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Chilblains, Boils, and Carbuncles: Three Painful Skin Problems

Updated on April 7, 2017
AliciaC profile image

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

Chilblains on the toes
Chilblains on the toes | Source

Painful Skin Bumps

Chilblains, boils, and carbuncles are swollen and painful areas on the skin which can make life miserable for the sufferer. Chilblains are red or purple bumps 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. When several neighbouring hair follicles are infected, the resulting swelling is called a carbuncle. Boils and carbuncles are red to begin with but eventually develop a white centre that is filled with pus. They become more and more painful as the amount of pus increases.

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. | Source

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, which 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.

A Doctor Discusses Chilblains

Susceptibility

Some common situations and conditions which increase the susceptibilty 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.

An Experience With Chilblains

Symptoms

Chilblains are red or purple patches of skin that are usually swollen. They are painful and may produce an intense itching or burning sensation. They sometimes form blisters or produce dry skin with cracks as they dry out. These must be covered with a dressing to prevent infection.

Although they are often unpleasant, chilblains generally aren't a serious health problem and don't cause any permanent damage. They should be watched carefully, however. Severe chilblains may develop ulcers (sores with tissue breakdown). The ulcers may become infected. Ulcers require medical attention.

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. | Source

Possible Treatments

Chilblains may not need any special treatment. In some circumstances they do, however. 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. Most people find that their chilblains disappear after a week or two if they're treated carefully.

If your chilblains last for a long time or disappear and then recur you should see a doctor, since they may have formed due to an underlying health problem. For example, people with diabetes, lupus, or Raynaud's disease (also called Raynaud's syndrome or phenomenon or simply Raynaud's) have an increased risk of developing chilblains. If a chilblain develops an ulcer or an infection due to a blister, crack, or scratches, it's important to see a doctor as soon as possible.

Keep fingers warm with gloves or mittens to avoid chilblains.
Keep fingers warm with gloves or mittens to avoid chilblains. | Source

Prevention

It's easier to prevent chilblains than to treat them. To reduce the chance of chilblain development it's helpful to avoid extreme temperature changes. It's also helpful to wear thick gloves, socks, hats, scarves, and other protective clothing in cold weather and waterproof clothing and footwear in the rain. Shoes that are wet shouldn't be worn until they are dry. Footwear should fit well, since the friction created by ill-fitting shoes can lead to chilblain development in susceptible people.

The body should be warmed 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. Other strategies that may help are to follow a healthy diet and to exercise regularly in order to improve circulation. Avoid smoking, since nicotine constricts blood vessels.

Raynaud's disease increases the chance of chilblain development. It's 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. My sister has the disorder, although she doesn't develop chilblains. She wears fingerless gloves indoors during an episode. This makes her cold fingers feel warmer while still enabling her to manipulate things. This strategy for reducing extremes in temperature may be helpful for people with Raynaud's who get chilblains. It's sometimes recommended for this purpose.

A skin boil or furuncle
A skin boil or furuncle | Source

Boils and Carbuncles

A boil is generally caused by Staphylococcus aureus bacteria, which often live on our skin. 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 becomes softer and more painful. It also develops a white or yellow centre, 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. Regular washing reduces the buildup of bacteria on the skin and reduces the chance of a boil appearing.

Staphylococcus aureus sometimes lives peacefully on the skin without causing problems. It's a common cause of skin infections, however, including boils and carbuncles.

Boil Information from a Doctor

Treating a Boil

Doctors say that small boils can be treated at home. They 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, 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. Multiple washcloths should be used during a treatment so that the boil is continually being covered with moist heat, as the doctor in the above video describes.

The heat on top of a boil increases blood flow to the area. This is helpful because the blood carries white blood cells and antibodies that can fight the bacteria. The warm soaking will 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 generally heal the area itself. The boil should be washed regularly once it has opened and covered with a sterile dressing between washes.

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. | Source

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. Hands should be washed thoroughly after treating a boil, since Staphylococcus aureus can cause food poisoning as well as skin problems. Washcloths and towels mustn't be shared with other people and should be washed in very hot water before being used again. Sheets and clothing that come into contact with the boil should also be washed in hot water. Dressings must be disposed of carefully. If these precautions don't work and new infections appear, a doctor's advice should be sought.

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. | Source

Seeking Medical Attention

There are some boils and carbuncles that need medical attention. You should seek a doctor's advice if a boil is very 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 generally minor problems. Occasionally these skin ailments can be more serious, however, so they should always be treated with care and attention.

References

Chilblain facts from the NHS (National Health Service)

More information about chilblains from the Victoria State Government in Australia

Raynaud's disease facts from the National Institutes of Health, or the NIH

Boil and carbuncle information from the Mayo Clinic

Carbuncle facts from the NIH

© 2011 Linda Crampton

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    • AliciaC profile image
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      Linda Crampton 5 years ago from British Columbia, Canada

      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 profile image

      moonlake 5 years ago from America

      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.

    • AliciaC profile image
      Author

      Linda Crampton 5 years ago from British Columbia, Canada

      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 profile image

      natures47friend 5 years ago from Sunny Art Deco Napier, New Zealand.

      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!

    • AliciaC profile image
      Author

      Linda Crampton 5 years ago from British Columbia, Canada

      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 profile image

      drbj and sherry 5 years ago from south Florida

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

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

    • AliciaC profile image
      Author

      Linda Crampton 5 years ago from British Columbia, Canada

      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 profile image

      CMHypno 5 years ago from Other Side of the Sun

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