This article discusses symptoms, potential causes, treatment, and diagnosis of cold hands.
Symptoms of Cold Hands
The most obvious symptom of cold hands is skin that feels cold to the touch. Other symptoms that can accompany cold hands include:
PainRednessPale skinBlue-tinted skinTingling or numbnessBlistersSwelling
What Causes Cold Hands?
Cold hands can be a normal reaction to cold exposure—such as submerging your hands in cold water, putting food in the freezer, sitting in an air-conditioned room, or spending time outdoors in cold temperatures. Blood vessels constrict (get narrower) to help the body conserve heat. Hand temperatures typically return to normal within a few minutes of removing the cold source.
However, cold hands can also be a sign of injury from cold exposure. They can also occur with a variety of health conditions or as a side effect of certain medications.
Cold Injury
Prolonged exposure to extreme cold can lead to frostbite—freezing of the tissues in your hands. Ice crystals can form inside the body, damaging structures as deep as your bones. In severe cases, affected fingers may be amputated.
Raynaud’s Phenomenon
A common cause of cold hands is a condition called Raynaud’s phenomenon. This disorder causes blood vessels to narrow, which decreases blood flow. It typically affects the fingers and toes.
Raynaud’s phenomenon can be a stand-alone condition (primary Raynaud’s phenomenon) or related to another health issue (secondary Raynaud’s phenomenon).
Primary Raynaud’s phenomenon occurs without a known cause. However, it is more common in women and often appears in adolescence. This condition also tends to run in families.
Secondary Raynaud’s phenomenon occurs with a variety of health conditions, such as:
Scleroderma (an autoimmune disease causing hardened skin) Rheumatoid arthritis (an autoimmune disease affecting the joints) Sjögren’s syndrome (a systemic (body-wide) autoimmune disease) Thyroid disorders Blood clotting disorders Inflammatory myositis (muscle inflammation) Lupus (an autoimmune disease causing rashes and/or joint and muscle inflammation and pain) Carpal tunnel syndrome (a compression of a nerve in the wrist causing pain and numbness in the hand and fingers)
Secondary Raynaud’s phenomenon can also occur as a side effect of certain medications, such as:
Heart medications (beta-blockers, Catapres-TTS-3 (clonidine)) Chemotherapy drugs, such as Platinol (cisplatin), Blenoxane (bleomycin), and tyrosine kinase inhibitors (TKIs) Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) Stimulants, suchas Adderall (amphetamine) Ergot alkaloids, such as Migranal (dihydroergotamine) and Cafergot (ergotamine) Dopaminergic agonists, such as Requip (ropinirole) and Mirapex (pramipexole) Sympathomimetics (appetite suppressants) Restasis (cyclosporine) Decongestants
Vascular Disease
Your hands receive blood from two main arteries in the wrist—the ulnar artery and radial artery. Damage to these structures or conditions that affect these blood vessels can cause cold hands.
This can occur from:
Trauma (cutting, stretching, or compressing the vessel) Aneurysm (weakness in the blood vessel wall) Blood clots Vessel defects (vascular malformations) Tumors Spasms in the vessel walls
In addition to cold hands, vascular diseases can cause other symptoms, such as:
PainTingling and numbnessSwellingPoor wound healingDiscolored fingertips
How Are Cold Hands Treated?
Treatment for cold hands depends on the underlying cause.
Treatment for Cold Exposure
Cold hands caused by general exposure to cold will warm up after the cold source is removed. However, cold hands caused by severe exposure to cold are best treated under the direction of a healthcare professional. The affected areas need to be gradually warmed, as high heat can cause further damage to numb areas.
Treatment for Raynaud’s Phenomenon
There’s no medication specifically approved by the Food and Drug Administration (FDA) to treat Raynaud’s phenomenon. However, calcium channel blockers (used to treat high blood pressure) also help reduce the frequency and severity of attacks from this condition.
Treatment for hypothermia begins with changing into dry, warm clothing and sipping warm fluids. However, immediate medical attention is essential to prevent further complications.
Lifestyle changes can also help improve life with Raynaud’s phenomenon, such as:
Wearing gloves Dressing in layers during cold weather Quitting smoking Avoiding over-the-counter (OTC) decongestants that contain pseudoephedrine or phenylephrine Talking to your healthcare provider about medication alternatives that do not cause cold hands
Treatment of Vascular Disease
Cold hands caused by vascular disease are treated based on severity.
Treatment interventions can include:
MedicationsPressure garmentsSurgery
In some cases, if nearby blood vessels continue to supply the affected area with blood, treatment is not required.
Tests for Diagnosing Cold Hands
There’s no specific test for diagnosing cold hands caused by exposure to cold or primary Raynaud’s phenomenon. Your healthcare provider will examine your hands and make a diagnosis based on your description of symptoms.
Secondary Raynaud’s phenomenon might require blood tests, such as the antinuclear antibody (ANA) test or nailfold capillary microscopy, which looks for tiny blood vessels in the fingernails that often develop with the condition.
Vascular conditions that cause cold hands can be diagnosed with:
Doppler ultrasound (uses sound waves to determine the narrowing of blood vessels) Arteriography (dye injected into blood vessels, followed by X-ray imaging) Magnetic resonance angiography (MRA, a scan of blood vessels) Cold stress test (measures blood pressure and temperature of fingers before and after being placed in cold water)
Summary
Cold hands can occur as a normal response to cold exposure. However, cold hands that occur frequently or are accompanied by other symptoms (such as swelling, pale skin, numbness, tingling, or pain) can indicate an underlying health condition. Raynaud’s phenomenon is a common cause of cold hands. This symptom can also be a side effect of certain medications.
Treatment for cold hands depends on the cause but can include home remedies, medications, pressure garments, and in severe cases, surgery. Cold hand diagnoses are typically made based on your history of symptoms and a physical exam.
A Word From Verywell
Experiencing cold hands once in a while is normal. However, if you notice this symptom occurring frequently, talk to a healthcare provider.
