Chilblains is a condition characterised by painful, itchy and red swellings of the skin, affecting mainly toes, fingers and ear, caused by exposure to cold, which causes narrowing of the blood vessels and consequently poor circulation. Chilblains is self-limiting condition meaning, it resolves itself without any treatment. Prolonged chilblains may require a GP intervention. Chilblains treatment may involve symptomatic management of pain and avoidance of cold and damp conditions to prevent further events of chilblains.
Chilblains: main symptoms
- Red, itchy, painful skin affecting toes, finger, ears, but can also affect face
- Skin which is swollen
- Burning sensation in the affected area
How to prevent Chilblains?
Chilblains can be prevented by keeping warm in cold weather. Main recommendations for prevention of chilblains:
- Stay warm
- Wear hat, gloves, leggings, and thick socks
- Use multiple layers of clothes
- Use hand warmers and/or feet warmers
- Carry a hot drink (in a travel mug) with you. It will warm you up from the inside.
Gradual warming of the skin is recommended however, direct heat should be avoided (NICE, 2019). Keep the affected area dry and avoid cold to prevent the condition getting worse.
Pain management involves taking over the counter medicines such as paracetamol and ibuprofen. Decongestants such as pseudoephedrine (e.g. Sudafed) should be avoided as it can cause blood vessel constriction, which can lead to poor circulation.
Chilblains treatment: Balmosa cream
Balmosa cream contains a mixture of:
- methyl salicylate, and
- oleoresin capsicum
All of the above active ingredients produce a sensation of warmth when applied to the skin. Balmosa cream can be used by adults and children o 12 years and above.
Although there is no specific evidence for Balmosa cream use in chilblains treatment, individually some of the active ingredients are known to cause dilation of the blood vessels.
Balmosa cream: active ingredients and their role
- Through unknown mechanisms menthol promotes vasodilation (Craighead et al, 2017). Vasodilation (opening of the blood vessels) improves blood flow, which regulates body temperature.
- Camphor is an organic compound produced from camphor tree (The Cinnamomum camphora) and has applications in cream, balms, lotions, and ointments. An experimental study in humans showed increased skin blood flow when camphor was applied to the skin. A similar effect was seen for the application of menthol to the skin (Kotaka, 2014).
- Methyl salicylate (related to Aspirin) may have a role in pain and has anti-inflammatory properties, however, no evidence exists to support this. Once absorbed in the body methyl salicylate can be changed into salicylic acid, which has anti-inflammatory properties.
- Capsicum is used in the formulation for pain management.
Where to buy Balmosa cream?
Balmosa cream is not commonly displayed on pharmacy shelves, however, some pharmacies keep it in stock for the public to buy. If needed Balmosa cream can be ordered by some pharmacy teams on one to one basis from main pharmaceutical suppliers for the same or next day delivery. Balmosa cream can be purchased online.
Chilblains treatment: drugs
In severe or prolonged cases of chilblains, a GP may prescribe a drug called nifedipine (NICE, 2018). Nifedipine is usually used in the treatment of high blood pressure and angina. Nifedipine causes the dilation of blood vessels, improving circulation in the affected areas.
Chilblains treatment: when to see GP
As mentioned before, chilblains should go on its own. Seek GP advice i:
- Chilblains do not go away after 2-3 weeks
- There are signs of infection in the affected area e.g. puss present
- If you are a diabetic patient
Craighead, Daniel H., Nathaniel B. McCartney, James H. Tumlinson, and Lacy M. Alexander (2017). Mechanisms and time course of menthol-induced cutaneous vasodilation. Available at: https://dx.doi.org/10.1016%2Fj.mvr.2016.11.008 Accessed on 27/11/2019
Kotaka, Tomohiko , Shoji Kimura, Makoto Kashiwayanagi, Jun Iwamoto (2014). Camphor Induces Cold and Warm Sensations with Increases in Skin and Muscle Blood Flow in Human. Available at: https://doi.org/10.1248/bpb.b14-00442Accessed on 27/11/2019
NICE (2018). Scenario: Management of chilblains. Available at: https://cks.nice.org.uk/chilblains#!scenario Accessed on 25/11/2019