Chilblains are a common skin problem on the feet of people who have the risk factors for how the small blood vessels respond to cold. They are very common in the colder climates and almost unheard of in the warmer climates. Despite being so common there is a lot that is not known about chilblains. For example, they can affect some people for a number of years and then just stop for no known reason. The are more common in those who smoke and more common in those with less body fat. They are more common in females. Despite all of these known risk factors it is not clear what the mechanism is by which they increase the risk. Without knowing that it can be somewhat difficult to develop treatments for chilblains that are universally affective. Most treatments are just based on anecdotes when the natural history of them is to heal up anyway given time. This raises the question as to did the treatment work or did it get better on its own anyway.
All of these issues were widely discussed in the Podiatry livestream, PodChatLive in which the hosts talked with Joseph Frenkel, a podiatrist from Melbourne, Australia. This episode was streamed live on Facebook and was later added to YouTube and also an audio version as a podcast. The episode talked about how easy it is to diagnose a chilblain based on the typical history and appearance, but also just how difficult it is to know which is the best treatment. There is not much, if any good evidence as to what is more effective and which treatment work any better than doing nothing. There was a good consensus on how to prevent the chilblains by keeping the feet warm and how to protect the foot once a chilblain had developed. Preventative measures were also discussed as they do appear to be very effective.