Hello Zidanya Thanks for sharing these details—your concern is absolutely valid. Chilblains usually improve with warmth and topical steroids, so if your patches are getting larger, more painful, and bruised-looking after 6 weeks (and especially worsening despite treatment), this needs a closer look.
What This Could Mean - Persistent or Worsening Chilblains: Sometimes, chilblains can be stubborn, but worsening despite treatment is unusual. - Other Causes: Conditions like vasculitis (inflammation of blood vessels), blood clotting disorders, or even infections can sometimes look similar and may need to be ruled out, especially if the color is dark purple and spreading. - Medication Side Effects: Rarely, topical steroids can thin the skin, but they don’t usually cause bruising or spreading patches.
What You Should Do Next - See a Doctor Soon: You need an in-person review, ideally with a dermatologist or physician. They may want to do blood tests or a skin biopsy to check for other causes. - Monitor for Red Flags: If you notice severe pain, numbness, ulcers, blisters, fever, or if the patches start spreading rapidly, seek urgent care.
What You Can Do at Home - Keep your hands warm and dry. - Avoid scratching or trauma to the area. - Don’t use more steroid cream unless advised by your doctor.
Thank you
Hello Zidanya, Thank you for sharing the details clearly. Chilblains (pernio) is NOT an infection. It is an inflammatory reaction to cold exposure, especially in cold, dry climates.
My advise would be to follow up with the same doctor and review as he/she would do an examination and decide further treatment.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Medicine
Your chilblains have become persistent and possibly secondarily infected, which is why warmth and steroid cream alone are no longer effective. The priority now is strict cold protection, stopping prolonged steroid use, treating any infection, improving circulation, and using barrier care. With the right approach and medical guidance, even stubborn chilblains can heal and future episodes can be prevented.
Use mupirocin ointment.
Hello,
Why it’s not healing Steroid cream alone doesn’t correct poor blood flow Persistent cold exposure keeps vessels inflamed
Nifedipine SR 20 mg once daily × 4 week Cetirizine 10 mg at night for itching Paracetamol for pain
Keep hands consistently warm (no sudden heating) Cotton inner gloves + wool outer gloves Avoid smoking and caffeine
Expected improvement: 2–3 weeks with proper treatment.
I trust this helps Thank you
Chilblains, indeed, arise from an abnormal reaction to cold and damp conditions, where small blood vessels in the skin become inflamed. When standard treatments such as warmth and Betamethasone Valerate cream don’t seem to help, it’s a signal that it might be worth considering other angles or consulting with your healthcare provider again—the worsening and increasing size of the patches might suggest a different complication or misdiagnosis that needs attention. Here are a few directions to consider: Ensure there is minimal exposure to cold and dampness by using warm gloves and socks to keep the extremities insulated from the elements. While moisturizing is important to prevent further skin damage, consider switching to a thicker, emollient-rich cream like Eucerin or Aquaphor which might help in creating a stronger barrier. If there is any suspicion of infection, due to bruising look, or if there’s a change in texture, it’s crucial to have it re-assessed as infections can manifest subtly. Oral medications like nifedipine might be prescribed in persistent cases as they help improve blood circulation, but these need clear evaluation by a professional considering any underlying health issues you may have. Checking for complications or other autoimmune disorders could also be beneficial if the situation doesn’t resolve or continues to worsen. Monitor for any systemic symptoms such as fever or joint pain, as they could suggest something more systemic. Remember, persistent or widening lesions warrant further medical consultation to exclude serious vascular conditions or other underlying diseases. It’s essential not to delay reaching out to your clinician to reassess your condition and adjust your treatment plan accordingly.
