Red-purple swollen bumps with crusty scabs on the toes.
Red-purple swollen bumps with crusty scabs on the toes.
Redness and crusting on the fingers and knuckles.
Redness and crusting on the fingers and knuckles.
Redness and swelling of the toes.
Redness and swelling of the toes.
Deep red coloring on the toes and a blister on the great toe.
Deep red coloring on the toes and a blister on the great toe.
Red bumps, some crusted, on the toes.
Red bumps, some crusted, on the toes.
Redness and small bumps on the ear.
Redness and small bumps on the ear.
Red-purple discoloration of toes.
Red-purple discoloration of toes.
Red-purple discoloration of toes with swelling.
Red-purple discoloration of toes with swelling.

Images of COVID Toes and Chilblains (8)

Red-purple swollen bumps with crusty scabs on the toes.
Redness and crusting on the fingers and knuckles.
Redness and swelling of the toes.
Deep red coloring on the toes and a blister on the great toe.
Red bumps, some crusted, on the toes.
Redness and small bumps on the ear.
Red-purple discoloration of toes.
Red-purple discoloration of toes with swelling.

COVID Toes and Chilblains

Chilblains (also known as pernio) are painful, swollen bumps that appear on exposed skin (fingers, nose, toes) in cold, damp weather. A rash called “COVID toes” (pseudo-chilblains), which can occur in coronavirus disease 2019 (COVID-19), is similar in appearance; like chilblains it can appear on the fingers as well as the toes.

Who's At Risk?

  • Women, people who are underweight or have poor circulation, and people with autoimmune disease have an increased risk of getting typical chilblains. Wearing clothing that exposes your skin to cold air increases the likelihood of chilblains.
  • Both children and adults can have COVID toes.

Signs & Symptoms

  • Red, swollen bumps appear on the feet and hands, including the toes and fingers. Sometimes the skin turns purple or rarely blue. You may see blisters or scabs. Skin can be tender to touch, painful, and red. The skin may burn or itch.
  • COVID-19-related lesions of the toes or fingers can appear anytime during the year. It is unclear why COVID toes occur, but people are likely still infectious when they have skin changes of COVID-19. Frequently, COVID toes are the only symptom of COVID-19. Skin changes can last for weeks and will resolve with the illness.
  • Chilblains typically appear in cold, damp weather. Chilblains due to cold weather causes the tiny blood vessels in the fingers, toes, and nose to clamp down. When these areas warm up again, the blood vessels open and there is swelling and inflammation. Chilblains last about 1 or 2 weeks after cold exposure.

Take a picture of your skin condition with Aysa

Symptom checkers like Aysa can help narrow down possible skin conditions by analyzing a skin photo.

Self-Care Guidelines

  • If you develop red or purple lesions on your fingers or toes, contact your health care provider about testing for COVID-19.
  • Acetaminophen can be helpful for tenderness. You can apply moisturizing cream to reduce itching.
  • For chilblains due to cold weather, rewarm the affected areas gently without the use of direct heat.
  • Wear protective gear such as gloves, scarves, and hats to prevent typical chilblains.
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Treatments

  • Your doctor may order COVID-19 testing.
  • Your doctor may want to do blood tests for any underlying medical conditions.
  • Your doctor may recommend removing a small piece of skin for further evaluation under a microscope (biopsy) if your diagnosis is in question.
  • Topical corticosteroid cream helps with inflammation.
  • For typical chilblains, medicine that lowers blood pressure can open the blood vessels and increase blood flow.
  • If skin breaks down and becomes infected, antibiotics may be prescribed.

Visit Urgency

See a doctor if:

  • You suspect COVID-19 infection. Call your doctor for instructions on how to best seek medical care in your community.
  • Fever, cough, diarrhea, or other flu-like symptoms develop.
  • The skin blisters or breaks down.
  • The condition worsens after self-care.
  • You suspect an underlying condition like lupus.
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References

Millard AN, Green CB, Stratman EJ. Cold Injuries. In: Kang S, Amagai M, Bruckner AL, et al, eds. Fitzpatrick’s Dermatology, 9th ed. New York: McGraw-Hill; 2019. 

Smith ML. Environmental and sports-related skin diseases. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. Philadelphia: Elsevier; 2018: 1576.