Chilblains can be defined as cold injury that is, while painful produces little or no permanent impairment. The term chilblain is an old English word compounded from chill and blain, an archaic word for inflamed bulging or sore on the body. Chilblains, also known as pernio and perniosis is a medical condition that is often confused with frostbite, trench foot, Equestrian Perniosis and Erythrocyanosis crurum.

Chilblains are a painful abnormal reaction of the small blood vessels in the skin when exposed to cold temperatures. Chilblains usually occur several hours after exposure to the cold in temperate humid climates. The cold causes constriction of the small blood vessels in the skin and if rewarming of the skin happens too rapidly, there is leakage of blood into the tissues as the blood vessels do not respond quickly enough to this rewarming.

The cold exposure damages capillary beds in the skin, which in turn can cause redness, itching, blisters, and inflammation. Chilblains are often idiopathic in origin but can be manifestations of serious medical conditions that need to be investigated.Chilblains can be prevented by keeping the feet and hands warm in cold weather. A history of chilblains is suggestive of a connective tissue disease.

Chilblains are not very common in countries where the cold is more extreme as the air is drier. The living conditions and clothing used in these climates are protective. Chilblains are more likely to develop in those with poor circulation, but chilblains are still common in those with good circulation. They usually affect the toes, soles of feet and backs of heels, but they can also affect other exposed areas of skin, such as the nose, ears, and the backs and sides of fingers. Chilblains may be caused randomly due to unknown reasons or they may be the symptom of another medical condition.

SYMPTOMS
Chilblains start during the winter (when the weather gets colder) - the initial symptoms include burning and itching in the area of the developing chilblain.chillblain is caused due to weak immune system of the body. It is a viral infection.These symptoms are often intensified when going into a warm room. Other symptoms include Dry skin, leading to splits and cracks. There is often some swelling and redness. In many cases, the skin over the chilblain can break down and becomes a sore (ulcer). An infection may develop in the chilblain. The lesion becomes very itchy and painful. Chilblains become increasingly painful as they get congested and take on a dark blue appearance.

CAUSES
Those at greatest risk are mainly young adult women. It is unknown why this is the case, but it is thought to be hormonal changes that place these women at greater risk. Some people can have chilblains occur every year for the rest of their lives while others may only get them for a few years and then never experience them again. It is unknown why this occurs. Any place where blood circulation is restricted is also at risk of developing chilblains including pressure points on the feet such as bunions and calluses or where the toes are under pressure from tight shoes.
In chilblains, freezing causes the terminal blood vessels to shut down. This is called vasoconstriction. The local tissue metabolism being at extremely low ebb, the requirement for oxygen is much more, due to extreme cold. Vasoconstriction decreases blood supply, which leads to tissue damage. Factors that contribute to tendency to chilblain include -

• A familial tendency.
• Poor circulation.
• anemia
• Hormonal changes.
• some connective tissue disorders and some
• Bone marrow disorders.
• Damp living conditions may also increase the risk for chilblains.
• The sudden onset of very cold water on the skin can also lead to a chilblain.
• Other contributing factors include dietary, hormonal imbalance and people who suffer from anemia.
• Since smoking slows the blood circulation, smokers are at risk as well as diabetics.
• Do not let the feet become exposed to any source of direct heat (like a heater), especially if the foot is very cold - this is a common factor causing chilblain.
• Bone marrow disorders (this is rare).

NATURAL TREATMENT FOR CHILBLAINS
Onion is best for chilblain.
If you suffer from chilblain use this remedy regularly winter. Cut a raw onion. Use the cut edge all over the chilblains; let the juice soak into the skin. The severity of itching dies down almost instantly and also helps in reducing the chilblain.
Ginger treatment
Ginger also acts as a circulatory stimulant and has anti-inflammatory properties. Rosemary is known to dilate and strengthen our body's blood vessels.
Gingko biloba treatment
Gingko biloba, an herb used in traditional Chinese medicine improves blood flow and the functioning of the circulatory system.
Egg and Honey can also reduce chilblain.
Take a tablespoon of honey, a little glycerin, and one egg white and add to this a little flour. Mix in to a paste. Apply all over the chilblain. Leave it on for 6-8 hours. Wash off. Cures your chilblain very quickly.
Potato is treatment for chilblain.
Slice a potato. Sprinkle some salt on it. Rub it all over the chilblain. Helps to soothe the itching and redness.
Regular Massage will help to reduce chilblains.
Regular massage of hands and feet in winter with any warmed vegetable oil, with a few drops of lemon added, improves circulation. Use the discarded halves of lemons to cup them around fingers/toes, and rub them for a while. Wash off with warm water. Helps in reducing the chilblains.
Black peppercorns with mustard or sesame seed oil.

• Grind a few black black peppercorns and fry them in a tablespoonful of hot mustard or sesame seed oil. Filter and while still warm, use this oil for massage. Make sure the skin is not abraded or bruised, or else this will cause pain and inflammation in the chilblains.
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Garlic Juice reduces the itching of the chilblain.
Fresh juice and warm oil helps in reducing itching of chilblain. Rinse out hands in warm water, or the pungent garlic smell will remain.
Recommendations
Suggestions for treating chilblains are include:

• The best treatment is to avoid having the chilblain problem in the first place by - wearing proper protection against the cold.
• Keep the affected areas warm. This means staying out of the cold, or wearing warm gloves, socks, etc, when outdoors.  
• A steroid cream rubbed onto the chilblains may reduce itch and soreness.
• Medication is sometimes used to prevent chilblains in people who have recurring chilblains. A drug called nifedipine can dilate (open wide) the small blood vessels and may help to prevent chilblains.
• Diltiazem drug will open up your blood vessels in order to allow increased blood flow around your body. This may also be prescribed to you if you maybe have high blood pressure or having suffered with angina.
• Resist the urge to scratch, as this will further damage the skin.
• Avoid scratching on affected areas.
• Use calamine lotion or witch hazel to soothe the itching. Your chemist may also supply a suitable product.
• Lanolin or similar, rubbed into the feet, will help retain body heat.
• Keep your whole body warm.
• Gentle exercise will improve circulation to your feet.
• Avoid long periods of exposure to cold or damp weather.
• Wear several layers of clothing, which trap body heat more efficiently than one bulky layer and tights under trousers.
• Make sure your shoes are comfortable and don't squeeze your toes.
• Regularly pamper and condition the skin of your feet with home pedicures.
• See a podiatrist for regular professional treatments.
• Avoid smoking.
• If your feet do get cold, allow them to warm up slowly - do not put them straight in front of a source of heat (this gives a chance for the circulation to respond to the warming skin).
• Padding and pressure relief may give some relief for the chilblain symptoms.