Cold Fingers and Toes

By  ,  National Institute of Health
Jan 19, 2013

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It Might Be Raynaud’s

When the temperature drops this winter, it’s normal to feel it most in your fingers, toes, ears and nose. But if your fingers and toes regularly turn bluish or white when the temperature dips even slightly, or if they often feel numb or painful or turn red and tingle when you’re stressed or cold, it may be a sign you have something called Raynaud’s disease.

Raynaud’s (pronounced Ray-NOSE) disease is a disorder that affects blood vessels. Estimates vary, but most studies suggest that it affects about 3-5% of the population, especially women. It can arise at any age, although it typically appears during teenage years or later.

In people with Raynaud’s disease, blood vessels have an extreme response to cold temperatures and stress. The body’s normal response to prolonged cold temperatures is to tighten blood vessels and reduce blood flow to the fingers, toes and other extremities. This helps to slow heat loss and keep warm blood flowing to your brain and other vital organs. Likewise, stressful situations normally trigger the release of hormones that can also cause blood vessels to narrow in your extremities.

But in people with Raynaud’s, the response to cold and stress is far more rapid and severe. Just taking something out of the freezer or sitting in an air-conditioned room can trigger an attack, which may last for less than a minute or as long as a few hours.

During a Raynaud’s attack, the blood vessels quickly narrow and reduce the flow of blood, causing the skin to temporarily turn white, then bluish. When blood flow later returns, the skin turns red. Your fingers and toes may throb or feel numb and tingly. With severe Raynaud’s, which is uncommon, prolonged or repeated episodes can cause skin sores or tissue death (gangrene).

Most cases of Raynaud’s have no known cause—a condition called primary Raynaud’s disease. Primary Raynaud’s is typically more of a bother than a serious illness. It can often be managed with minor lifestyle changes, like wearing warm socks around the house or wearing gloves when removing things from the freezer.

When Raynaud’s disease can be linked to an underlying medical condition, it’s called secondary Raynaud’s or Raynaud’s phenomenon. Secondary Raynaud’s is a more complex and typically more serious condition. It is most often caused by connective tissue disease, like scleroderma or lupus. Some of these diseases reduce blood flow to the fingers and toes. Secondary Raynaud’s can also be caused by some medications that reduce blood flow, including certain blood pressure and migraine headache drugs. Treating the underlying condition or changing medications, if possible, is often the best way to reduce Raynaud’s symptoms.

Physicians usually recommend non-drug treatments for patients with primary Raynaud’s, because they’re not at risk for tissue damage. Secondary Raynaud’s may require prescription medications that help to improve blood flow and heal skin sores on fingers and toes. Be sure to talk with your doctor if you think you may have Raynaud’s disease.

Avoid Raynaud's Attacks

You can take some simple steps to prevent or reduce the severity of Raynaud’s attacks:

  • Keep warm. Wear a hat, gloves, scarf and coat when it’s cold. Soak your hands in warm water at the first sign of an attack.
  • Don’t smoke. The nicotine in cigarettes causes the skin temperature to drop, which may lead to an attack.
  • Avoid certain medications that cause blood vessels to narrow. These can include beta-blockers, some over-the-counter allergy or cold remedies and some migraine headache medications.
  • Control stress. Steer clear of stressful situations. Relaxation techniques may help.
  • Exercise regularly. Many doctors encourage patients who have Raynaud’s disease to exercise regularly, but talk with your doctor before beginning an exercise program.


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