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Chilblains: symptoms and treatment, bulk billed

Itchy red-purple patches on your toes or fingers after cold weather are usually chilblains, and most settle within 1 to 3 weeks. Bulk billed with no out-of-pocket costs if you're Medicare eligible: a NewDoc GP can confirm the diagnosis from photos or video and treat severe or recurrent cases.

Can a telehealth GP treat chilblains?

Yes. Chilblains are itchy, red-purple swollen patches that appear on toes, fingers, and sometimes ears or the nose a few hours after cold exposure, caused by small blood vessels over-reacting to cold and rewarming. They are common in Australian winters, especially in cold houses. An AHPRA-registered GP at NewDoc can usually confirm the diagnosis from photos or video, guide treatment, and prescribe for severe or recurrent cases where appropriate.

Most chilblains settle within 1 to 3 weeks with warmth and skin care. See a GP promptly if the skin breaks or shows signs of infection, and seek in-person care the same day if redness is spreading or you develop a fever.

Quick answer: what chilblains are and how to treat them

Chilblains are itchy, red-purple swollen patches on the toes, fingers, ears, or nose that appear hours after cold exposure, caused by small blood vessels reacting to cold-to-warm changes. Most settle within 1 to 3 weeks. Treatment is keeping the whole body warm, rewarming gradually, moisturising, and not scratching; never put the affected skin directly on a heater or hot water bottle. As Healthdirect Australia describes them, chilblains are itchy, swollen, painful areas of skin on your fingers and toes caused by cold. A GP should review broken or infected chilblains, and severe or recurrent cases may warrant prescription treatment or checks for an underlying cause. The consult and any eScript are $0 out-of-pocket, bulk billed, for eligible Medicare cardholders, median 5.0 hours booking-to-consult per NewDoc April 2026 utilisation data.

What are chilblains?

Chilblains (the medical name is pernio) are an inflammatory reaction of the small blood vessels in the skin to cold. When skin gets cold, its small vessels narrow; when it warms again, they widen. In people prone to chilblains that response is exaggerated: blood returns to the area faster than the vessels can comfortably handle, fluid leaks into the surrounding tissue, and the result is the swollen, discoloured, intensely itchy patches that give the condition its name.

Chilblains are not frostbite: they occur at cold but above-freezing temperatures, and damp conditions make them more likely. They typically show up a few hours after cold exposure rather than during it, most often on the tops of the toes and on the fingers, and sometimes on the heels, ears, or nose. The Better Health Channel notes they are common in winter and usually settle without lasting harm, though severe cases can blister or ulcerate.

Symptoms of chilblains, and how long they last

Typical features include:

  • Small swollen patches or lumps that look red, purple, or blue
  • On the toes, fingers, and occasionally the heels, ears, or nose
  • Itching or burning that gets noticeably worse as you warm up
  • Tender, tight-feeling skin over the affected area
  • Appearing a few hours after being out in the cold
  • In severe cases, blisters or small open sores

An individual crop of chilblains usually settles within 1 to 3 weeks, faster if further cold exposure is avoided. The frustration is recurrence: the same toes or fingers often flare again with the next cold snap, and for some people chilblains are a whole-of-winter companion unless prevention is taken seriously.

Why Australian winters bring chilblains

Chilblains thrive on exactly the winter many Australians live through: cold, damp air outside and homes that hover in the low teens indoors, without the central heating that is standard in colder countries. Feet spend the day cold, then get warmed quickly against a heater, in a hot shower, or under an electric blanket, and that rapid cold-to-hot swing is precisely what triggers the reaction.

People especially prone to chilblains include those with poor circulation to the hands and feet, people with a low body weight, people with Raynaud phenomenon, smokers, and people taking certain medicines that narrow blood vessels. Chilblains can also occasionally accompany connective tissue conditions such as lupus, which is one reason unusual or persistent cases deserve a proper look rather than another winter of putting up with them.

Self-care: what helps, and what makes chilblains worse

Most chilblains can be managed at home:

  • Warm your whole body, not just the affected part: layers, warm drinks, and a warmer room all improve blood flow to the skin
  • Rewarm gradually: let cold feet and hands come back to temperature slowly rather than heading straight for the heat source
  • Never put chilblains on direct heat: no heaters, hot water bottles, or hot water on the affected skin, as rapid rewarming feeds the reaction and can damage the skin
  • Do not scratch or rub: broken chilblains heal slowly and invite infection
  • Moisturise the area to protect the skin, and keep it covered and warm
  • Keep any broken skin clean and covered with a dry dressing, and watch for signs of infection

Gentle movement helps circulation, tight shoes make things worse, and smoking narrows the very vessels involved, so this is a good reason to address it. If the itch is unbearable, a GP or pharmacist can suggest safe short-term options for settling it.

When to see a doctor, and when to seek in-person care

Book a GP review if:

  • Chilblains are severe, very painful, or not settling after a few weeks
  • They keep returning each winter despite sensible prevention
  • The skin has broken or ulcerated
  • Chilblain-like patches appear outside cold weather, or alongside other symptoms such as joint pains, rashes, or mouth ulcers, which may warrant investigation
  • You have diabetes or known circulation problems: any foot skin damage deserves a lower threshold for review, and your GP may recommend in-person foot care

Seek in-person care the same day, at a GP clinic or an emergency department, if a chilblain becomes markedly more painful with spreading redness, pus, or fever, which suggests a deeper skin infection, or if any area of skin turns dusky, grey, or black, which is a circulation emergency. Telehealth is not a substitute for hands-on care in those situations, and a NewDoc GP will direct you to the right place if your photos raise concern.

How a telehealth GP can help with chilblains

Chilblains are highly visual, which makes them well suited to photo and video assessment. A NewDoc GP can:

  • Confirm the diagnosis from photos or video and distinguish chilblains from look-alikes such as eczema, infection, or circulation problems
  • Advise on skin care for the current crop and a prevention plan for the rest of winter
  • Prescribe for severe or recurrent chilblains where appropriate and send the eScript to your phone
  • Review your regular medicines in case any are contributing to cold-sensitive circulation
  • Arrange blood tests to screen for underlying causes, such as an autoimmune screen, when chilblains are recurrent, severe, or atypical

In guideline terms, the prescription option most often considered for severe or recurrent chilblains is a calcium-channel blocker such as nifedipine, used to relax the small blood vessels and taken over the cold months; whether it is appropriate, and at what dose, is a decision your GP makes with you based on your blood pressure, other medicines, and history. A short course of a topical corticosteroid is sometimes used for intense itch, although the evidence for it is modest.

For eligible Medicare cardholders the telehealth consultation is bulk billed, with no out-of-pocket cost for the appointment, and any eScript or referral issued during it is included.

Preventing chilblains next cold snap

Prevention is about keeping the temperature of your skin stable and your circulation moving:

  • Dress warmly before you get cold: socks, covered shoes, gloves, and layers
  • Keep your home as warm and dry as you reasonably can through winter
  • Change out of damp socks, shoes, or gloves promptly
  • Warm up gradually after coming in from the cold
  • Keep moving through the day to maintain circulation to hands and feet
  • Avoid tight footwear that compresses the toes
  • Do not smoke

If you know chilblains find you every winter, it is worth a bulk billed telehealth consultation early in the season: a GP can check whether anything treatable is driving them and, for recurrent severe cases, discuss preventive prescription options before the cold settles in.

References

This content is informational and does not replace individual medical advice. For personal assessment, book a consultation with your GP. In emergencies, call 000.

Reviewed by Dr. Jason Yu FRACGP

Last reviewed 2 August 2026. Editorial policy

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Frequently asked questions

What do chilblains look like?

Chilblains are small, swollen patches or lumps of skin that look red, purple, or blue, most often on the tops of the toes and on the fingers, and sometimes on the heels, ears, or nose. They itch or burn, especially as you warm up, and the skin can feel tight and tender. In more severe cases they blister or break open. They usually appear a few hours after being out in the cold.

Why do I get chilblains every winter?

Some people's small blood vessels are simply more reactive to cold, and that tendency does not change much from year to year. If your circulation, body weight, medicines, or an underlying condition such as Raynaud phenomenon make your vessels prone to clamping down in the cold, chilblains will tend to return each winter unless you change the conditions: warmer feet and hands, a warmer home, and gradual rather than rapid rewarming.

How do I get rid of chilblains fast?

There is no instant cure, and most chilblains settle on their own within 1 to 3 weeks. You can help them along by keeping your whole body warm, avoiding further cold exposure, resisting scratching, and moisturising the skin. Do not put the affected skin on direct heat, because rapid rewarming makes chilblains worse. If they are severe, ulcerated, or keep recurring, a GP can discuss treatment options for the season.

Should I pop or scratch chilblains?

No. Scratching, rubbing, or bursting chilblains breaks the skin, and broken chilblains are slow to heal and prone to infection, particularly on the feet. If the itch is hard to bear, keep the area moisturised and covered, and ask a GP or pharmacist about safe options for settling it. If the skin has already broken, keep it clean and covered with a dry dressing and watch closely for signs of infection.

When do chilblains need a doctor?

See a GP if chilblains are severe or very painful, keep coming back each winter, have broken open or ulcerated, show signs of infection such as spreading redness or pus, or are not settling after a few weeks. Also book a review if you get chilblain-like patches outside cold weather or alongside other symptoms such as joint pains or rashes, or if you have diabetes or known circulation problems, where any foot skin damage deserves a lower threshold for review.

Can chilblains be a sign of something else?

Occasionally. Most chilblains are an isolated response to cold, but recurrent, severe, or unusual chilblains can be associated with Raynaud phenomenon, autoimmune conditions such as lupus, low body weight, or circulation problems. Chilblain-like patches appearing without cold exposure are a particular prompt to investigate. A GP can take a history, examine photos, and arrange blood tests to check for an underlying cause where appropriate.

Are chilblains related to Raynaud's?

They often travel together. Raynaud phenomenon is an exaggerated blood-vessel response to cold that turns fingers or toes white, then blue, then red, and people with Raynaud are more prone to chilblains because their small vessels react strongly to temperature changes. Having one does not mean you have the other, but if you notice both, mention it to your GP: it helps guide whether any further checks are worthwhile.

How do I prevent chilblains?

Keep your whole body warm, not just the affected part: layers, warm socks, gloves, and covered shoes when you head into the cold, and a warm (not hot) home in winter. Warm up gradually after being outside rather than going straight to a heater, keep moving to boost circulation, avoid tight footwear, and do not smoke, as smoking narrows the small vessels involved. If you are prone to chilblains despite this, a GP can review your medicines and discuss preventive options before winter.

Is the chilblains consultation bulk billed?

Yes. NewDoc bulk bills telehealth consultations for eligible Medicare cardholders, so there is no out-of-pocket cost for the GP appointment. Any eScript, blood test referral, or specialist referral issued during the consultation is included at no extra charge. Medicines themselves may be subsidised under the PBS at your pharmacy.

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