From the Research
Perniosis, also known as chilblains, is a condition that should be treated with gentle warming of the affected areas and prevention of further cold exposure, with nifedipine being a viable option for more severe cases at a dose of 20-60 mg daily, as evidenced by the most recent and highest quality study 1.
Key Points
- Perniosis typically affects the extremities, particularly the fingers, toes, ears, and nose, and is characterized by painful inflammation of small blood vessels in the skin that occurs in response to cold, but not freezing, temperatures.
- Treatment involves gentle warming of the affected areas, avoiding direct heat sources like heating pads or hot water which can worsen the condition.
- Topical corticosteroids such as betamethasone 0.1% cream applied twice daily for 1-2 weeks can help reduce inflammation.
- Prevention is crucial and includes keeping extremities warm with proper insulation (gloves, thick socks), avoiding damp conditions, gradually warming cold skin, and maintaining core body temperature.
- Perniosis occurs because cold exposure causes blood vessels to constrict and then dilate abnormally, leading to leakage of red blood cells into tissues and subsequent inflammation, as noted in 2.
Important Considerations
- People with poor circulation, low body weight, or conditions like Raynaud's phenomenon are particularly susceptible to perniosis, as mentioned in 3.
- If symptoms persist despite treatment, medical evaluation is recommended to rule out underlying conditions, such as connective tissue disease or cryopathies, as discussed in 1.
- Nifedipine has been shown to be effective in reducing pain, facilitating healing, and preventing new lesions of pernio, as demonstrated in 4.