What is the recommended initial management for chilblains?

• A. Remove wet or constrictive clothing, wash and dry the area gently, elevate the area, and cover with warm, loose, dry clothing or blankets
• B. Massage the area vigorously to stimulate circulation
• C. Apply creams or lotions aggressively and use high levels of heat
• D. Keep the area exposed to cold, damp conditions

Answer: (A)

Chilblains occur after exposure to cold and damp conditions, causing inflammation of small blood vessels in the skin. The main idea in initial management is gentle rewarming and protection of the affected area. Start by removing wet or constrictive clothing, then wash and dry the area gently to keep the skin clean. Elevate the limb if possible to reduce swelling, and cover it with warm, loose, dry clothing or a blanket to rewarm gradually. Avoid vigorous rubbing or massage, and steer clear of applying aggressive creams or lotions or using high heat, which can damage the skin or worsen the inflammation. Also avoid keeping the area exposed to cold, damp conditions, which would prolong symptoms. If symptoms persist, worsen, or blisters form, seek medical advice.