Raynaud's and Chilblains; How to manage them leading up to the Colder Months!

As we head into the colder months in Sydney, we start to see a noticeable increase in patients presenting with cold-related foot conditions—most commonly Raynaud’s phenomenon and chilblains.

While these conditions can be uncomfortable (and sometimes painful), the good news is that early prevention and simple management strategies can make a big difference—and this is strongly supported by clinical research.

What is Raynaud’s?

Raynaud’s phenomenon is a vascular condition where the small blood vessels in your toes temporarily narrow (vasospasm), reducing blood flow in response to cold or stress.

This exaggerated response has been well documented in vascular research, showing that people with Raynaud’s have increased sensitivity of digital arteries, leading to reduced circulation in the extremities (Herrick, 2012).

What you might notice:

• Toes turning white → blue → red

• Numbness or pins and needles

• Cold, “dead” sensation in the toes

• Pain as circulation returns

  
  

From a podiatry perspective, this reduced blood flow can affect skin integrity, wound healing, and overall foot comfort, particularly during winter.

What are Chilblains?

Chilblains (perniosis) are inflammatory skin lesions that develop after exposure to cold, damp conditions.

They occur due to an abnormal vascular response to cold followed by rewarming, causing leakage from small blood vessels into surrounding tissues and resulting in inflammation (Cappel et al., 2020).

Common signs:

• Red, purple or swollen patches on toes

• Itching or burning sensation

• Pain or tenderness

• Occasionally blistering or skin breakdown

Research shows chilblains typically develop 12–24 hours after cold exposure, making them a delayed but predictable response in susceptible individuals.

Why Your Feet Are More Vulnerable

At Hip to Sole Podiatry, we often explain that feet are particularly at risk because:

• They are furthest from the heart, meaning circulation is naturally reduced

• They are exposed to cold surfaces and environments daily

• They are often enclosed in damp footwear, prolonging cold exposure

Studies on cold-induced vascular conditions confirm that reduced peripheral circulation and prolonged cold exposure significantly increase the risk of both Raynaud’s and chilblains (Dowd et al., 2021).

Patients with:

• Poor circulation

• Autoimmune conditions

• Low body weight

The Link Between Raynaud’s & Chilblains

These two conditions are closely connected.Raynaud’s causes reduced blood flow, and when the feet are then rapidly rewarmed, this can trigger chilblains due to inflammatory vascular leakage.

Clinical studies highlight that individuals with Raynaud’s are more prone to developing chilblains, reinforcing the importance of early management and prevention.

How to Manage Chilblains and Raynaud's!

1. Keep Your Feet Warm — Gradually

• Wear thermal or wool socks

• Consider feet warmers

• Choose insulated, well-fitting footwear

• Avoid walking barefoot on cold floors

Rapid rewarming (e.g., heaters or hot water) should be avoided, as research shows it can worsen vascular instability and increase the risk of chilblains.

2. Keep Feet Dry

Moisture significantly increases heat loss.

• Change socks if damp

• Use moisture-wicking fabrics

• Rotate shoes

Evidence shows that cold + damp environments amplify skin damage and vascular response, increasing susceptibility to chilblains.

3. Improve Circulation Daily

Movement plays a key role in prevention.

• Walking regularly

• Foot and ankle exercises

• Avoid prolonged sitting

Even simple movements improve peripheral blood flow, which is essential in reducing Raynaud’s episodes.

4. Avoid Vasoconstrictors

Certain factors worsen blood vessel narrowing:

• Smoking

• Excess caffeine

• Stress

These contribute to vasoconstriction, a key mechanism in Raynaud’s, and are widely recognised in vascular research as modifiable risk factors.

5. Protect Your Skin Barrier

• Daily moisturising

• Prevent cracks and dryness

• Reduce infection risk

Maintaining skin integrity is essential, as compromised skin is more vulnerable to inflammation and delayed healing in cold conditions.

When Should You See a Podiatrist?

At Hip to Sole Podiatry, we recommend booking in if you notice:

• Persistent pain or severe colour changes

• Skin breakdown or signs of infection

• Recurring chilblains each winter

• Difficulty managing symptoms

Early intervention is important, particularly as research shows that ongoing vascular dysfunction can lead to more severe complications if left unmanaged.

Final Thoughts

Raynaud’s and chilblains are common during the colder months—but they are highly manageable with the right care.

By focusing on:

✔ Keeping feet warm and dry

✔ Supporting circulation

✔ Avoiding triggers

…you can significantly reduce symptoms and protect your foot health.

If you’re starting to notice changes in your toes as the weather cools down, it’s worth addressing early—prevention is always easier than treatment.