Cold hands: Causes, Symptoms, Signs & Treatments

Picture of Cold feet and hands


What is Cold hands?

Having cold hands even when you’re not in a cold environment is common. Often, having cold hands is a part of your body’s natural response to regulate your body temperature and shouldn’t be cause for concern.

But if you have persistently cold hands, particularly if accompanied by color changes, it could be a warning sign. For example, having cold hands could mean you have a problem with the nerves or blood circulation or a problem with tissue damage in your hands or fingers. If you are outside in extreme cold weather and you have cold hands, you should watch for warning signs of frostbite.

Other signs and symptoms to watch for when you have cold hands include:

  • Cold feet or toes
  • Changes to the color of the skin on your hands, such as blue or white skin
  • Numbness or tingling
  • Open sores or blisters
  • Tightened or hardened skin

Cold Hands & Feet Causes

Humans are tropical animals. We are adapted to a warm climate. When exposed to cold, the body tries to stay warm. If the body is cooling off, circulation decreases in the arms, legs, ears, and nose so that the rest of the core body can stay warm. When temperatures are below freezing, ice may form in these areas with less circulation.

  • Nonfreezing cold injuries are also caused by cooling of the skin. In immersion injuries, the nerves and blood vessels are damaged after exposure to cold, wet conditions at or above freezing temperatures.
  • Pernio is caused by exposure to cold for a long period of time without freezing or by very wet conditions.
  • Raynaud’s phenomenon is an abnormal narrowing of the blood vessels that constrict with cooling of the fingers or toes.
  • Cryoglobulins are proteins, which are normally dissolved in the blood, that become solids or gels when cold. Cryoglobulinemia is the condition associated with cryoglobulins in the blood, whereby cold exposure leads to bluish discoloration of the fingers or toes.
  • The formation of hives in response to cold exposure of the skin is called cold urticaria.

Disease that Trigger Cold Hands and Feet

  • Frostbite is not a disease but a condition of being out in extreme cold weather. Damage to skin and tissues is due to freezing. Severe frostbite kills the muscles, tendons, blood vessels, and nerves. The skin shrinks and tears. A loss of feeling is a symptom and gangrene can be the result.
  • Anemia often causes extreme pale skin fatigue, weakness and cold hands and feet. Iron deficiency anemia often goes undiagnosed until you experience Raynaud”s disease.  If your hands and feet stay cold despite warming measures, check your iron levels.
  • Diabetes causes different types of problems and including cold hands and feet due to circulatory problems, high blood pressure and thyroid problems.
  • Lupus may be a contributor to cold hands and feet. Blood vessels come under attack with systemic lupus. Small blood vessels in the skin of hands and feet and prevent normal blood movements. Icy hands and feet are the result.
  • Raynaud”s Disease or blood vessels in the hands and feet overacting to cold temperatures or stressful situations are a major cause of freezing hands and feet. Raynaud”s disease triggers arteries in fingers and toes to enter vasospasm or a condition that narrows your blood vessels and limits blood supplies to the extremities. Over time these arteries thicken which further limits blood flow. One symptom is a pale and or dusky color to your fingers and toes.

An attack of Raynaud”s can be started by cold water on hands and feet, holding a cold item, exposure to cold air or emotional stress. Primary Raynaud”s has no underlying medical issue that contributes to severe cold hands and feet. It is simply an inherited disorder with inconvenient symptoms.

Secondary Raynaud”s may be a serious disorder caused by different underlying diseases. One disease is scleroderma or a rare disease that causes hardening and scarring of our skin. Lupus is an autoimmune disease characterized by shrinking blood vessels located in the hands and feet. Rheumatoid arthritis may be an underlying factor to Raynaud”s and diseases of the arteries can be culprits.

  • Artery damage and diseases such as atherosclerosis or the buildup of plaque in the bloods vessels can be an underlying condition of cold hands and feet or Raynaud”s phenomenon.
  • Carpal tunnel syndrome or a condition with pressure being placed on the nerve in the wrist causes pressure, pain, tingling, cold and numbness in the affected hand. Raynaud”s and cold hands are symptoms of carpal tunnel syndrome.
  • Smoking cause blood vessels to constrict. If you are chronic smoker you may find your hands and feet are constantly cold.
  • Beta blockers used to treat high blood pressure; migraine medications and some over the counter cold medications have been linked to cold hands and feet and contribute to Raynaud”s.
  • Working with vinyl chloride in the plastics industry can cause scarring and pitting in your hands. This leads to Raynaud”s disease and cold hands.

Additional factors that can lead to cold hands and feet and/or Raynaud”s disease are gender, age, cold climates and family history. Question your immediate family and determine if they have primary Raynaud”s.

Cold Hands & Feet Symptoms and Signs

  • Frostbite and frostnip
    • Frostbitten body parts are white and hard or waxy. They may be white-purple or white-yellow.
    • Frostnipped parts are white but not hard and are generally very small areas.
    • Frozen parts have no feeling.
    • During the freezing process, they may tingle or feel like a block of wood.
    • Once frostbitten areas thaw, they may be painless or tingle.
    • When they are rapidly rewarmed in warm water by the recommended method, they may be painful.
    • Over the next few days, the part is often painful and swollen.
    • Blisters may appear, and severely affected areas turn black.
  • Immersion injury
    • Areas affected by immersion injury are first red and then turn pale and swollen.
    • Numbness or painful tingling may occur.
    • After the first few days, the part becomes very red, tingling, swollen, and may have blisters, skin breakdown, or even liquefy.
  • Pernio
    • Pernio is a rash on the lower legs, feet, toes, hands, or ears that may be red or blue and may form scaly areas or lumps.
    • Rarely, affected parts may bleed, blister, or have skin breakdown.
    • Often pernio causes itching and burning.
  • Raynaud’s phenomenon refers to constriction of the blood vessels of the hands or feet in response to cold exposure. Raynaud’s phenomenon causes white, then blue, then red-colored fingertips and toes and is often painful.
  • Cryoglobulins cause a wide array of symptoms, depending on whether or not internal organs are involved, including deep-blue fingertips.
  • Cold urticaria refers to raised red bumps or hives produced in response to cold exposure

Treating Cold Hands and Feet

If your cold hands and feet symptoms are related to Raynaud”s disease or are chronic and disturbing there are medication that can help. To dilate blood vessels and encourage circulation you can use calcium channel blockers, alpha blockers, and vasodilators.

Do not take over the counter cold medications, beta blockers, or birth control pills if you have chronic cold hands and feet or discolored pale skin.

Nerve surgery may relieve your Raynaud”s symptoms. Nerves are cut around blood vessels through small incisions in the hands and feet. This type of surgery is called sympathectomy and helps reduce the frequency of cold hands and feet attacks. Do be aware that this surgery is not always successful.

Chemical injections to block sympathetic nerves in your affected limbs can help. You will have to have these injects repeated.

Amputation or removing tissue damaged from a lack of blood flow might be necessary. If the blood supply to your hands and feet is completely blocked, gangrene may develop. This is very rare however.

Stop smoking. Smoking causes your skin temperature to drop and blood vessels to constrict. Exercise regularly to increase your circulation to affected areas. Control your stress levels. Stress can trigger an attack or Raynaud”s. Avoid caffeine. Caffeine contributes to blood vessel narrowing. Take care of your hands and feet. Guard them from injury and avoid walking barefoot. Keep your nails clipped and groomed. Avoid wearing constricting gloves, socks or shoes. Do avoid using tools that vibrate the hands. Do not wear rings, watches and bracelets that are tight.

If you experience cold hands and feet, move to a warmer area, place your hands and feet under warm running water, massage hands and feet and wiggle your fingers and toes.

Take fish oil supplements to improve tolerance to cold. Biofeedback or mind body temperature control using guided imagery can help. Therapists can teach you biofeedback techniques.

Dress appropriately when outdoors in the cold. Wear socks and when taking food out of the freezer, use oven mittens or gloves. Set your air condition to a warmer temperature to prevent cold hands and feet. If you live in a cold climate, you might want to consider moving to a warmer location. Be practical if you have chronic cold hands and feet. Be aware of underlying medical conditions, dress warm in cold climates and weather, and use warming techniques.