Perniosis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Perniosis?
A primary care doctor can usually diagnose and treat perniosis. If the case is severe, keeps coming back, or is linked to another condition, you may be referred to a dermatologist or a rheumatologist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Perniosis is a skin reaction that happens after exposure to cold and damp weather. Some people call it chilblains. It causes small, itchy, and sometimes painful patches, most often on the fingers and toes. The patches may look red or purple and can feel like burning. Perniosis is not frostbite, which is a deeper injury from freezing cold.
Symptoms
The signs usually show up a few hours after cold exposure. You may notice itchy or burning spots that are red, purple, or bluish, and the skin may look swollen. In some cases, small blisters or open sores can form. Symptoms often go away on their own within one to three weeks if you keep the area warm and dry.
Causes and who gets it
Doctors do not know the exact cause. It seems to be an abnormal reaction of small blood vessels in the skin to cold and moisture. It is more common in women, in younger people, and in people who live in damp climates. In some cases, it is linked to autoimmune diseases. Poor blood flow and being underweight may also raise the risk.
How doctors diagnose it
There is no single test for perniosis. A doctor usually looks at the skin and asks about your recent exposure to cold, your symptoms, and your health history. Blood tests may be ordered to check for similar conditions. In rare cases, a skin biopsy may be done.
Treatment
Perniosis often gets better on its own once the skin stays warm and dry. Doctors recommend keeping the affected areas warm and avoiding more cold exposure. A doctor may prescribe a medicated cream to improve blood flow, or pills that widen the blood vessels. Scratching can lead to infection, so avoid it.
When to see a doctor
See a doctor if itchy or painful patches after cold exposure do not improve within a couple of weeks. Get care sooner if the skin breaks open or shows signs of infection, such as pus, spreading redness, or fever. Recurring episodes each winter may point to an underlying condition.
How a direct primary care or concierge doctor fits in
A direct primary care doctor is paid with a flat monthly fee instead of insurance; a concierge doctor works similarly but usually costs more. Either type can examine your skin, start treatment, and follow up closely. If your case is severe or suggests another problem, they would refer you to a specialist.
Common questions
Is perniosis contagious?
No, perniosis is not contagious. It is a reaction of your own blood vessels to cold. You cannot catch it from or pass it to another person.
Can perniosis come back?
Yes, many people get perniosis again during the next cold season. Keeping your hands and feet warm and dry may help lower the chance of repeat episodes.
How is perniosis different from frostbite?
Frostbite happens when skin actually freezes and the cold damages the tissue, sometimes badly. Perniosis is a milder reaction to cold and damp that causes itchy, inflamed patches without freezing the skin.
Does warming up too fast make it worse?
Rapid rewarming, such as putting cold feet right in front of a heater, may make symptoms worse for some people. Doctors generally suggest warming the skin slowly and gently.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
