severe sensory disturbances, a doctor should be consulted. If numbness, sensory disturbances or cold fingers as well as feet occur, a check-up visit is advisable. The cause of the circulatory disorders must be found, otherwise a life-threatening condition may occur. If vascular constrictions are present, blood stasis may occur. In the case of an unfavorable course, a stroke is imminent without medical care. In case of pain, itching or the appearance of open wounds, a doctor should be consulted. Pathogens enter the organism via a non-sterile wound and trigger further illnesses. In severe cases, the affected person is threatened with blood poisoning resulting in death.
Treatment and therapy
If chilblains occur repeatedly, tissue loss (atrophy) and scarring of the affected areas may occur. This means that – even if chilblains are actually harmless and disappear on their own – tissue damage can occur in severe cases. Especially for young women, who are the main risk group for chilblains, this is primarily a cosmetic-aesthetic problem. This is another reason why nifedipine is used to treat particularly severe chilblains. This drug, from the calcium antagonist group, causes vascular smooth muscle to dilate, thus greatly lowering blood pressure. Fortunately, this is really only necessary in the rarest of cases.In general, frostbite is annoying but not dangerous.
Outlook and prognosis
Frostbite can cause a variety of symptoms, but it is not life-threatening. If the bumps are treated quickly, the typical symptoms subside after a few days to weeks. The affected person usually feels sick and weary for a few days before the state of health slowly improves again. However, if chilblains are not treated, serious complications can develop. This can lead to circulatory problems, which can cause severe inflammation of the affected tissue and, in extreme cases, even death. If the patient is treated immediately, however, drugs that promote blood circulation can prevent this. Only the elderly, the sick, pregnant women and children run the risk of developing skin damage or overloading the cardiovascular and immune systems. This can then lead to a number of complaints, which may be associated with a further deterioration of the state of health. In this case, emergency medical treatment must be provided immediately to avoid serious complications such as circulatory collapse or scarring. So, in principle, frostbite has a good prognosis. With comprehensive treatment and medical supervision, the bumps usually subside quickly without any late effects.
Prevention
Gloves, stockings and shoes must allow the limbs enough freedom of movement. By the way, stockings deserve more attention than before. Oddly enough, stockings are still made that have a pointed symmetrical closure at the front, because this shape not only compresses the toes and takes them out of their natural position, but also hinders blood circulation. Stockings and socks with a wide toe should therefore be preferred, especially during the transitional period. However, it is quite wrong to pull several such tapered stockings or socks over each other, because this restricts the freedom of movement of the toes even more. But not only at the ends of the body, but also centrally the blood circulation must not be hindered by too tight garments. Constricting garters or too tight elastic sleeve closures can be to blame if you come home from an outing with frostbite. Those who are already prone to circulatory problems naturally have to deal with such phenomena particularly frequently. In such cases, it is therefore advisable not only to limit prevention to appropriate clothing, but also to increase the general reactivity of the vessels. If it is possible to train the vascular system so that it can easily adapt to rapidly changing temperatures (transition from a heated room to the outdoors, drafts, etc.), then this is not only the best prophylaxis against frostbite, but against circulatory disorders in general. But how to do it? The means are quite simple. You need a sponge or a cloth and cool and hot water. Then proceed by washing one part of the body first with hot water, then with cold water, then dry it and move on to the next. At the end of this warm and alternating washing, the body is towelled vigorously and this procedure results in a pleasant stimulation of the blood circulation. It is also possible to make partial baths with alternating warmth. For this you need a bucket of cold water (about 25 degrees Celsius) and a second bucket of hot (37-40 degrees) water. In the beginning, do not choose too big temperature differences. Now put the legs first ½ to ¾ minute in hot water, then a few seconds in cold water and change about five times, finish with cold water and finally rub everything dry. These simple measures are an excellent way to exercise the vascular muscles. They have only one disadvantage, which is that they cost five minutes more in time than, for example, taking a tablet. But in return, the effectiveness of such applications is far more intense, lasting, pleasant and often faster. With a well-trained vascular system, however, one not only avoids the unsightly and annoying chilblains during the wet and cold transitional period, but also protects against the threat of colds and flu. Frostbite and frostbite on the extremities are underestimated by many people. Some therefore decide that a visit to the doctor would be necessary. In any case, it is recommended to see a doctor.It is even more important to inform yourself in advance about possible self-help measures. Anyone who does something wrong here can cause skin damage and permanent frostbite damage. There are four degrees of frostbite. Frostbite is already the second degree of frostbite. For this reason alone, they should be taken seriously. Anyone who can should thaw the frostbite with warm water and then consult a doctor. Frostbite causes circulatory problems with tissue damage that requires treatment. To prevent permanent damage to the affected areas of skin, follow-up care may be advisable. Contrary to the generally prevailing opinion, chilblains can already develop at temperatures around zero degrees. Prevention would therefore definitely be better than aftercare. Too tight shoes or constricting stockings as well as circulatory disorders promote the development of chilblains. Aftercare must ensure that the associated skin damage is kept to a minimum. Itching can be relieved with ointments. Regular follow-up examinations are advisable until the frostbites have healed. Frostbite and frostbite on the extremities are underestimated by many people. Therefore, some decide that a visit to the doctor would be necessary. In this case, it is definitely recommended to see a doctor. It is even more important to inform oneself in advance about possible self-help measures. If you do something wrong here, you can cause skin damage and permanent frostbite. There are four degrees of frostbite. Frostbite is already the second degree of frostbite. For this reason alone, they should be taken seriously. Anyone who can should thaw the frostbite with warm water and then consult a doctor. Frostbite causes circulatory problems with tissue damage that requires treatment. To prevent permanent damage to the affected areas of skin, follow-up care may be advisable. Contrary to the generally prevailing opinion, chilblains can already develop at temperatures around zero degrees. Prevention would therefore definitely be better than aftercare. Too tight shoes or constricting stockings as well as circulatory disorders promote the development of chilblains. Aftercare must ensure that the associated skin damage is kept to a minimum. Itching can be relieved with ointments. Regular follow-up examinations are advisable until the frostbites have healed. Frostbite and frostbite on the extremities are underestimated by many people. Therefore, some decide that a visit to the doctor would be necessary. In this case, it is definitely recommended to see a doctor. It is even more important to inform oneself in advance about possible self-help measures. If you do something wrong here, you can cause skin damage and permanent frostbite. There are four degrees of frostbite. Frostbite is already the second degree of frostbite. For this reason alone, they should be taken seriously. Anyone who can should thaw the frostbite with warm water and then consult a doctor. Frostbite causes circulatory problems with tissue damage that requires treatment. To prevent permanent damage to the affected areas of skin, follow-up care may be advisable. Contrary to the generally prevailing opinion, chilblains can already develop at temperatures around zero degrees. Prevention would therefore definitely be better than aftercare. Too tight shoes or constricting stockings as well as circulatory disorders promote the development of chilblains. Aftercare must ensure that the associated skin damage is kept to a minimum. Itching can be relieved with ointments. Regular follow-up examinations are advisable until the chilblains have healed.
Follow-up care
Frostbite and frostbite on the extremities are underestimated by many people. Therefore, some decide that a visit to the doctor would be necessary. In this case, it is definitely advisable to see a doctor. It is even more important to inform oneself in advance about possible self-help measures. If you do something wrong here, you can cause skin damage and permanent frostbite. There are four degrees of frostbite. Frostbite is already the second degree of frostbite. For this reason alone, they should be taken seriously. Anyone who can should thaw the frostbite with warm water and then consult a doctor. Frostbite causes circulatory problems with tissue damage that requires treatment.To prevent permanent damage to the affected areas of skin, follow-up care may be advisable. Contrary to the generally prevailing opinion, chilblains can already develop at temperatures around zero degrees. Prevention would therefore definitely be better than aftercare. Too tight shoes or constricting stockings as well as circulatory disorders favor the development of chilblains. Aftercare should be directed in such a way that the associated skin damage is kept to a minimum. Itching can be relieved with ointments. Regular follow-up examinations are advisable until the chilblains have healed. As aftercare measures, local self-treatment with oak bark or horsetail baths can be used for worse chilblains. The temperature should be lukewarm. Drug treatments are also possible but controversial.
What you can do yourself
Frostbite is harmless in most cases and can be treated out by the affected person himself. If frostbite occurs for the first time or very rarely and without accompanying symptoms (flu-like symptoms), sufferers can take action themselves before going to the doctor. Thus, the most important thing is to keep the affected area warm at all times. At best, care is also taken to ensure that the body temperature remains constant. The cold should therefore be avoided for a few days without sufficiently warm clothing – especially on the extremities. In case of a freshly appeared pernionis it is important that a warming up of the body takes place quickly. Under no circumstances should the corresponding area be blow-dried or otherwise strongly heated. Wrapping the affected area in clothing (and the body in an airy blanket) is sufficient. The freedom of movement of the affected area should be maintained, so that the blood circulation is not additionally disturbed. Scratching the itchy areas should not be done. Various herbal or pharmaceutical preparations stop the itching. As a rule, chilblains subside within a few days or weeks and do not require any follow-up treatment. The corresponding place is only to be observed, since a chilblain can also always indicate an existing blood circulation problem.
