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Chilblains, Boils, and Carbuncles: Painful Skin Problems

Linda Crampton is a writer and teacher with a first-class honors degree in biology. She often writes about the scientific basis of disease.

Keep your feet warm with cozy socks to reduce the chance of chilblain development, especially in winter.

Keep your feet warm with cozy socks to reduce the chance of chilblain development, especially in winter.

Painful Skin Conditions

Chilblains, boils, and carbuncles are swollen and painful areas on the skin that can make life miserable for the sufferer. Chilblains are red or purple patches or swollen areas that sometimes appear when the skin warms up after being cold. They generally form on fingers, hands, toes, feet, ears, earlobes, and the nose, although they may also appear on the ankles, calves, or thighs of horse riders. Some people are prone to developing chilblains while others never get them.

A boil, or furuncle, is caused by a bacterial infection in a hair follicle and can appear anywhere on the skin and in anyone. It may look like a pimple to begin with. When several neighboring hair follicles are infected, the resulting swelling is called a carbuncle. Boils and carbuncles are red at first but eventually develop a white center that is filled with pus. They become more painful as the amount of pus inside them increases.

Facts About Chilblains

Chilblains are sometimes known as pernio or perniosis. The name “chilblain” is derived from the chilled skin that leads to the chilblain formation and from the word “blain”, which is an old term for a swelling or open sore. Chilblains usually appear several hours after a body part has been chilled and then rewarmed. The more rapid the rewarming, the more likely their development.

Normally, when our body gets cold the blood vessels near the surface of the skin constrict. This reduces blood flow to the skin and decreases heat loss from the body. When the body warms up, the vessels in the skin expand and there is increased blood flow to the area. The extra blood cools the body down as heat is radiated out of the blood and through the skin to the outside world.

The mechanism of chilblain formation isn't understood very well. It's known that in susceptible people blood vessels in the skin behave abnormally as they expand in the warmth after being chilled and that inflammation is involved. The expanding vessels become leaky, allowing fluid, white blood cells, and other materials to leave the blood vessels and enter the surrounding tissue. The area becomes red due to increased blood flow, swollen due to fluid buildup, and painful as the fluid presses on the nerves in the area.

Susceptibility to the Condition

Some common situations and conditions that increase the susceptibility to chilblain development are listed below.

  • Chilblains are most likely to form if the skin is warmed rapidly, such as when a person sits close to a hot fire after coming indoors after being outside in the cold.
  • They tend to occur in cold and damp environments and are most common in the autumn and winter.
  • They are found more frequently in children and the elderly than in other age groups.
  • More women suffer from chilblains than men.
  • People with circulatory problems are more susceptible to developing chilblains.
  • Chilblains sometimes run in families.

Possible Symptoms

Chilblains are red or purple in color and are often swollen. They sometimes produce an intense itching or burning sensation. These seem to be the most common symptoms of the disorder.

Chilblains sometimes develop blisters, or pockets filled with fluid. The fluid is often serum, which is the liquid portion of blood without the clotting agents. In addition, chilblains may develop dry skin with cracks as they dry out. Severe chilblains may develop ulcers (sores with tissue breakdown). Blistered, cracked, or ulcerated skin may become infected.

Although they are frequently unpleasant, chilblains are usually not a serious condition and don't cause any permanent damage. Many people find that chilblains with the most common symptoms disappear on their own within a couple of weeks without treatment. They should be watched carefully in case problems develop, however.

Possible Treatments and Concerns

Chilblains may not need any special treatment. In some circumstances, they do. If they are itchy, it's important to avoid scratching them, since this may damage the skin and increase the risk of infection. A doctor or pharmacist should be able to recommend a cream or lotion that will reduce itching and pain.

Padding over chilblains helps to protect them from pressure and sterile dressings help to prevent infection. Anyone who is concerned about applying the correct treatment for their chilblains should seek medical aid. This is especially important if the chilblain develops more serious symptoms than the basic condition. If the area develops an ulcer or an infection, it's important to see a doctor as soon as possible.

Disorders Linked to Chilblains

If your chilblains last for a long time or frequently disappear and then recur, it would be a good idea to consult a doctor in case the problem is linked to an underlying health problem. For example, people with diabetes, lupus, or Raynaud's disease have an increased risk of developing chilblains.

Diabetes involves a problem related to blood sugar level and the insulin hormone that controls it. Lupus is an autoimmune disease that may produce symptoms in multiple areas of the body. Raynaud's disease is a condition in which small blood vessels going to the skin of the fingers or toes (or another part of the body) periodically spasm and become narrower. As a result, less blood is delivered to the area, causing it to feel cold.

Don't warm a chilled body part in front of a fire if you have a tendency to develop chilbains.

Don't warm a chilled body part in front of a fire if you have a tendency to develop chilbains.

Prevention

It's easier to prevent chilblains than to treat them. To reduce the chance of chilblain development, the following steps may be helpful.

  • Avoid extreme temperature changes.
  • Wear thick gloves, socks, hats, scarves, and other protective clothing in cold weather.
  • Wear waterproof clothing and footwear in the rain.
  • Wait until wet shoes are dry before putting them on again.
  • Wear footwear that fits well. The friction created by ill-fitting shoes can lead to chilblain development in susceptible people.
  • Warm the body gradually after being chilled.
  • If you tend to develop chilblains, don't warm yourself by sitting in front of a fire or a heater or by using a heating pad or a hot water bottle. Use a gentler technique of warming up, such as by changing or adding clothing.
  • Follow a healthy diet and exercise regularly. This may improve circulation and provide other health benefits.
  • Avoid smoking, since nicotine constricts blood vessels.
Keep fingers warm with gloves or mittens to avoid chilblains.

Keep fingers warm with gloves or mittens to avoid chilblains.

Staphylococcus aureus is a bacterium that may live peacefully on the skin without causing problems. It's a common cause of skin infections, however, including boils and carbuncles.

Boils and Carbuncles

A boil is generally caused by Staphylococcus aureus bacteria. The microbes often live on our skin and are frequently harmless in this location. If the bacteria get into a hair follicle (the tube in the skin from which a hair emerges), the follicle and nearby skin tissue may develop an infection.

At first a boil is a red, warm, and firm bump that hurts when touched. The boil gradually becomes filled with a thick liquid called pus, which contains dead white blood cells, bacteria, tissue debris, proteins, and serum. At this point, it may become softer and more painful. It may also develop a white or yellow center, or "head". If several hair follicles next to each other are infected, a group of boils may form. Each boil in the group has its own head. The group is called a carbuncle.

A boil or carbuncle can develop anywhere on the skin, but the most commonly affected areas are the face, the neck, the armpits, the thighs, and the buttocks. Anyone can develop boils, but people with impaired immune systems are especially susceptible to their development.

Staphylococcus aureus is a common cause of boils. The bacterial cells in this photo have been magnified 20,000 times. False colour has been added to the photo.

Staphylococcus aureus is a common cause of boils. The bacterial cells in this photo have been magnified 20,000 times. False colour has been added to the photo.

Dealing With a Boil

Doctors often say that a small boil can be treated at home. There are exceptions to this rule, however, as described in the last section of this article. The boil and its progress must be watched carefully during the treatment.

Boils mustn't be squeezed or pierced (lanced) to let the fluid out, except by a doctor, because these treatments can cause the infection to spread. Instead, medical practitioners say that a warm and wet washcloth should be placed over the affected area for at least ten minutes at a time and for several times a day.

The heat on top of a boil increases blood flow to the area. This is helpful because the blood carries helpful white blood cells and antibodies that can fight the bacteria. The warm soaking should eventually cause the boil to open and release its pus, which will relieve the pain. Once the fluid in a boil has drained, the body can often heal the area itself. As in the case of a chilblain, however, the area should be watched carefully.

The boil should be washed regularly once it has opened and covered with a sterile dressing between washes. Every time the area is washed or a fresh dressing is applied, the person should remember that bacteria are present and that everything that contacts the area will become contaminated and will need to be washed or carefully discarded.

The video below was created by the American Academy of Dermatology, or AAD. The video discusses boils and styes. A stye (or sty) is a bump on an eyelid caused by a bacterial infection of oil glands. The bacterium is often Staphylococcus and the stye may resemble a boil.

Preventing the Transfer of Bacteria

It's important to prevent the transfer of bacteria in a boil to other parts of the skin or to other people. The following procedures should help.

  • Hands should be washed thoroughly after treating a boil. Staphylococcus aureus can cause foodborne illness if it gets into food and multiplies there.
  • Washcloths and towels that have come into contact with the boil mustn't be used by other people until they have been thoroughly cleaned. They should be washed in very hot water before being used again. Anything that can't be reused should be safely discarded.
  • Sheets and clothing that come into contact with the boil should also be washed in hot water.
  • Dressings must be disposed of carefully to avoid spreading the bacteria to other people or to other parts of the patient's body.
Care must be taken with towels and washcloths when someone in a home has a boil  in order to prevent the transportation of skin bacteria from one person to another.

Care must be taken with towels and washcloths when someone in a home has a boil in order to prevent the transportation of skin bacteria from one person to another.

Seek Medical Attention When Necessary

Some boils and carbuncles require medical attention. You should seek a doctor's advice if a boil is large or if it doesn't disappear within two weeks. You should also seek medical help if you have numerous boils or if a boil is located on your face or spine. If other symptoms are present, such as a fever, chills, fatigue, red lines extending from the boil, or swollen lymph nodes, or if you feel unwell, it's important to visit a doctor immediately.

Like chilblains, boils and carbuncles are unpleasant but often minor problems. Occasionally, these skin ailments are more serious, so they should always be treated with care and attention.

References

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2011 Linda Crampton

Comments

Linda Crampton (author) from British Columbia, Canada on December 06, 2011:

Thanks for the visit and the comment, moonlake. I'm so lucky that I've never had a boil or a carbuncle, and I hope I don't get one in the future! It sounds like you had a very unpleasant experience.

moonlake from America on December 06, 2011:

Boils and carbuncles can be terrible and painful. I still have a scar from a carbuncle I had in my eyebrow.

Lots of good information in this hub.

Linda Crampton (author) from British Columbia, Canada on December 03, 2011:

Hi, natures47friend. Thanks for the comment. While I was doing research for this hub I learned about a person who had boils on many parts of their body. It's really important to see a doctor in this situation. Multiple boils and feeling ill are definite signs that medical help is needed. I hope that your friend eventually accepts the advice from you and her husband!

natures47friend from Sunny Art Deco Napier, New Zealand. on December 03, 2011:

This is great information. My friend (no...not me...I have never had a boil or chilblains) has had boils on her behind, they healed and now she has more on her stomach and the front of her thighs. She refuses to go to the doctor (they spend enough on takeaways) so she went to a natural shop and spent a lot on honey to put on the boils and olive leaf stuff. She is tired as had to go back to work as the oldest is off to varsity next year and the two middle kids are going to private schools. No one seems to be able to tell her she needs antibiotics to heal it quickly, not even her husband...have you heard this before....she says she has been really ill with it...I give up..

My daughter had a boil a few years back, went to the doctor, got cream and antibiotics. I was on her upper back so when it popped she could lean forward and it would ooze. Lovely subject, but glad you wrote about it!

Linda Crampton (author) from British Columbia, Canada on November 27, 2011:

Thanks for the funny comment and for the information too, drbj. I had to look up what "chitlins" are on the Internet. Very interesting!

drbj and sherry from south Florida on November 27, 2011:

I have never suffered from chilblains, Alicia, but I have eaten chitlins.

Fascinating information but I had to wash my hands right after reading.

Linda Crampton (author) from British Columbia, Canada on November 27, 2011:

Thank you for the visit and the comment, CMHypno. No, it's not a cheerful subject, but unfortunately some people do suffer from chilblains, boils or carbuncles. I think these problems are interesting, even thought they're not pleasant conditions!

CMHypno from Other Side of the Sun on November 27, 2011:

Thanks for the great information on chilblains and boils Alicia. Not a cheerful subject, but one that is useful to know about