Chilblain Treatment

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Although I hate to say it the chilblain season is nearly here. As a sufferer myself I can sympathise with patients and just wondered if anyone has any good experiences of treatments that work well.

I have been having a look at "warming" creams which are on the market such as Gehwol Red, Laufwunder Warming footbalm, Akileine Winter Creme, has anyone had any experience of these (good or bad?)

Thanks

 

In Grandma's day a common cure for chilblains was to dip the affected foot in the Gazunda. With the introduction of inside sewage the modern equivalent is a urea cream. The origins of todays medications are often stranger than truth......

 

netizens

Spare a thought this October for helping the homeless. When the colder weather comes many people living rough face severe pain and discomfort caused by exposure to cold. Being near a heat source such as an open fire can further complicate already damaged tissues especially if the extremities are thawed then refrozen. Something as simple as wearing two pairs of dry socks can frost nip and in severe conditions frost bite. Throughout the world there are many charities and volunteer groups which collect and distribute clothing including socks to the homeless. In Seattle, Operation Nightwatch hosts "Sock It to Homelessness" every October. This is an annual sock drive where community groups, churches, youth groups, and concerned citizens are invited to donate new socks to the cause. As a novelty the gifted hose are rolled into balls before being distributed to homeless people. In 2009, they collected more than 25,000 pairs of socks. Sock it to the homeless 2010 commences on Sunday 10th October. This also marks World Homeless Day.

The Joy of Sox is based in Philadelphia and is an another organization committed to raise funds from individuals, companies and foundations to buy socks for the homeless. They too conduct sock drives to collect funds and socks from the community. All the socks donated and purchased are given to homeless people attending soup kitchens and homeless shelters.

Comfort Socks is a 501(c)3 public charity that also provides new socks to homeless shelters, all across the United States.

Other agencies such as National Project Homelessencourage volunteers to help the homeless with housing, services, food and clothing. Socks can be donated to Project Home or The Interfaith Hospitality Network .

In Central London the Sock Mob are a group of volunteers who regularly give out socks to the homeless.

In November, Topman stores across the UK and Ireland launch a new promotion with a limited edition of Topman Crisis Charity socks. The socks retail at £4 with 100% of the proceeds going direct to Crisis. These limited edition socks make a perfect Christmas stocking filler. Topman will also donate a winter wool hat to all visitors passing through the Crisis Open Christmas Centre in London and Newcastle.

More information
Sock it to homelessness call (206) 323 4359 or email: ann@seattlenightwatch.org
Joy of Sox
Comfort Socks contact: mindless.chatter@hotmail.com or visit comfortsocks.blogspot.com
Sock Mob: http://www.meetup.com/thesockmob/
World Homeless Day http://www.worldhomelessday.org/

toeslayer

 

Katie 123,

I have recommended both of these products to my patients and they are effective if used!

I have no preference for either, it just depends what's in stock.

Angie

 

The old fashioned but still available Snowfire is the best that i have found, but patients also need to keep feet as warm as possible (plenty of room in shoes for thicker socks, thicker soled shoes, wiggling toes as soon as they start feeling cold!). I'm already into thicker socks and winter shoes ( used to be a victim myself but no more)

 

1/8 plastazote shoe liners really helps. In severe cases I have often given a suitable ankle block resulting an local sympathectomy which flushes out the lesions. The most I have had to do for these clients is two/winter.

 

And has anyone got any suggestions for someone who regularly suffers from chilblains in the colder weather AND erythromelalgia all the time?

 

plastazote insoles helps, I often advise it. as well as wrapping the toes individually with tubigauze, although its time consuming. and inadine paint can also be helpful. although be careful with neuropathic patients. hth

 

Gehwol red and their warming balm have produced excellent results within the welly wearers of Dartmoor over the last year or two. I also recommend a decent fleecy insole and an insulated sole on footwear and two thin sock layers of wool mix.
Just out of interest has anyone else experienced an acute onset of perniosis in clients returning from winter sun holidays?

 

I swear by Balmosa. Several patients wjho previously experienced severe chilblains with breakdowns have no problems at all as long as they start using the preparation as soon as the weather starts to become colder.

CM

 

Dear Graham,

I think you have hit the nail on the head.

If chilblains are a vasospastic disorder then the use of local anaesthetic for their effects on the vasonervosum seems logical. I tried it at LFH back in the 80's and the effect was dramatic. At the time I didn't even realise that LA would affect the sympathetic nervous system. At that stage there was no direct research into the sympathetic effects of LA. The one study I found was not looking directly at the sympathetic effects but noted that following LA injection the local temperature was still elevated 24hrs later. The study only lasted 24hrs so the limit of the sympathetic effect lasted longer. How much longer?

I have never really understood the rational for most of the podiatric and other remedies for chilblains.

The build up of ketabolites, within the affected tissues, resulting from the continued vasoconstriction in the face of increased metabolic demand, would normally act as an 'irritant' which should produce vasodilation or inflammation but doesn't. Why should 'irritating' the tissues from the outside produce vasodilation?

Just to complicate things. The chilblain represents an area of reduced tissue vitality and in some cases the reduction in vitality is so great that the area ulcerates. It doesn't seem reasonable to further insult the overlying skin by 'irritating' (damaging) it.

I can see a certain rationale if irritants are used on the relatively 'normal' tissues surrounding the chilblain. If an inflammatory response can be induced in the surrounding tissues then possibly it might help to 'flush out' some of ketabolites at least from the periphery of the chilblains and might even extend the inflammatory response to cover the chilblains.

Is the use of local anaesthetics widely used by podiatrists in the management of chilblains. Has any research been done in this area?

For my money the injection of local anaesthetic has the potential to make a real and significant difference to the management of chilblains.

best wishes,

Bill Donaldson

 

I used to suffer from chilblains badly with toes going numb and burning and itching when warming. About 5years ago I discovered socks impregnated with silver from a company called TDS healthcare. They keep feet (and hands as gloves available) at a constant temp so reducing heat loss. I have not had a cold foot or chilblain since and recommend them to patients with similar results. It is vital that they are worn daily to get the best results and preferably started before the weather chills ie about august. They are very comfortable and seem to work. Katie