17861 Cold Hands

Overview

Cold hands means your hands often feel chilly to you, or feel cold to other people, even when the room seems warm enough. It is very common and is usually simply how your body responds to cold. When you are cold, your body sends less blood to your fingers to save heat for your vital organs, so your hands cool down first. Sometimes, though, cold hands can be a sign of an underlying problem with your circulation, your thyroid gland (the butterfly-shaped gland in your neck that controls how fast your body works), or your blood. Finding out the cause helps you know whether it is something to simply manage or something to have checked.

Yes. Cold hands are one of the most common everyday complaints in general practice. Most people never need any tests, because the cause is simply temperature or normal body variation.

Anyone can get cold hands. They are more often noticed in women, in people who are slim, in younger adults, and in people who work outdoors or with vibrating tools. They also become more likely as people get older, when circulation can become less efficient.

Symptoms

Common symptoms

• Hands that feel cold to touch when other people's hands feel warm
• Fingers that go white, then blue, then red after cold or stress (typical of Raynaud's)
• Numbness, tingling or a 'pins and needles' feeling in the fingers
• Aching, throbbing or burning as the hands warm up again
• Skin that looks pale or slightly mottled on the fingers
• Cold hands together with cold feet

Symptoms in children

• Cold hands are very common in children, whose bodies lose heat faster than adults'
• Fingers that turn white or blue briefly when playing outside in cold weather
• Crying or pulling away when hands are rubbed to warm them
• Usually no other symptoms and normal energy and play — a reassuring sign

Symptoms in older adults

• Cold hands with cramping pain in the hands or arms when walking or using the hands
• Slow-healing cuts, sores or cracks on the fingers
• Cold hands alongside feeling more tired, breathless or generally unwell
• Shiny, thin or hairless skin on the fingers or hands
• Cold hands with confusion or fever in a frail person, which needs prompt attention

Causes

Main causes

• Cold surroundings — the most common cause by far; the body reduces blood flow to the hands to keep its core warm
• Raynaud's phenomenon — blood vessels in the fingers over-narrow in response to cold or stress
• Normal individual variation — some people simply have naturally cooler hands
• Stress, anxiety or strong emotion, which triggers the 'fight or flight' response and narrows blood vessels
• Low body weight or low body fat, meaning less insulation
• Anaemia — too few red blood cells or too little iron, so less oxygen is carried around the body
• An underactive thyroid gland, which slows the body's metabolism and can make you feel the cold
• Narrowed arteries in the arms or hands (peripheral arterial disease), more common in smokers and in people with diabetes
• Long-term use of vibrating tools, which can damage the small blood vessels and nerves in the fingers
• Some medical conditions such as lupus or scleroderma, where the body's immune system affects blood vessels
• Some medicines can make hands feel cold as a side effect — ask your pharmacist or doctor about yours
• Smoking and too much caffeine, both of which narrow blood vessels

Risk factors

• Being female
• Being slim or underweight
• Family history of Raynaud's
• Smoking
• Diabetes, high blood pressure or high cholesterol
• Working outdoors or with vibrating tools
• Long-term stress or anxiety
• An autoimmune condition such as lupus or thyroid disease
• Getting older

When to see a doctor

See a doctor urgently if:

• A finger or hand that suddenly becomes cold, pale and very painful
• A new sore or ulcer on a finger, or skin that looks blackened
• Cold, clammy hands with chest pain, breathlessness or feeling faint — call emergency services
• Fever, confusion or a non-fading rash together with cold hands

Book a routine appointment if:

• Cold hands that are frequent, uncomfortable or affecting your daily life
• Fingers that change colour (white, blue, red) in the cold
• Cold hands with tiredness, weight change, hair loss or feeling cold all the time
• Cold hands on one side only, or in one or two fingers only
• Cold hands that have become noticeably worse over weeks or months
• A family history of Raynaud's, lupus or thyroid problems

Diagnosis

A doctor will usually start by talking to you about your symptoms — when your hands feel cold, whether your fingers change colour, whether cold, stress or particular activities trigger it, and whether you have any other symptoms. They will examine your hands, check the pulses in your wrists and arms, look at your skin and nails, and check your blood pressure. There is no single test for cold hands; the aim is to decide whether this is normal for you or whether an underlying condition should be looked for.

Tests that may be done

• Blood tests to check for anaemia, thyroid function, blood sugar and sometimes markers of inflammation or immune conditions
• Blood pressure and pulse checks
• A look at the tiny blood vessels at the base of your fingernails (sometimes with a small magnifier called a capillaroscopy)
• A cold challenge test, where your hands are cooled to see how the blood vessels respond
• Blood flow tests such as a Doppler ultrasound of the arms or hands, if narrowing of the arteries is suspected
• A heart tracing (ECG) if you also have chest symptoms or palpitations

What to expect at your appointment

Most people need only a short appointment and a routine blood test. Results usually come back within a week or two. If everything is normal, you may simply be given advice on keeping your hands warm. If something is found, your doctor will explain what it means and whether any treatment or onward referral is needed. It can help to bring a note of when your symptoms happen and any photos of colour changes in your fingers.

Treatment

Treatment depends on the cause. For most people, keeping warm and making small lifestyle changes is all that is needed. If an underlying condition such as anaemia, thyroid problems or narrowed arteries is found, treating that condition usually improves the cold hands too. For Raynaud's, the focus is on avoiding triggers and, where needed, medicines that help keep the blood vessels open.

Self-care at home

• Wear gloves — thin thermal liners indoors and windproof gloves outside — and put them on before you go out into the cold
• Dress in layers and keep your core warm; a warm body sends more blood to your hands
• Use hand warmers in your pockets on cold days
• Warm your hands slowly with lukewarm (not hot) water or by holding them near — not on — a gentle heat source
• Avoid sudden temperature changes, such as moving quickly from a hot room to a cold street
• Wiggle your fingers and swing your arms in wide circles to encourage blood flow when your hands get cold
• Cut down or stop smoking, and limit caffeine, as both narrow blood vessels
• Try to manage stress — slow breathing, regular breaks and gentle exercise can help
• Keep your hands dry and moisturised to prevent painful cracking

Medical treatments

If lifestyle measures are not enough, your doctor may suggest treatment for any underlying condition — for example, iron supplements for anaemia or thyroid replacement for an underactive thyroid, both prescribed and monitored by your doctor. For Raynaud's that is frequent or painful, doctors sometimes prescribe medicines that help keep the small blood vessels open; these are started at a low level and adjusted carefully. Your doctor or pharmacist will explain the benefits, side effects and any precautions, and will check how you are getting on. Some people are referred to a specialist (such as a rheumatologist or vascular specialist) if symptoms are troublesome or the cause is unclear.

When is surgery considered?

Surgery is rarely needed for cold hands. In a small number of people with very severe Raynaud's that does not respond to other treatment and causes sores or ongoing pain, a specialist may discuss a procedure to interrupt the tiny nerves that control the blood vessels. This is not suitable for most people and would only be considered after a specialist assessment.

Living with this condition

Most people with cold hands live completely normally once they learn their triggers. Keep gloves by the door, in the car and at work so you are never caught out. Get into the habit of warming your hands gradually rather than plunging them into hot water, which can be painful and can damage numb skin. If your fingers go white or blue, warm up gently and slowly; the colour and feeling usually return within 15 to 20 minutes. Keep an eye on your skin and tell your doctor about any cuts or sores that are slow to heal.

Lifestyle tips

• Stay active — movement improves circulation
• Keep to a healthy weight; extreme thinness makes cold hands more likely
• Stop smoking, and ask your pharmacist or doctor for support if you would like help
• Reduce strong coffee, energy drinks and other high-caffeine drinks
• Wear protective gloves if you work with vibrating tools, and take the breaks your employer provides
• Keep warm at home, especially in winter, and keep rooms you use at a comfortable temperature
• Consider a small humidifier or hand cream if your fingers get dry and cracked

Diet and exercise

There is no special diet for cold hands, but eating regularly and including iron-rich foods (such as beans, lentils, leafy greens, eggs and lean meat) helps prevent anaemia, and vitamin C helps you absorb iron from plant foods. Regular aerobic exercise — walking, cycling, swimming or dancing — improves circulation and reduces stress, both of which help. Aim for something you enjoy most days, and build up gradually if you have not exercised for a while.

Mental health and emotional wellbeing

Cold hands themselves are rarely a cause of distress, but Raynaud's attacks can be painful, tiring and sometimes embarrassing, and being uncomfortable in the cold can limit what you do. Long-term stress and anxiety also make blood vessels narrow, so stress can make cold hands worse — a bit of a loop. If worry about your hands, or stress in general, is affecting your mood, sleep or daily life, please talk to your doctor. Help is available and effective. If you ever feel you cannot cope or have thoughts of harming yourself, contact your local emergency services or a crisis support service in your country straight away.

Prevention

Sometimes. You cannot change your genes or the weather, but you can reduce how often and how badly cold hands affect you. Keeping warm, not smoking, staying active, managing stress and treating any underlying condition such as anaemia or thyroid disease all help a great deal. If you work with vibrating tools, using protective gloves and taking proper breaks lowers your risk of long-term hand problems.

Screening programmes

There is no national screening programme for cold hands. If you have an ongoing condition such as diabetes, your regular check-ups may include a look at your feet and circulation. If you have a family history of Raynaud's, lupus or thyroid disease, mention it to your doctor so they can keep an eye on things.

Complications

If left untreated

• Generally none — most cold hands are harmless
• Skin cracks, dryness or chapping from repeated cold exposure
• Painful, frequent Raynaud's attacks that interfere with work, sleep or hobbies
• In severe cases, small sores or ulcers on the fingertips that can become infected
• In rare cases, permanent damage to the fingertips if blood flow is very poor and the problem is not assessed
• Cold hands that are a sign of an untreated condition (such as anaemia, thyroid problems or narrowed arteries) may mean that condition goes without help for longer

Long-term outlook

The outlook is good. For most people, cold hands are simply an everyday nuisance and nothing to worry about. Even where there is an underlying cause, conditions such as Raynaud's, anaemia, thyroid problems and narrowed arteries can usually be well controlled with straightforward measures and, where needed, treatment. Most people find they can carry on with everything they want to do by keeping their hands warm and looking after their general health. If anything changes or you are worried, your doctor is there to help.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.