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As the weather gets increasingly cold out, there are certain conditions involving the foot that can be exacerbated.

Some of the issues that affect cold feet and toes are tough to diagnose and patients come to us saying,

“Listen, I feel crazy. Everyone thinks I’m crazy. No one believes me. Something is WRONG with my toe!”

Arterial Emboli

When a small piece of a cholesterol plaque in the leg breaks off and travels downstream into the tiny arteries of the toes, it’s called an arterial emboli.

What was once a small obstacle for the circulating blood to traverse (higher in the leg) has now become a massive road block for the small vessels of the toes. If blood cannot reach the toe, the toe will die. Serious, right?


Other patients have similarly appearing bluish or red irritated toe(s), but have a different diagnosis. When 1 or 2 toes develop painful inflammation of the blood vessels when exposed to cold air, that’s chilblains. Women are more at risk than men and often women that weigh less than average and/or have poor circulation have an increased risk of developing chilblains.

Both issues can be tricky to diagnose and unfortunately, we’ve seen some patients in the past month that have been undergoing treatments for athletes foot, mistaking the purplish toe and itching to be a fungal infection. Some have diagnosed the purple toes as Raynaud’s alone (another issue that can result in discolored or purple toes), making the patient feel frustrated when the treatments haven’t helped.

How do you know if your cold toes have an arterial emboli or chilblains?

  • Monitor your feet daily for changes in color of 1 or 2 toes (dusky or purplish in nature).
  • Watch for changes in temperature. The affected toe will gradually become colder when compared to the other toes of the same foot.
  • Pain is a good indicator as well. Pain will be mild and can become severe quickly.

To treat these conditions, it is important to keep your feet warm and dry because the cold and moisture can make it worse. Seeing a podiatrist is a must and vascular testing may be required. We have vascular testing in house, so you don’t have to go elsewhere for testing. Sometimes, a prescription blood thinner or blood pressure medicine can be necessary, depending on the diagnosis.

Many other doctors are not familiar with these conditions and inaccurately diagnose it as Raynaud’s or athletes feet, which leads to a delay in treatment and the possibility of amputation.

Contact Lexington Podiatry at 859-264-1141 or make an online appointment today if you suspect you have an arterial emboli.