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What Are Chilblains? How Can They Be Prevented?
Category Injuries And Recovery Altitude And Health
By Varun Sharma
I f you’re hearing this word for the first time and thinking: “What is a Chilblain? How does it matter to me as a trekker?” Then, you need to read this article. There’s a reason why high altitude trekkers even in best of boots fear them.
Chilblains are itchy, painful and burning red-blue swellings on the skin that occur as a reaction to a sudden change in temperatures.
Although it rarely affects the average Indian trekker, it is important to be aware of this medical condition and its preventive measures.
Signs And Symptoms:
So how exactly do you identify a Chilblain?
Chilblains are bumpy, nodule-like structures that appear swollen, itchy and reddish to purplish in colour. It may also become infected or ulcerated leading to severe pain or infection. They cause persistent itching and numbing of the affected body part.
Long-standing chilblains may convert into another condition called Frostbite, in which the tissues below the skin freeze.
A file picture of Chilblains. Notice the extremes of toes being red and swollen.
The most common underlying reason is cold. When the skin is cold, blood vessels near its surface gets constricted. Now if the skin is exposed to heat, the blood vessels become dilated.
If this change from cold to warm temperatures is abrupt (eg: placing skin near fire or very hot object), the blood from the vessels starts to leak in the surrounding tissues, causing chilblains.
Some people are at a greater risk to have chilblains than others. Below is a list:
1. A family history of chilblains
2. Tobacco smokers – as nicotine act as a vasoconstrictor (an agent that enables constricting of vessels).
3. Women and children
4. Underweight individuals.
5. People with Raynaud’s disease- a condition that interrupts blood circulation to the toes and fingers.
6. People wearing an incorrect, smaller sized shoe.
On a trek, it’s important to pay attention to your feet and prevent Chilblains. With proper care, its occurrence can be prevented. Let me quickly tell you few tips that I follow for preventing them:
1. Stop smoking – Drink enough water so that the nicotine is washed out as urine. Exercising also helps in detoxifying. Having fruits rich in antioxidants such as oranges help in flushing out the nicotine.
2. Avoid tight shoes and boots – Don’t put your feet on extra stress. At times blisters caused by incorrect shoe sizes also lead to chilblains. Before starting a trek properly break-in your shoes.
3. Eat one hot meal per day – this will help in maintaining your core body temperature and protect against temperature drops.
4. Dry your socks – This is a continuous process. During the day hang your socks under your shirts or at the waist tip of your pants. During the night you can drape them around your chests inside your sleeping bags. Always keep an extra pair of socks.
5. Sleep with warm, dry feet – There’s no exception to this rule. Even a single day of sleeping in wet, cold socks can undo days of effort. Carry a small towel specific for your feet if possible.
6. Travel early, stop before nightfall – Always follow nature’s routine while trekking. When you start early and stop before nightfall you utilise sun’s warmth and prevent the colder temperatures. You also get enough time to take care of your feet. Don’t wait until bedtime to take care of your feet. As soon as you reach a campsite change into a pair of dry socks and begin drying your wet and damp shoes and socks.
7. Always inspect your feet regularly throughout the day. Don’t hesitate to change your socks on the route if you feel they have become wet due to sweat. At times messages sent from the brain may be faulty due to nerve injury (a symptom of mountain sickness) and there’s no realisation of a chilblain. Therefore, it’s important to check your feet every now and then.
8. Keep sudden temperature change to a minimum. Use your body warmth to your advantage but don’t rub vigorously since that would further aggravate the chilblain.
Chilblains can be easily avoided by keeping the feet dry. The above infographic is taken from NOLS Wilderness Medicine Book.
Consult and bring this to your trek leader’s attention immediately.
Chilblains often self-heal after a week or two provided they are not further abused.
A soothing lotion such as calamine can be used to relieve itching. If the skin is unbroken a 1% hydrocortisone cream is soothing to apply.
Always remember to rewarm the affected skin gently. Warm your cool feet on a companion’s belly. Don’t rush to a campfire or a hot source instantly.
That’s all from me on this topic. Do comment below and let me know if you have some valuable inputs.
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