How do I tell chilblains from Raynaud's?
Timing and feeling separate them: chilblains appear a few hours after you have been cold and damp. They itch or burn and stay for two to three weeks. A Raynaud's attack happens during the cold itself. One or more fingers go white and numb within minutes, often turn blue, then flush red as they warm.
| Feature | Chilblains | Raynaud's |
|---|---|---|
| Trigger | Damp cold above freezing, then warming up too fast | Cold air or water, a sudden change from warm to cold, or stress |
| Timing | Appear several hours after the cold exposure | Within minutes of the trigger, while you are still cold |
| Colour | Red to purple patches or swellings | White, then blue, then red; not everyone gets all three |
| Pain or itch | Itching and burning; tender when pressed | Numbness and pins and needles, then stinging or throbbing pain as blood returns |
| Duration | 2–3 weeks per episode, often back the next winter | A few minutes to a few hours per attack, repeated through the cold months |
| Who gets it | Young to middle-aged adults, more women than men; smokers, outdoor workers | About 10 million in the UK, mostly women, usually from the teens or twenties |
| When to see a doctor | Not better after 2–3 weeks, pus, fever, repeat chilblains, or diabetes | First attack after 30, one side only, fingertip sores, joint pain or rashes |
The whole Raynaud's episode lasts from a few minutes to a few hours. People with Raynaud's are more prone to chilblains, so having one does not rule out the other.
What are chilblains?
Chilblains are small, itchy, red to purple swellings on the toes, fingers or ears that appear a few hours after cold, damp weather. The skin itches or feels as if it is burning, and the patches are tender when pressed. On brown and black skin the redness is harder to see, so go by the swelling and the itch.
Damp, non-freezing conditions make the small blood vessels in the fingers and toes narrow. When you warm up, the surface vessels open while the deeper ones stay narrow, and the patch swells, changes colour and itches.
Late winter and early spring, when it is wet and just above freezing, are the peak months. Smoking, a low body weight, poor nutrition and outdoor work raise the risk. A first chilblain in later life is unusual and is a reason to look for an underlying cause.
Our doctors offer a chilblains assessment over video for the condition on its own. Itching all over rather than on cold toes is a different problem; start with our dry skin page. A long-standing itchy rash fits our eczema page better. For the full list of winter causes, read why skin itches more in winter.
What are the symptoms of Raynaud's?
Raynaud's is an exaggerated version of a normal reflex. Cold or stress makes the small blood vessels in the fingers narrow sharply, blood flow drops, and one or more fingers turn white and numb. While the flow stays sluggish the fingers can turn blue. When it returns they go bright red, swell and throb or sting.
Not everyone gets all three colours, and the blue phase is often missing. Toes, ears, nose, lips and nipples can be affected too. Attacks are triggered by cold air, cold water, a sudden change from warm to cold, or emotional stress.
Around 10 million people in the UK are thought to have Raynaud's, and it affects at least one in five young women. It usually starts in the teens or twenties and is up to nine times more common in women.
In 80–90% of people it is primary Raynaud's, which occurs on its own, sometimes runs in families and is usually mild. The remaining 10–20% is secondary Raynaud's, caused by another condition, by certain medicines or by years of working with vibrating tools.
If cold hands are only part of the story, our post on why you always feel cold runs through the other causes. Pins and needles with no colour change, after sitting or sleeping on a limb, is a pressed nerve rather than Raynaud's. Our pins and needles page explains it.
Chilblains vs frostbite: when does cold become an emergency?
Frostbite is the dangerous one. The skin itself freezes, which can happen once the air is at 0°C or below, and it hits the fingers, toes, nose and ears first. The skin feels cold and firm, numb or stinging, and looks red or pale. A chilblain comes from damp cold above freezing and appears hours later.
As it worsens the skin becomes hard and frozen, white, blue or blotchy, with blisters filled with blood or clear or milky fluid, and can turn black. Unlike a chilblain, frostbite is a hospital problem, not a pharmacy one. Our frostbite page explains what happens next. Our guide to urgent care in Europe shows where to go.
Could it be cold urticaria instead?
Cold urticaria is an allergic-type skin reaction to cold rather than a circulation problem. Itchy, raised weals appear within 2–5 minutes of cold air, water or a cold object touching the skin and fade within 1–2 hours. It affects about 0.05% of people, twice as many women as men, mostly young and middle-aged adults.
Swimming in cold water is the most common cause of a severe, whole-body reaction. Doctors confirm it with an ice cube held on the forearm for a few minutes: a red, swollen weal within minutes means cold urticaria. Our cold urticaria page explains what to expect.
Where in Europe is the risk highest in January?
Ireland for chilblains, the Alps for frostbite: the two conditions want different weather. Chilblains need damp cold that sits just above freezing, which describes an Irish January well. Frostbite needs air at 0°C or below, which is what an Alpine ski week delivers.
At Dublin Airport the January mean temperature is 5.2°C, with a mean daily maximum of 8°C and minimum of 2.3°C. The month brings 61.8 mm of rain, 15.2 days of ground frost and 7.1 days of air frost (Met Éireann 1991–2020 averages). That is chilblain weather: wet, windy and rarely cold enough to freeze skin.
In the Bavarian Alps the January mean is -2.1°C at Garmisch-Partenkirchen and -0.5°C at Munich Airport (Deutscher Wetterdienst 1991–2020 means). The typical pattern is a Raynaud's attack on the first morning, when gloves come off for a lift pass. Frostbite of the nose and fingers is a real risk on the coldest days.
If you fall ill on the slopes, our guide to seeing a doctor on a ski holiday explains how care works there. Over the holidays, our guide to finding a pharmacy or doctor over Christmas shows what stays open. If your knees and hips also complain in this weather, read why joints hurt in cold weather.
How long do chilblains last?
Most chilblains clear on their own in 2–3 weeks. Severe ones can blister, break open and ulcerate. They often come back with the next cold spell or the next winter. See a doctor if a chilblain is not better after 2–3 weeks, has pus coming from it, or you have a high temperature.
A chilblain that blisters or breaks open needs a clean, dry dressing and a doctor to look at it. Pus or a fever means it has become infected.
How do our doctors treat chilblains and Raynaud's?
Our doctors start with the same instruction for both: warm up slowly and completely. Get out of the cold, take off wet socks and gloves, and let the skin come back to room temperature on its own or in warm, not hot, water. Keep hands and feet off radiators, hot taps and fires, and do not rub the skin.
A pharmacist can suggest a soothing lotion, and a plain emollient keeps the skin over the swelling from drying and cracking. When the itch is severe, a short course of a prescription-only topical steroid cream can relieve it. Stop smoking, caffeine and decongestants while the chilblain heals; all three affect blood flow in the fingers and toes.
For Raynaud's the first treatment is keeping the whole body warm, and the second is checking what else narrows the vessels. Beta-blockers, some migraine medicines and years of vibrating tools can all cause or aggravate attacks.
When warmth is not enough, guidelines support a calcium-channel blocker. Our doctors consider one when Raynaud's attacks are very bad or getting worse, and when chilblains are severe, ulcerate or keep coming back. The usual choice is nifedipine, a prescription-only blood-pressure medicine that widens small vessels. In chilblains it speeds healing and lowers the chance of relapse; because it lowers blood pressure, a doctor decides whether it suits you.
Frostbite is different again: it is treated in hospital. While you wait for help, get indoors, take off rings and wet clothing, and put the part in warm, not hot, water. Cover the frostbitten part with a light dressing and take paracetamol for the pain. Cold urticaria is treated with non-sedating antihistamines, and anyone who has had a whole-body reaction carries emergency adrenaline.
Secondary Raynaud's: red flags our doctors look for
Most Raynaud's is primary and usually mild, but 10–20% is secondary to another condition. The usual causes are autoimmune or connective tissue diseases such as systemic sclerosis (scleroderma), lupus, Sjögren's disease or rheumatoid arthritis, or a thyroid disorder. Raynaud's often appears years before systemic sclerosis is recognised, with an average gap of more than ten years.
- Sores or ulcers on the fingertips or toes, which are a complication of secondary Raynaud's, not primary.
- Attacks on one hand or one side of the body only.
- A first attack after the age of 30, when primary Raynaud's has usually already started.
- Joint pain, skin rashes or muscle weakness alongside the colour changes.
- Attacks that began after a new medicine, or after years of working with vibrating tools.
Any of these needs a doctor who can examine your hands and look at the nailfold vessels under magnification. An antinuclear antibody (ANA) blood test follows if an autoimmune cause is suspected. That nailfold check is central to separating primary from secondary Raynaud's, and it has to be done in person.
How can I prevent chilblains and Raynaud's on a winter trip?
Prevention is the same list for both conditions: keep the whole body warm and dry, and avoid sudden temperature changes. Dress in several loose layers with a waterproof outer layer, a hat and a scarf, gloves or mittens, and thick socks and boots. A thin liner glove under mittens lets you use a phone without baring the skin.
- Change damp socks and gloves as soon as you can; damp cold is what chilblains need.
- Pack hand and foot warmers for lifts, viewpoints and long waits outdoors.
- Warm your hands in warm water before going out, and keep moving; exercise keeps the circulation up.
- Avoid sudden temperature changes: no stove when you come in, no bare hands stepping into the wind.
- Stop smoking, cut caffeine and avoid decongestants: all three affect blood flow in the fingers and toes.
- Anyone who has had weals after cold should skip cold-water swims until cold urticaria is ruled out.
When to see a doctor
Call 112 for frostbite: hard, frozen or blistered skin after cold exposure, or swelling with loss of feeling. Call 112 too for signs of hypothermia: constant shivering, slurred speech, slow breathing and confusion. An allergic emergency also needs 112: swelling of the face, lips or throat, wheezing, shortness of breath, faintness or collapse.
For a child with any of these, or a child under 12 with Raynaud's-type colour changes, use local paediatric care or 112; our service is for adults. See a doctor within a day or two if:
- a chilblain is not better after 2–3 weeks, has pus, or you feel hot, cold and shivery;
- you have diabetes and a chilblain on your foot;
- you keep getting chilblains, or your first chilblain came in later life;
- Raynaud's affects one side only, started after 30, or comes with any red flag above;
- Raynaud's is very bad, getting worse or affecting your daily life.
What a video doctor can do
Chilblains and Raynaud's are diagnosed from the history and the look of the skin, which is why a video consultation works well for both. Our doctors ask when the change appeared, which colours came in which order, how long it lasted and which digits are affected.
They look at the skin on camera or at photos you took during an attack, since a Raynaud's attack is usually over by the time you call. They can usually tell which of the four cold reactions you have. A prescription, when appropriate, goes to a pharmacy you choose in the twelve countries Mobi Doctor covers.
Licensed, EU-registered doctors are available daily 7am–11pm CET, usually within 15 minutes, over video. Frostbite goes to hospital, and fingertip ulcers or blackened skin need a clinic visit within days. Suspected secondary Raynaud's needs blood tests and the nailfold examination that cannot be done through a screen.
Red, itchy toes hours after a wet day, or white, numb fingers when the gloves came off: our doctors can tell you which it is and what to do next.
Sources
- NHS: Chilblains (accessed 2 November 2026)
- NHS: Raynaud's (accessed 2 November 2026)
- NHS: Frostbite (accessed 2 November 2026)
- SRUK (Scleroderma & Raynaud's UK): What is Raynaud's? (accessed 2 November 2026)
- DermNet: Chilblains (pernio, perniosis) (accessed 2 November 2026)
- DermNet: Raynaud phenomenon (accessed 2 November 2026)
- DermNet: Cold urticaria (accessed 2 November 2026)
- British Society for Rheumatology: The 2024 BSR guideline for management of systemic sclerosis (Denton et al., Rheumatology 2024;63(11):2956–2975) (accessed 2 November 2026)
- Met Éireann: Dublin Airport 1991–2020 averages (accessed 2 November 2026)
- Deutscher Wetterdienst (DWD) Climate Data Center: Multi-annual mean temperature 1991–2020 by station (Temperatur_1991-2020.txt) (accessed 2 November 2026)
Written by the Mobi Doctor Medical Team. Medical review by Dr Chrysoula Liakou, MD, PhD: pending.
