When a child comes in from the cold with red or purplish, swollen fingers or toes that itch and burn once they warm up, it can be worrying. This pattern may be chilblains (also called pernio). Here is what causes them, how to care for them, and when to call a clinician.
Why It Happens
Cleveland Clinic explains that chilblains develop after repeated or prolonged exposure to cold, damp air, when small blood vessels near the skin tighten. Rewarming cold skin too quickly is also described as a trigger, since vessels widen suddenly and the tissue can become inflamed. Chilblains can occur at temperatures above freezing, so a long stretch outdoors on a chilly, damp day can be enough. The MSD Manual describes the condition as itching, pain, redness, or swelling after cold, dry weather, and says it is uncommon and not serious.
How It Differs by Age
Chilblains are reported more often in young women but can affect children and teenagers. Cleveland Clinic notes that babies can get them if not dressed properly for damp or cold weather. Children who play outside for long periods without noticing the cold tend to have trouble in their fingertips, toes, ears, and nose. Typical signs are red or purplish discoloration, swelling, itching, and burning, and in more severe cases blisters. Episodes usually settle within one to three weeks, though some children get them again each cold season.
Care at Home
The key is gradual rewarming. Take off wet gloves and socks, change into dry clothes, and let your child warm up slowly in a comfortable room. Avoid putting the skin close to a heater or in hot water. Keep fingernails short so scratching does not break the skin, and a moisturizer or mild soothing lotion can ease itching. Prevention matters most: dress the whole body warmly with a hat, mittens, and thick socks, check that shoes are not so tight that they restrict circulation, dry damp shoes before the next wear, and carry spare mittens.
Common Misunderstandings
First, that chilblains are the same as frostbite. Frostbite means the skin has actually frozen and is generally described as pale or gray, hard, and numb, which is different. Second, that hot water will cure the itch; rapid rewarming can make symptoms worse. Third, that rubbing the skin makes heat and helps; rubbing can injure the skin. Fourth, that every case is only about cold. Occasionally chilblains are linked to another condition, and Cleveland Clinic notes that clinicians may order blood tests to look for causes such as lupus.
Signs That Need Emergency Care Right Away
If the skin looks white or gray, feels hard, and is numb, which could mean frostbite, rewarm gently and go to the emergency room right away. Blisters that break and ooze pus, or any fever alongside the skin changes, can also need emergency care. Even when it is not an emergency, consider calling your pediatrician if pain is strong, the area is large, it has not improved after about three weeks, it returns every year, or your child also has joint pain or fever. Consider talking with a pediatrician if you are unsure. This information reflects general guidance for the United States; if you live elsewhere, check with a local pediatrician. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.