Some things are 100% reliable. Tax season comes every year, your friend will be late for dinner, it’s raining in Seattle and your hands are cold. We all know someone who always has cold hands. It could be your significant other. It might even be you. Cold hands, even in warm settings, are a very common complaint and while it’s a bit uncomfortable, the symptoms are generally benign. About 5% of the U.S. population has Raynaud’s, a disease affecting circulation, causing blood vessels to narrow in the hands and sometimes toes. What are your cold hands trying to tell you?
There are two different types of Raynaud’s, primary and secondary. To discuss the differences, causes and concerns, we spoke with Sarah Blankenheimer, a nurse practitioner focused on rheumatology at Banner – University Medicine Rheumatology Clinic in Phoenix, Arizona. She explained the disease and when a person should become concerned.
Cold hands could be attributed to other issues such as anemia. Even under normal conditions, our hands are often the first things to get cold. Blankenheimer explained that “when we are exposed to the cold, it’s normal for our bodies to reduce blood flow to our skin to help maintain our core temperature. This will cause our hands and toes to become pale and cold. In those with Raynaud’s, this physiological response is exaggerated.”
“Primary Raynaud’s is the most common and is usually benign,” said Blankenheimer. “Your fingers will get especially cold on occasion. After a few minutes, blood flow will resume, your fingertips will warm up and you will feel circulation return.” For people dealing with primary Raynaud’s, these symptoms could show up at any time, regardless of the temperature. The symptoms are minor and typically don’t require further treatment. If these symptoms sound familiar, Blankenheimer recommended keeping your hands warm and avoiding common triggers such as exposure to cold environments, caffeine, nicotine and over-the-counter nasal decongestants.
Secondary Raynaud’s exhibits more extreme symptoms. Blankenheimer elaborated, “In some cases, secondary Raynaud’s is an indication of an underlying rheumatological disorder such as lupus or scleroderma. Like primary Raynaud’s, your fingers or toes may change color to take on a white or even blue/purple hue. In secondary Raynaud’s, the discolored area will be more defined.”
Raynaud’s “attacks” can happen spontaneously or as triggered by cold temperature and can last for 20 minutes or more. When blood is restricted for this long, tissue can become damaged and you may feel pain in the affected areas. Over time, this damage can become severe. If there is not enough oxygen getting to the digit, an ulceration or skin sores can form, or more seriously, amputation may be necessary. Blankenheimer explained that about 7% of those with recurrent ulcers require amputation.
A condition called livedo reticularis can also occur in those with Raynaud’s which is a mottling of the skin in a mesh-like pattern on the arms or legs. This can be mild and benign if it resolves quickly as a patient warms up. But if it lingers, it can be a sign of something more serious. If sores are developing at the end of your fingers or toes, seek evaluation from a rheumatologist for secondary Raynaud’s.
In cases of secondary Raynaud’s, your physician will focus on treating any underlying conditions. Prescription medications may also be prescribed to manage your discomfort with Raynaud’s.
Talk to an Expert
There is some nuance to every case. Understanding if you should be concerned about your cold hands may be difficult on your own. If you are concerned, or if you show any symptoms consistent with the description for secondary Raynaud’s, contact your physician or set up a visit with a Banner Health expert today.