Answer

From what she’s described, Jamie may actually be making her chilblains worse by warming her feet up too quickly. The cold weather causes the blood vessels near the surface of the skin to constrict, to help the body maintain its core temperature.

However, heating up the skin too quickly, as Jamie is doing, means the blood vessels in her toes expand again too quickly and flows rapidly to her toes, causing inflammation and the pain and itching she has described.

As well as ensuring she warms up her feet gradually when she gets home and avoids direct heat, there are some simple measures that Jamie can take to reduce the chance of getting chilblains.

These include staying active to help improve her circulation, keeping her feet well moisturised to stop the skin becoming dry and cracked, and avoiding tight-fitting footwear that restricts blood flow to the feet. 

Wearing thermal socks and boots can help stop her feet from getting too cold when she is out. Avoiding cold and damp conditions where possible is also advisable, as is cutting down on caffeine and stopping smoking, as these can cause blood vessel constriction.

If Jamie’s chilblains are severe and chronic and do not respond to these self-care measures, she should be referred to a GP. If no underlying cause is identified and there are no contraindications, she may be prescribed modified-release nifedipine 20-60mg daily.

This is an off-label indication and the evidence to support its use is based on a limited number of small studies.