With winter well and truly set in and quite a few cold weeks still to come, training and exercising in the icy temperatures is unavoidable. One of the problems which can arise from outdoor exercise at this time of the year is an area many of us don’t really consider…..our skin.
When we are cold, our body naturally tries to limit blood flow to our extremities, in order to maintain body heat. This means areas such as our hands and feet, as well as areas like our nose and ears, can be particularly vulnerable to cold temperatures. This is especially the case when these areas are left exposed to the elements. One of the skin conditions which can develop as a result of this exposure is Chilblains.
WHAT ARE CHILBLAINS?
Chilblains are areas of skin where the blood vessels have become inflamed and burst. When skin is cold, the blood vessels constrict. As the skin is warmed, blood returns to the area which can sometimes burst the blood vessels, meaning fluids will leak into the surrounding tissue, causing damage and inflammation.
They are usually red or purple areas of skin which are swollen, itchy and painful to touch. Often they can develop into blisters, and the skin can sometimes break and bleed. In some instances, broken skin from Chilblains can become infected, which requires treatment with antibiotics.
Repeated exposure to cold air is one of the main cause of Chilblains, so those of us who are outdoors on a regular basis in the middle of winter are usually at risk. Usually Chilblains appear on the fingers and toes; but areas such as the nose and the earlobes can also be affected. This is especially the case with cyclists……as the relatively high speeds we move at creates a fair amount more wind chill compared to other sports!
Individuals who suffer from poor blood circulation are more susceptible to Chilblains; which is something that needs to be considered during the cold winter months.
HOW TO AVOID CHILBLAINS
The obvious answer for this one is to stay warm. Don’t go outside during winter….just stay on the couch, curled up under a nice warm blanket, with a good book and a nice cup of tea. Although it sounds pretty awesome, after 2 days of not heading out on the bike, I would personally go nuts!
Instead, think about the clothing you are putting on when you head outdoors. Where you can, wear full finger gloves to protect your hands and make sure you have thicker socks to keep your feet toasty. Long tops and pants are a good idea to keep your arms and legs nice and warm; while beanies or skullcaps are a good option for keeping your head and ears covered.
But what if its not practical to cover yourself up with thick layers like the Michelin Man? Many winter sports, such as Aussie Rules Football, see athletes running around in shorts and sleeveless tops! Well, try to keep yourself as warm as possible before you head outdoors or onto the field, and during breaks. Once you are done, try not to jump straight into a hot shower or start roasting yourself directly in front of a heater.
Rapid changes in temperature can increase the chances of developing Chilblains, or make existing sores even worse. Have you ever run cold hands under hot water to warm them up? Bad idea. Instead, try to gradually warm yourself up by putting more clothing on, or wrapping yourself in a blanket. It may take a bit longer, but it is a much better option for your body.
TREATMENT OF CHILBLAINS
If you unfortunately develop Chilblains, treatments are available to help the skin heal and make things a bit more comfortable. Obviously, keeping the affected area warm will aid the healing process, but topical creams are also available.
Moisturisers can help damaged skin to heal faster, while topical corticosteroids such as hydrocortisone are great for reducing the inflammation and making the skin less itchy. Creams containing numbing agents such as lignocaine can reduce pain and sensitivity; while bruise creams can help to eliminate the excess fluids which may be causing the swelling.
Another treatment option is haemorrhoid creams. These often contain corticosteroids and numbing agents, as well as ingredients to help improve blood circulation around the affected area…….and don’t worry, they are perfectly fine to use on your fingers and toes!
Slightly stronger, more obscure treatments are available on prescription. These are options which have to be made specially by a compounding pharmacy….but unfortunately, not too many GPs are familiar with them as a choice!
Individuals with poor circulation are able to talk to their GPs about taking prescription only oral medications across the winter months to help improve their blood flow….but these types of medications come with a few risks. Treatments like this can lower your blood pressure, which can lead to faint spells and being lightheaded, which is obviously not ideal.
For the professional athletes out there who are suffering with Chilblains, over the counter treatments, especially those containing steroids, are okay to use without risk of getting in trouble with anti-doping authorities.
Skin problems such as Chilblains are probably one of the last things people would think about when heading out to train or exercise in the colder weather…..but they can have a rather uncomfortable impact when they appear. Keeping yourself warm when possible and doing the right things can help to prevent Chilblains from developing, so you can continue to train without the discomfort they can cause!
The Sports Pharmacist 