Why Your Toes Might Be Burning This Winter: Understanding Chilblains on the Feet

By FootHouse Podiatry, Folkestone

As the temperature drops and the damp weather sets in, some people notice their toes becoming red, sore, itchy or even swollen. These painful, inflamed patches are often due to a condition called chilblains, medically known as perniosis.

Though common in the UK’s cool and damp climate, chilblains are often misunderstood and sometimes confused with infections or circulation problems. Let’s explore what’s really happening, who’s most at risk, and how to protect your feet this winter.

What Are Chilblains?

Chilblains are small areas of inflammation that appear after exposure to cold, non-freezing temperatures, especially in damp or drafty conditions. They most commonly affect the toes and feet, though they can also appear on fingers, ears, or nose.

Typically, chilblains look like red, purple or bluish patches, and may feel:

• Itchy or burning

• Tender or sore to the touch

• Swollen or slightly blistered

They usually appear within 12–24 hours of exposure to cold and can last up to three weeks.

Why Do They Happen?

Research suggests that chilblains occur due to abnormal blood vessel responses to cold.

In cold weather, blood vessels in the skin constrict to preserve warmth. When they rewarm too quickly, blood rushes back, causing small leaks and inflammation in the tissues. In some people, this reaction is exaggerated, leading to the painful lesions we call chilblains.

Scientific studies have shown that this process involves:

• Microvascular injury (tiny vessel inflammation and leakage)

• Local hypoxia (low oxygen in the skin tissue)

• Inflammatory immune response in the dermis (skin layer)

In rare cases, chilblains may be a sign of an underlying condition such as lupus or a connective tissue disorder — known as secondary chilblains.

Who Gets Chilblains — and Why the Feet?

The feet are particularly vulnerable because they are furthest from the heart, often exposed to damp shoes or floors, and easily become cold. You may be more likely to develop chilblains if you:

• Have poor circulation or vascular disease

• Have a lower body fat percentage (less insulation)

• Spend time in cold, damp environments

• Wear tight or damp shoes

• Smoke (which narrows blood vessels)

• Are female – studies show women are affected slightly more often

• Have certain autoimmune or connective tissue conditions

  
  

Common Symptoms on the Feet

• Itchy, burning or stinging sensation in toes

• Red or purplish patches on the skin

• Swelling and tenderness

• Dry, cracked skin or blistering

• In severe or persistent cases, ulceration may occur

Chilblains can look worrying, but they are usually not dangerous and will heal with time if the skin is protected from further cold exposure.

How to Prevent and Manage Chilblains at Home

Keep your feet warm and dry

Keep your feet warm but not sweaty. Use moisture-wicking socks (avoid cotton) and well-insulated and fitted footwear. Change out of damp shoes as soon as possible.

Avoid direct heat

Don’t warm cold toes by placing them on a radiator or hot water bottle — this sudden rewarming can worsen inflammation. Instead, warm gradually with gentle movement or warm (not hot) socks.

Avoid smoking and exercise.

Nicotine constricts blood vessels and slows healing. Keep active to maintain healthy blood flow.

Soothe the skin

If the skin is itchy or sore, gentle moisturizing and protecting cracked skin with barrier cream can help. Warming creams stimulate the circulation and dispense a pleasant feeling of warmth. We can advise you on what is best for your feet and provide diabetic safe, dermatologically tested products.

Let them heal naturally

Most cases resolve within 2–3 weeks once the trigger (cold, damp) is removed.

When to see your Podiatrist

If your symptoms persist beyond three weeks, blister, ulcerate, or become infected, it’s best to get them checked. You should also seek professional assessment if:

• You get recurrent chilblains each winter

• You have circulatory problems or diabetes

• You notice open sores or colour changes in the toes

• You suspect secondary chilblains linked to an autoimmune condition

• You would like laser therapy to improve circulation and reduce inflammation.

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At FootHouse, we can assess the health of your circulation, skin integrity, and footwear to help prevent recurrence or complications.

Final Thoughts

Chilblains may be small, but they can cause significant discomfort and, if ignored, may lead to infection or ulceration — especially in people with poor circulation or diabetes.

By keeping your feet warm, dry and well-protected, and seeking professional advice when needed, you can enjoy the colder months comfortably.

If you’re struggling with sore or swollen toes this winter, book a consultation at FootHouse Podiatry, Folkestone. We’ll help identify the cause, assess your circulation and footwear, and guide you on the best path to warm, healthy feet.