Chilblains on Toes: What They Look Like, How Long They Last and How to Treat Them
Why cold toes turn itchy, red and swollen hours later, what helps and what makes it worse, and the signs that mean it is time to get them checked.
Chilblains on toes tend to turn up in the cold, damp months, with a peak in late winter and early spring. A few hours after your feet got cold, one or more toes turn red or purple, puff up, and start to itch or burn. The medical name is pernio. For most people they are a nuisance that heals by itself in about 1 to 3 weeks, once the cycle of chilling and fast rewarming that causes them stops.
Below: each stage, how long they last, what helps and what makes them worse, how they differ from frostbite and Raynaud's, and when a chilblain needs a doctor.
ASG Foot & Ankle patient education. Updated October 27, 2026. General information, not a diagnosis.
The short answer
Chilblains on toes are small, swollen, itchy or burning patches, usually red, bluish or purple, that appear a few hours after your feet have been cold and damp but not frozen. They usually clear up on their own in about 1 to 3 weeks if you keep your feet warm and dry. Treat them by warming up slowly (never on a radiator or under hot water), not scratching or rubbing, and soothing the itch. Get them checked if they blister, break open or look infected, are not improving after 2 to 3 weeks, keep coming back, appear without cold exposure, or if you have diabetes or poor circulation.
Get It Seen Promptly If
Book with a doctor or podiatrist, rather than waiting it out, if:
- •The skin has blistered, cracked or opened into a sore
- •There is pus, spreading redness or warmth, or you have a high temperature or feel hot, cold or shivery
- •The chilblains are not improving after 2 to 3 weeks, or you keep getting them
- •You have diabetes or poor circulation in your legs and feet
- •A toe is turning dark gray or black, or the discoloration is spreading
- •They appear without any cold exposure, last beyond the winter, or come with joint pain or rashes elsewhere
Go to the emergency room if your feet were in freezing temperatures and the skin is hard, white or blotchy, has lost feeling, or has blisters filled with clear, milky or bloody fluid. That is frostbite, not chilblains.
What Are Chilblains (Pernio)?
Chilblains are small areas of inflammation in the skin caused by an abnormal reaction to cold. Cold narrows the small blood vessels in the toes. As the feet warm up, the vessels near the surface widen while the deeper ones stay narrow, and that mismatch brings on the itching, pain and color change. Nobody fully knows why some people react this way and others do not.
The recipe is cold that is not freezing, especially damp cold, followed by warming up too quickly. An NHS podiatry leaflet names rapid rewarming, such as standing next to a heat source with cold feet, as the main trigger.
Cold, damp, but not freezing
Chilly, wet weather above freezing, and feet that stay damp in socks or shoes. This is a nonfreezing cold injury.
Warming up too fast
Cold feet put straight onto a radiator, in front of a fire or heater, or under hot water.
Tight footwear
Snug shoes, boots or socks in cold, damp weather raise the risk.
Smoking and some substances
Smoking, caffeine and decongestant medicines for a blocked nose can all reduce blood flow to the toes.
What Do Chilblains Look Like?
Usually several small patches or bumps rather than one, often on more than one toe and frequently on both feet. Toes are the most common place, along with fingers, ears and the nose; less often the lower legs.
Color
Red, bluish or purple. On brown and black skin the redness is harder to see, so the swelling, shine and itch may be easier to notice than the color.
Shape
Swollen, raised patches or small lumps, sometimes shiny. Several can join into one larger swollen area.
Feel
Itching, burning or both, and tender when pressed or squeezed into a shoe. They appear hours after the cold, not during it.
Chilblains Stage by Stage
Usually Nothing to See Yet
- Chilblains typically appear a few hours after the cold, not while you are still out in it
- Pale, numb, frozen-feeling toes while you are out in freezing weather point to frostnip or frostbite instead
Itching, Burning, Swelling
- Itching or a burning feeling starts, usually within 24 hours of the cold exposure
- Small red, bluish or purple patches or bumps appear, often on several toes and often on both feet
- The skin swells and can be tender to touch
Swollen, Tender Patches
- Patches can look shiny and puffy, and several may join into one larger swollen area
- Each patch lasts more than 24 hours, unlike a Raynaud's attack, which comes and goes
Blisters or Broken Skin
- In more severe cases the skin blisters, cracks or opens into a small sore
- Broken skin can become infected, which is the main risk with chilblains
- Time to get it seen, promptly with diabetes or poor circulation
Settling Down
- Most chilblains heal on their own in this window if the feet are kept warm and dry
- They usually leave no lasting damage; scarring can happen but is uncommon
How Long Do Chilblains Last?
Cleveland Clinic and DermNet both put it at 1 to 3 weeks, and the NHS at 2 to 3 weeks. The catch is that the clock only really starts once the chilling stops: every fresh cold, damp day can bring a new crop on top of the old one.
One episode
1 to 3 weeks
With the feet kept warm and dry. The NHS says 2 to 3 weeks.
Cold keeps coming
All winter
Each new chill can bring new patches; some people have them on and off all season.
Prone to them
Every year
They can come back each winter, and relapses often occur as the weather warms in spring.
Not improving
After 2 to 3 weeks
Time to see a doctor or podiatrist rather than keep waiting.
Chilblains that last for months, show up in warm weather, or keep breaking down need a look for an underlying cause, covered further down.
Chilblains Treatment: What Helps
There is no instant fix: the aim is to calm the itch and break the cycle of chilling and rewarming. A pharmacist is a good first stop.
Warm up slowly
Take off damp socks, dry the feet well, and let them warm gradually at room temperature, in dry socks or under a blanket.
Soothe the itch
A pharmacist can suggest a soothing lotion; calamine and witch hazel are common choices. If you soak your feet, keep it brief and warm, not hot.
Moisturize unbroken skin
An unscented moisturizer keeps the skin supple. Leave it off any skin that is cracked or open.
Ease the pain
An anti-inflammatory such as ibuprofen can help, if it is safe for you to take.
Protect the toes
Wear roomy shoes that do not rub, and cover any broken skin with a clean, dry dressing.
Stay warm all day
Warm socks, dry shoes, a warm room, and loose layers to keep the rest of you warm.
What Not to Do
Direct heat
No radiators, fires, heaters or hot water on cold toes. Fast rewarming is the main trigger.
Scratching or rubbing
It damages already fragile skin and opens the way to infection. Do not pick at it either.
Smoking, caffeine, decongestants
All of them can reduce blood flow to the fingers and toes.
Tight shoes and socks
Tight footwear in cold, damp weather is a known risk factor, and it rubs swollen skin.
What a doctor can prescribe
For chilblains that are severe, slow to settle or come back every winter, the usual options are:
- A steroid cream or ointment to calm itching and inflammation, used for a limited time because strong steroids can thin the skin.
- Nifedipine, a tablet that widens small blood vessels. It can speed healing and lower the chance of new chilblains in people prone to them.
- Less often, a nitroglycerin ointment applied to the skin, or pentoxifylline, a tablet that improves circulation.
The evidence comes mostly from small studies, and keeping warm stays the foundation either way.
If a chilblain blisters or breaks open
Cover it with a clean, dry dressing, keep it dry, and leave it alone: no picking and no rubbing. Watch for infection: pus, redness or warmth spreading out from the sore, more swelling or pain, or feeling feverish. The signs are laid out in signs a foot wound is infected.
A sore on a toe that is not clearly healing over 2 to 3 weeks needs a proper look rather than more waiting; see is it normal for a foot wound to take weeks to heal. Persistent sores on the feet are what our wound care service treats.
Chilblains vs Frostbite vs Raynaud's
All three involve cold toes and color changes, but only one is an emergency.
| At a glance | Chilblains | Frostbite | Raynaud's |
|---|---|---|---|
| What causes it | Cold, damp conditions above freezing, then warming up too fast | Freezing cold, at 0°C (32°F) or below | Cold, but also stress, anxiety and sudden temperature changes |
| When it shows | A few hours after the cold | During the cold exposure | In attacks, during cold or stress |
| How long it lasts | Usually 1 to 3 weeks | Treated in hospital; the full damage can take weeks to judge | A few minutes to a few hours per attack |
| How it looks | Swollen red, bluish or purple patches or bumps, sometimes shiny or blistered | Cold, firm, then hard skin; white, blue or blotchy; blisters; can turn black | White or pale, then blue, then red as the blood returns |
| How it feels | Itching, burning, tenderness | Numbness, stinging or burning, then loss of feeling | Numbness, pain, pins and needles |
| What to do | Warm slowly, protect the skin, soothe the itch | Emergency care. Warm (not hot) water, no rubbing, no direct heat | Keep warm, avoid sudden temperature changes; see a doctor if severe, worsening or new after age 30 |
The quick test: frostbite happens in freezing cold and the skin goes hard and numb; do not rub it or put it near a fire, radiator, hot water bottle or heat lamp. A Raynaud's attack comes and goes within hours. Chilblains turn up hours after milder, damp cold and itch for days. Raynaud's is also a known risk factor for chilblains, so the two often travel together.
Raynaud's and other causes of cold, pale or bluish feet are covered in poor circulation foot pain warning signs.
Red, Itchy, Swollen Toes in Cold Weather: What Else It Could Be
When the timing does not quite fit chilblains, consider these look-alikes:
| What you notice | What it can point to | What to do |
|---|---|---|
| Hard, numb, white or blotchy skin after being out in freezing temperatures | Frostbite | Emergency room now |
| Toes turn white, then blue, then red, for minutes to hours at a time | Raynaud's | See a doctor if severe, getting worse, one-sided or new after age 30 |
| Feet wet and cold for days, then numb, blotchy blue, then very painful and swollen | Trench (immersion) foot | Medical care |
| Chilblain-like toes with no cold exposure, often in a child or young adult after a viral illness | Chilblain-like lesions linked to COVID-19 (known as COVID toes) | Mention it to your doctor |
| Patches that last beyond winter, ulcerate, or come with joint pain or rashes | Possible chilblain lupus or another underlying condition | Doctor visit, usually with blood tests |
| Sudden, severe pain in one joint, most often the big toe, with hot, red skin | Gout | Doctor visit |
A single hot, swollen big toe joint belongs in gout in the big toe. A toe that is going dark gray or black, rather than red or purple, is covered in toe turning black, and it should be seen the same day.
Who Gets Chilblains?
Anyone can, but they are seen most in young and middle-aged adults, and more often in women. They are uncommon in children and unusual in older adults, so chilblains that appear for the first time later in life are a reason to look for an underlying cause. Things that raise the risk:
- Low body weight or a low body mass index
- Smoking
- Living or working in a cold, damp climate, including outdoor jobs
- Tight shoes, socks or gloves in cold, damp weather
- Raynaud's phenomenon or acrocyanosis (persistently cold, bluish hands or feet)
- Lupus and other connective tissue diseases
- Peripheral artery disease or other poor circulation
- Some bone marrow and blood disorders
- A family history of chilblains
How to Prevent Chilblains
Prevention is much better than cure: once a chilblain has formed, it mostly has to run its course.
- Keep feet warm and dry: thick socks, or two thin pairs, in waterproof shoes or boots with room for your toes
- Change out of damp socks and shoes as soon as you can
- Dress in loose layers and keep your whole body warm, including a hat, not just your feet
- Keep your home warm and dry through the cold months
- Avoid sudden temperature changes, and warm cold feet slowly rather than putting them near a heater
- Stay active: moving keeps you warmer
- Stop smoking, and go easy on caffeine and decongestant medicines
- If you get chilblains every winter, ask a doctor about preventive treatment before the cold sets in
Chilblains With Diabetes or Poor Circulation
In healthy feet, chilblains rarely cause lasting harm. With diabetes or poor circulation the stakes change: the skin over a chilblain can crack and become infected, and an NHS podiatry service singles out people who heal slowly for these reasons as the main concern. The NHS advises seeing a doctor about chilblains if you have diabetes.
- •Look at your toes every day through the cold months, including between them
- •Warm cold feet gradually, never on a heater, radiator or hot water bottle
- •Cover any crack or blister with a clean, dry dressing and get it seen promptly
- •Do not wait out a sore that is not clearly healing
More in foot wounds and diabetes and diabetic foot blisters. Burning feet that have nothing to do with the cold are more often nerve related; see burning feet at night.
When Chilblains Point to Something Else
Most chilblains have no underlying cause. Rarely, they are a sign of another condition, and the most common is lupus. Chilblain lupus is a form of skin lupus that causes red or purple sores on the toes or fingers that form or worsen in the cold. Cleveland Clinic reports that 18% of people whose chilblain lupus has no genetic cause go on to develop systemic lupus; a UK dermatology guide puts it at up to 20%.
Signs that point beyond ordinary chilblains:
- •Severe chilblains, or chilblains that persist beyond the usual winter period
- •Patches that ulcerate or leave dead, dark tissue
- •Chilblain-like toes with no cold exposure to explain them
- •Chilblains appearing for the first time later in life
- •Joint pain, rashes elsewhere, or muscle weakness alongside them
A doctor usually starts with a blood count and an antinuclear antibody (ANA) test, sometimes a skin biopsy. Chilblain-like toes were also reported after mild COVID-19, mostly in children and young adults. Treating any underlying condition helps the chilblains settle faster.
Feet cold, pale or bluish most of the time? The circulation warning signs. Poor Circulation Foot Pain Warning Signs →
A toe going dark rather than red? Which causes need care today. Toe Turning Black →
A broken chilblain looking angry? Normal healing versus infection. Infected Foot Wound Signs →
A sore on the toe that will not close? How long foot wounds should take. Foot Wound Healing Time →
Frequently Asked Questions
How long do chilblains last?
Most chilblains clear up on their own in about 1 to 3 weeks, as long as the toes are kept warm and dry; the NHS puts it at 2 to 3 weeks. If your feet keep getting cold, new patches can keep appearing, and some people have them on and off all winter. See a doctor if they are not improving after 2 to 3 weeks or keep coming back.
What do chilblains look like on toes?
Small, swollen patches or bumps on one or more toes, usually red, bluish or purple and sometimes shiny, that appear a few hours after the feet got cold. They itch or burn and can be tender. Several can merge into one larger swollen patch. On brown and black skin the redness is harder to see. In more severe cases the skin can blister or break open.
How do you get rid of chilblains on your toes?
Warm the feet slowly, dry them well, and keep them warm and dry from then on so the skin can settle. Do not put them on a radiator or under hot water, and do not scratch or rub them. A pharmacist can suggest a soothing lotion for the itch. For chilblains that are severe or keep coming back, a doctor can prescribe a steroid cream or nifedipine.
What is the difference between chilblains and frostbite?
Chilblains come from cold, damp conditions above freezing, appear a few hours later as itchy red or purple swellings, and usually heal on their own. Frostbite happens at 0°C (32°F) or below: the skin is cold, firm or hard, numb, and white, blue or blotchy, and can blister and turn black. Frostbite needs emergency care. Chilblains usually do not.
What is the difference between chilblains and Raynaud's?
Raynaud's comes in attacks lasting a few minutes to a few hours: toes or fingers turn white, then blue, then red as blood flow returns, with numbness or pins and needles. Chilblains are inflamed patches that appear hours after cold exposure, last for days to weeks, and itch or burn. The two often go together, since having Raynaud's raises the chance of getting chilblains.
Can chilblains be a sign of lupus?
Usually not: most chilblains have no underlying cause. Rarely they are chilblain lupus, a form of skin lupus, and Cleveland Clinic reports that 18% of people whose chilblain lupus has no genetic cause go on to develop systemic lupus. Get checked if chilblains are severe, ulcerate, last beyond the winter, appear without cold exposure, or come with joint pain or rashes.
Should I worry about chilblains if I have diabetes?
Get them looked at. The NHS advises seeing a doctor about chilblains if you have diabetes, because foot problems can be more serious. Chilblains can crack and become infected, and diabetes and poor circulation slow healing. Look at your toes daily through the cold months, cover any broken skin with a clean, dry dressing, and have a sore that is not healing or looks infected seen promptly.
Sources and further reading
- NHS: Chilblains
- DermNet: Chilblains (pernio)
- Cleveland Clinic: Chilblains (pernio)
- Cleveland Clinic: Chilblain lupus
- StatPearls (NCBI Bookshelf): Pernio
- American Family Physician: Hypothermia and cold weather injuries (2019)
- Primary Care Dermatology Society: Perniosis (chilblains)
- The Dudley Group NHS Foundation Trust: Chilblains, podiatry leaflet
- NHS: Frostbite
- NHS: Raynaud's
General patient education. Your examination and individual treatment instructions take priority.
See a Podiatrist Near You
ASG Foot & Ankle has offices in Homewood, South Chicago Heights and Mokena. Our board-certified podiatrists accept most insurance. Find the office closest to you:
Toes That Will Not Settle This Winter?
Chilblains that keep coming back, break open, or show up on feet affected by diabetes or poor circulation need more than waiting. ASG Foot & Ankle can examine the toes, check the circulation, and treat broken skin and slow-healing sores.