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Suggest treatment for chilblains

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Posted on Sat, 26 Mar 2016
Question: OK, I have been diagnosed with chilblains in 2nd toe to right and the chilblains has tried to set up in other toes, but not to the effect of the original toe. The year I lived in a warm winter climate - no problems, but when I return to cold winters - UGH. Very painful, as if my poor toe will explode - its like a little balloon. If it got that bad in other toes, I would be unable to walk and crying a lot. Anything to do except move to warmer winter climate? Almost forgot -- I had Mortons Neuroma under that toe, had surgery 12 yrs ago, and the pain has returned, almost as bad as the original. Three middle toes, R foot are mostly numb. Also that foot has symptoms similar to peripheral neuropathy and have been told those symptoms can be attributed to original surgery for MN. Whatcha' think?
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Answered by Dr. Suresh Heijebu (6 hours later)
Brief Answer:
Please upload images

Detailed Answer:
Hello, Madam.

I can certainly understand your concerns.

I can guide you better if you can upload images of the involved toes and feet areas.

This can help me to assess your condition better and do the needful.

Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Suresh Heijebu (6 hours later)
I don't have pictures. Surely what I described is clear. Right foot. Second toe from little toe is one critically involved. It began about 6 years ago in Tennessee in coldest part of winter, Continued each year until last when I lived in XXXXXXX Did not happen there in warm TX winter. Now live in Arizona with winter very cold at times. It has happened this year and involved all toes except little toe, although not to the extent of original toe. Weather warmed up and all toes are now well, except original toe, altho it is better. Please do not ask me to do anything else. I'm a bad tech person. I know that your answers cannot be 100% accurate, but please try an answer based on the info I've provided, Otherwise I'll have to ask AX to have my $15 returned. I'd rather not do that. Thanks, Tina
doctor
Answered by Dr. Suresh Heijebu (13 hours later)
Brief Answer:
Oral pills of NIFEDEPINE will Help

Detailed Answer:
Hello, Madam.

I apologize for the delayed response considering my hectic work as schedule.

I worked through your query in detail and can certainly understand your concerns.

Steroids have no proven value in the treatment of Chillblains.Also, it is wise to avoid them considering your age and other medical comorbidities.

Cold induced vasospam is the main underlying cause for the injury if the toe.

You possibly seem to have chronic resistant and recurrent pernio.Thus need treatment with oral pills of Calcium channel blockers.

These are excellent drugs known to control and cause symptomatic improvement in Chillblains.

I generally prescribe to my patients oral pills of extended release form of Tab NIFEDEPINE 60 mg once a day for 3 months.Further dose and duration of therapy is largely based on the degree of response shown by your toes, which can be assessed after 1 month.

Avoid exposure to cold and keep your extremities warm and dry.

If possible and feasible, I recommend exposure of feet to UV radiation which is known to offer prophylactic benefits in Chillblains.

Additionally, I recommend blood tests like CBC and ANA profile to rule out connective tissue disorder which is very commonly associated with recurrent Chillblains.

Overall the prognosis is pretty good in isolated Chillblains and NIFEDEPINE should offer you the required assurance.

Post your further queries if any.
Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3664 Questions

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Suggest treatment for chilblains

Brief Answer: Please upload images Detailed Answer: Hello, Madam. I can certainly understand your concerns. I can guide you better if you can upload images of the involved toes and feet areas. This can help me to assess your condition better and do the needful. Thank you