Chilblains (pernio) form after intermittent or prolonged exposure to cold or damp air. The cold air causes blood vessels near your skin’s surface to tighten or constrict, leading to decreased oxygenation and inflammation in these exposed areas. Rewarming of cold skin also causes small blood vessels under the skin to expand more quickly than nearby larger blood vessels can handle. The exact reason why this reaction occurs is unknown. However some experts believe pernio develops because of:
- Genetics.
- Hormonal changes.
- Underlying diseases, such as connective tissue disorders or perpipheral arterial disease.
- Certain medications
These are discussed briefly below:
Genetics can play a role in the development of chilblains. People with a family history of chilblains or other conditions related to poor circulation, such as Raynaud’s disease, may be more susceptible to developing the condition.
Hormonal changes, such as those that occur during pregnancy, can also increase the risk of chilblains. Hormones play a role in regulating blood flow and can affect the constriction and dilation of blood vessels, which can contribute to the development of chilblains.
Underlying diseases, such as connective tissue disorders and peripheral arterial disease (PAD), can also increase the risk of chilblains. Connective tissue disorders, such as lupus and rheumatoid arthritis, can affect the blood vessels and cause poor circulation. PAD is a condition in which the blood vessels of the legs become narrowed or blocked, which can lead to poor circulation in the feet and legs.
Certain medications, such as beta-blockers, can also contribute to the development of chilblains by affecting blood flow and constriction of blood vessels.
Risk factors
The following factors increase the risk of chilblains:
- Wearing clothing and shoes that are tight or expose skin to the cold. Wearing tightfitting clothing and shoes in cold, damp weather may make you more susceptible to chilblains.
- Being a young woman. This condition is most common in females between the ages of 15 and 30.
- Being underweight. This condition is most common in people with a low body mass.
- Living in cold, humid areas. Your risk of chilblains is higher if you live in an area with high humidity and cold but not freezing temperatures.
- Being a smoker. Smoking can decrease blood circulation in the extremities, such as the toes and fingers, making them more susceptible to the cold.
Overall, chilblains are caused by a combination of factors that affect blood flow to the extremities and can be influenced by genetics, hormonal changes, underlying diseases and medications.