How do you treat chilblains? The short answer is gently. Warm the skin slowly, keep it dry, wear warm waterproof clothing when you go out, and leave the sore patches alone. Do not hold your hands or feet against a radiator, do not run them under hot water, and do not scratch them, however much they itch. Most chilblains clear up on their own within two to three weeks if you keep them warm and dry, and a pharmacist can suggest a lotion to soothe the itching. That is the whole treatment for most people, and it is also the reason chilblains are so easy to make worse: the instinct to warm cold toes as fast as possible is exactly what the NHS tells you not to do.
Chilblains are small, itchy patches that appear on the skin after you have been in the cold. They are most common on the fingers and toes, but they can also appear on the face and legs. They are not frostbite, and they are not the same as Raynaud’s, although all three are the body’s reaction to cold, and all three become more likely now that the cold weather has arrived. This week the UK Health Security Agency issued its first yellow cold-health alert of the 2026/27 winter season, covering the North West and the West Midlands, with temperatures below freezing in places and widespread frost. Chilblains follow cold, damp weather, so the first cold snap of the season is when they start to appear. This article explains what they are, why they happen, what helps, what to avoid, and the signs that mean a GP should take a look.
What chilblains are
Chilblains, also known as perniosis or pernio, are localised cold-induced inflammatory lesions, which is the clinical description used by NICE. In plain language, they are patches of inflamed skin that appear where the skin has been exposed to cold, most often the fingers and toes, and also the nose and ears. They are a reaction to damp cold rather than to freezing temperatures, which is one of the things that sets them apart from frostbite. DermNet notes that chilblains are seen in temperate climates rather than in countries with extreme cold, where the air is often dry and clothing and living conditions reduce the risk, and that they are most often seen in late winter and early spring, when it is wet and temperatures sit above freezing. The first cold snap of the season still brings the first cases, because that is when people first spend long enough in cold, damp air for the reaction to start.
The mechanism is a mismatch in how the blood vessels respond to cold. The NHS explains it plainly: the cold makes the blood vessels in your fingers and toes get smaller, which stops blood moving around as easily. Chilblains happen when the blood vessels deep in your skin stay small, but the vessels closer to the surface of your skin get bigger as you warm up. That combination causes pain or itching and changes in skin colour. NICE gives the same account in clinical terms: prolonged or intermittent cold-induced narrowing of the deep cutaneous arterioles, with widening of the smaller superficial vessels, in people who are susceptible. The itch that arrives as you warm up is not a sign that the skin is healing badly. It is the reaction itself, and it is why warming up slowly matters more than warming up fast.
Chilblains usually appear a few hours after you have been in the cold, according to the NHS, and NICE puts the window at 12 to 24 hours after exposure. Acute chilblains develop in that window and usually resolve within two to three weeks, provided that further cold exposure is avoided. Chronic chilblains are persistent lesions that can develop on repeated exposure to cold, and in some cases they can lead to scarring and atrophy, which is thinning of the skin. That distinction matters, because a single patch that fades in a fortnight is a different problem from patches that return every winter and never quite clear. Most people reading this will have the first kind.
What chilblains look and feel like
The symptoms are consistent enough that the NHS can list them in a few lines. Chilblains usually appear a few hours after you have been in the cold. You mostly get them on your fingers and toes, but you can also get them on your face and legs. If you have chilblains, your skin can feel itchy or like it is burning. Your fingers or toes may become red or purple, although redness may be harder to see on brown and black skin. DermNet adds that the patches are typically swollen, and that the red or purple discolouration is blanchable, which means it fades briefly when pressed and then returns. The itch or burning pain is the usual complaint, although some lesions cause no symptoms at all.
How long they last is one of the most useful things to know, because it tells you whether what you have is behaving normally. The NHS says chilblains usually go away on their own in two to three weeks. DermNet gives a similar range of one to three weeks, and notes that recurrences may occur with later exposures, or annually. A patch that is still there after three weeks, or that keeps coming back, is worth a GP visit, which is covered in detail below.
Most chilblains are uncomfortable rather than dangerous, but they can cause trouble if they are scratched or if the skin breaks. NICE lists the complications: skin excoriation from scratching, which means raw skin where the surface has been rubbed away, secondary infection from blistered or scratched chilblains, ulceration, permanent discolouration, and scarring. Severe chilblains may blister, or become eroded and ulcerated, according to DermNet. That is why the advice about not scratching is not a minor point. A chilblain that is left alone usually heals cleanly. One that is scratched open can become infected, and an infected patch takes longer to heal and can leave a mark.
Who gets chilblains
Chilblains can affect all age groups, but DermNet notes that they are most common in young to middle-aged adults, with a female predominance. Childhood chilblains are well described but appear to be uncommon, and primary chilblains are unusual in older people, so when they appear in an older person an underlying cause should be looked for. That pattern is worth knowing, because it means a first episode in later life deserves more attention than a first episode in a healthy adult in their thirties.
Some people are more likely to get chilblains than others. NICE lists the risk factors as family history, peripheral vascular disease, and low body weight or poor nutrition. DermNet adds smoking, work outdoors in the cold, such as fishing and farming, participation in ice-skating sports, an underlying tendency to Raynaud phenomenon, and a familial tendency. Underlying bone marrow disorders and connective tissue disorders, particularly systemic lupus erythematosus, dermatomyositis, Behcet disease and cutaneous small vessel vasculitis, are also listed as risk factors, and chilblains linked to lupus have their own name, chilblain lupus.
That leads to an important distinction. Primary or idiopathic chilblains are not associated with any underlying condition, according to NICE. Secondary chilblains are associated with underlying conditions such as connective tissue or haematological disorders. Most chilblains are primary, which means they are simply the skin’s reaction to cold in a susceptible person, and no deeper cause needs to be found. But when chilblains keep returning, appear without much cold exposure, or come with other symptoms such as joint pain, rashes or muscle weakness, a GP may need to refer for tests with a specialist to check for an underlying cause. The NHS says the same: a GP will check your symptoms, and may need to refer you for tests if they are not sure why you are getting chilblains.
One more group deserves a brief mention. During the COVID-19 pandemic, many cases of chilblain-like changes on the toes, often called COVID toes, were reported as a late manifestation in children and young adults after a mild illness suspected of being due to SARS-CoV-2. DermNet notes that swabs and antibody tests in those patients were mostly, but not always, negative, and that the association between COVID-19 and chilblains is still being defined. A chilblain-like lesion that appears without exposure to damp cold should be suspected as being related to SARS-CoV-2 infection, according to DermNet, although the evidence remains incomplete. If your chilblains appeared without any cold exposure at all, that is worth mentioning to a GP rather than assuming cold was the cause.
Chilblains, Raynaud’s and frostbite: how to tell them apart
Cold affects the hands and feet in three common ways, and they are easy to confuse, because all three involve cold, colour change and discomfort. The differences are in timing, temperature and how long the symptoms last. The NHS Raynaud’s page even includes chilblains in its own table of other possible causes, describing them as burning or itchy swelling on fingers and toes that happens after being very cold and gets worse as you warm up.
| Condition | What happens | How long it lasts | When to worry |
|---|---|---|---|
| Chilblains | Itchy or burning red or purple patches, usually on fingers and toes, appearing hours after damp cold | Days to weeks, usually two to three weeks | See a GP if not better after two to three weeks, if there is pus, or if they keep returning |
| Raynaud’s | Fingers and toes turn white, then blue, then red as blood flow is restricted and returns | Minutes to a few hours per episode | See a GP if symptoms are severe or worsening, only on one side, or start after age 30 |
| Frostbite | Skin exposed to 0C or below becomes cold, firm and numb, then hard and frozen, sometimes with blisters | Damage continues while exposed to freezing cold | Call 999 or go to A and E if skin is hard and frozen, swollen and numb, or blistered |
Raynaud’s is the closest lookalike. In Raynaud’s, the fingers and toes change colour when you are cold, anxious or stressed, turning white or paler as blood flow is restricted, sometimes blue as the blood vessels react, and then red as blood flow returns. The symptoms of Raynaud’s may last from a few minutes to a few hours, according to the NHS. That short, repeated pattern is the key difference from chilblains, which arrive hours after cold exposure and then stay for days or weeks. If your fingers go white in the cold and then return to normal within the hour, that is the Raynaud’s pattern, and our earlier guide to it explains the full picture.
Frostbite is the most serious of the three, and the distinction matters because frostbite needs urgent care. The NHS says you can get frostbite if your skin is exposed to temperatures of 0C or below, and that at first the skin may be cold and firm, numb, or stinging, burning, painful or red. If it gets worse, the skin can become hard and frozen, white, blue or blotchy, swollen and without feeling, with blisters filled with blood or clear or milky fluid. Frostbite is treated in hospital. Chilblains, by contrast, happen in damp cold above freezing, and the skin stays soft and itchy rather than hard and numb. If you have been out in freezing temperatures and your skin is hard, frozen or without feeling, call 999 or go to A and E. Do not wait to see whether it improves.
How do you treat chilblains
How do you treat chilblains at home? Start with the NHS advice, which is simple and specific. Chilblains usually go away on their own in two to three weeks, and there are things you can try that may help and stop them from coming back. Warm the affected skin slowly and dry it thoroughly if you have been exposed to cold. Avoid being outside when it is cold or damp, and if you do go out, wear warm, waterproof clothing, gloves and thick socks. That is the core of it: keep the skin warm and dry, and let it warm up gradually.
A pharmacist can help with chilblains in two ways. You can ask a pharmacist about a lotion that may help to soothe any itching, and about whether you need to see a GP. The NHS lists both, which makes the pharmacy a sensible first stop for a first episode that is itchy but not broken, infected or unusually painful. A pharmacist can also tell you whether what you have looks like chilblains at all, which is useful when the patches appear on the face or legs rather than the fingers and toes.
What a GP can offer depends on how bad the chilblains are and how often they return. The NHS says that sometimes a GP may prescribe a medicine that helps to widen your blood vessels, which can help chilblains. NICE is more specific: drug treatment should not be routinely prescribed, but may be considered for severe chronic chilblains and recurrent episodes of severe chilblains that do not respond to appropriate self-care measures. Modified-release nifedipine, used off label for this purpose, is an option, but current evidence is based on small trials with conflicting results. DermNet lists nifedipine at 20 to 60 mg per day as a systemic treatment that hastens healing time and reduces the risk of relapse, and lists topical nitroglycerine 0.2 percent and topical betamethasone valerate 0.1 percent twice daily, which may relieve itch, as topical options a clinician may consider. None of these are self-care measures. They are treatments a clinician may discuss when self-care has not been enough, and the evidence for the prescription option is limited, which is worth knowing before you ask for it.
The other part of treatment is reassurance, which NICE spells out for clinicians. People with idiopathic chilblains should be reassured that the condition is self limiting, caused by exposure to cold, and will resolve if further exposure to cold is avoided. That is not a dismissal. It is the diagnosis: a self limiting reaction to cold that clears when the cold is kept away. If it does not clear, or if it keeps returning despite keeping warm, then it stops being a simple case, and that is when further checks are appropriate.
What not to do with chilblains
The list of things to avoid is as important as the list of things to do, because the wrong kind of warming is the most common way people make chilblains worse. The NHS says not to put your feet or hands on a radiator or under hot water to warm them up. NICE gives the same advice in clinical terms: dry and gradually warm the skin, and avoid direct heat. The reason is in the mechanism. The small vessels near the surface of the skin widen as you warm up, while the deeper vessels stay narrow. Warming the skin suddenly with strong heat makes that mismatch worse, which is why the itch and burning can flare when you come in from the cold and stand by a radiator. Warm the skin slowly, with dry layers and time, and let the circulation catch up on its own.
Do not scratch or pick at your skin, the NHS says. Scratching breaks the surface, and broken skin can become infected, which turns a two-week problem into a longer one and can leave scarring or permanent discolouration. Keep the nails short, cover the patches with clean, dry clothing, and use a soothing lotion from the pharmacist if the itch is hard to ignore.
Do not smoke, have drinks that contain caffeine, or take medicine for a blocked nose, the NHS says, because these can affect the flow of blood in your fingers and toes. Smoking narrows blood vessels, caffeine has a similar effect, and decongestants work by narrowing blood vessels in the nose, which can reduce blood flow elsewhere too. NICE gives the same advice about avoiding smoking. If you smoke and you get chilblains every winter, stopping is the single change most likely to reduce how often they return, and it also helps the circulation that protects your hands and feet in the first place.
How to stop chilblains coming back
Prevention is mostly the treatment, repeated before the cold rather than after it. DermNet lists the measures: avoiding cold, wet environments if possible, wearing warm, dry clothing during cold weather to protect hands, feet and ears, vigorous exercise to keep warm and improve circulation, keeping indoor areas warm and dry, soaking hands in warm water before exposure, and stopping smoking and other vasoconstrictors, which are substances that narrow the blood vessels. The NHS advice fits the same pattern: avoid being outside when it is cold or damp, and wear warm, waterproof clothing, gloves and thick socks when you do go out.
A few practical points make the advice easier to follow. Warm your hands and feet before you go out, rather than waiting until they are cold, and keep them covered the whole time you are outside, because chilblains follow exposure, not just a single cold moment. Change out of damp socks and gloves promptly, and dry the skin thoroughly before putting dry ones on. Keep rooms warm but not overheated, and avoid sitting with your feet against a radiator after coming in from the cold, which is the same mistake as warming them directly. If you work outdoors, the risk is higher, so insulated gloves, thick socks and waterproof footwear are worth the investment, and regular movement to keep the circulation going helps more than standing still in heavy clothing.
Expect that chilblains can return. DermNet notes that recurrences may occur with later exposures, or annually, which means that getting them once makes you more likely to get them again next winter, in the same places. That is not a sign that something is wrong with you. It is a sign that your blood vessels react to cold in this particular way, and that the prevention measures need to become a habit for the cold months rather than a one-off fix. If they return every year despite careful prevention, or if they are severe, that is a reason to talk to a GP about whether a prescription treatment is worth trying, rather than a reason to put up with them.
When to see a GP about chilblains
Most chilblains do not need a GP, but the NHS lists clear reasons to make an appointment. See a GP if your skin is not getting better after two to three weeks, if there is pus coming out of your skin, if your temperature is very high or you feel hot, cold or shivery, if you keep getting chilblains, or if you have diabetes, because foot problems can be more serious if you have diabetes. Pus, spreading redness or a high temperature suggest infection, which needs treatment rather than patience. Chilblains that keep returning, or that appear without much cold exposure, may need tests to check for an underlying cause.
Diabetes deserves a special mention, because the NHS flags it on the chilblains page for a reason. Foot problems can be more serious if you have diabetes, and a sore on the foot that is slow to heal needs checking sooner rather than later. If you have diabetes and you develop chilblains on your feet, do not wait the full two to three weeks to see whether they clear. Book a GP appointment, and mention the diabetes when you do.
At the appointment, a GP will check your symptoms to see if you have chilblains, according to the NHS. They may need to refer you for tests with a specialist if they are not sure why you are getting chilblains. NICE adds that arterial circulation and peripheral sensation should be normal in chilblains, and that further investigations or referral are required if an underlying cause is suspected or the diagnosis is in doubt. In practice, that means the GP will look at the patches, ask about cold exposure, check the circulation and feeling in your hands and feet, and decide whether any blood tests or a specialist referral are needed. For most people, the appointment ends with the same advice as this article: keep warm, keep dry, warm up slowly, and come back if it does not clear.
Frequently asked questions
How do you treat chilblains?
How do you treat chilblains? Warm the skin slowly and dry it thoroughly, keep it warm and dry, and wear warm waterproof clothing, gloves and thick socks when you go out. Do not put your hands or feet on a radiator or under hot water, do not scratch the patches, and avoid smoking, caffeine and decongestants, which can affect blood flow. A pharmacist can suggest a lotion to soothe the itching. Most chilblains clear up on their own within two to three weeks. A GP may prescribe a medicine that widens the blood vessels, such as modified-release nifedipine, for severe chilblains that keep returning, although the evidence for it comes from small trials with conflicting results.
How long do chilblains take to go away?
Most chilblains clear up on their own within two to three weeks, according to the NHS, provided you avoid further cold exposure. DermNet gives a similar range of one to three weeks. See a GP if your skin is not getting better after two to three weeks, if there is pus coming out of the skin, if your temperature is very high, or if you keep getting chilblains. Chilblains that return every winter can become chronic, and in some cases they can lead to scarring.
Are chilblains the same as Raynaud’s?
No. Chilblains are itchy or burning red or purple patches that appear hours after exposure to damp cold and last for days or weeks. Raynaud’s is a colour change in the fingers and toes, which turn white, then blue, then red, and each episode lasts from a few minutes to a few hours. The NHS Raynaud’s page lists chilblains as a separate cause of hand symptoms, describing them as burning or itchy swelling after being very cold that gets worse as you warm up. Both are reactions to cold, and both are helped by keeping warm, but they are different conditions.
What should I avoid doing with chilblains?
Do not put your hands or feet on a radiator or under hot water to warm them up, and do not scratch or pick at the skin. Do not smoke, have drinks that contain caffeine, or take medicine for a blocked nose, because these can affect the flow of blood in your fingers and toes. Warm the skin slowly and dry it thoroughly instead, wear warm waterproof clothing, gloves and thick socks outdoors, and ask a pharmacist about a lotion to soothe the itching.
Can chilblains be prevented?
Yes, in most cases. Avoid being outside when it is cold or damp, wear warm, dry, waterproof clothing, gloves and thick socks, and keep indoor areas warm and dry. Warm your hands and feet before going out, change out of damp socks and gloves promptly, and exercise regularly to improve circulation. Stop smoking if you smoke, because smoking narrows the blood vessels. Chilblains can still return in later winters, so the prevention measures need to become a habit for the cold months.
When should I see a GP about chilblains?
See a GP if your skin is not getting better after two to three weeks, if there is pus coming out of your skin, if your temperature is very high or you feel hot, cold or shivery, if you keep getting chilblains, or if you have diabetes, because foot problems can be more serious if you have diabetes. A GP will check your symptoms and may refer you for tests with a specialist if they are not sure why you are getting chilblains. If your skin is hard and frozen, swollen and without feeling, or blistered after exposure to freezing temperatures, that may be frostbite, so call 999 or go to A and E.
Related reading
- Why Do My Fingers Go White in the Cold?
- Why Does My Skin Get So Dry in Winter?
- What Are the Early Signs of Type 2 Diabetes?
Sources
- NHS, Chilblains, https://www.nhs.uk/conditions/chilblains/ (page last reviewed 22 April 2026)
- NHS, Raynaud’s, https://www.nhs.uk/conditions/raynauds/ (page last reviewed 20 July 2023)
- NHS, Frostbite, https://www.nhs.uk/conditions/frostbite/ (page last reviewed 9 June 2025)
- NICE Clinical Knowledge Summary, Chilblains, https://cks.nice.org.uk/topics/chilblains/
- DermNet, Chilblains (Pernio): Symptoms and Management, https://dermnetnz.org/topics/chilblains (updated February 2021)
- Beinsure, UKHSA issues first yellow cold-health alert as freezing temperatures and snow approach UK, https://beinsure.com/news/ukhsa-yellow-cold-alert-issued/ (report of the UKHSA and Met Office Weather-Health Alerting System alert, November 2026)
