Cold Hands

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Everyone experiences cold hands at some point, usually after exposure to cold temperatures. However, cold hands can also signify that an underlying health condition is affecting blood flow. Raynaud's phenomenon is a common cause of cold hands, but this symptom can also occur with vascular diseases (conditions affecting blood vessels) or as a side effect of certain medications.

This article discusses symptoms, potential causes, treatment, and diagnosis of cold hands.

Cold hands clenched in a sweater.

pepifoto / Getty Images

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:

  • Pain
  • Redness
  • Pale skin
  • Blue-tinted skin
  • Tingling or numbness
  • Blisters
  • Swelling

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:

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:

  • Pain
  • Tingling and numbness
  • Swelling
  • Poor wound healing
  • Discolored 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 Hypothermia

Frostbite in the hands often occurs with hypothermia—a life-threatening condition that occurs when body temperature gets too low. Symptoms can include confusion, decreased coordination, and a slow heartbeat.

Treatment for hypothermia begins with changing into dry, warm clothing and sipping warm fluids. However, immediate medical attention is essential to prevent further complications.

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.

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:

  • Medications
  • Pressure garments
  • Surgery

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)

When to See a Healthcare Provider

Talk to your healthcare provider if you experience cold hands frequently—especially without an apparent cause. If you've been exposed to prolonged cold, or have pale skin and/or numbness, seek immediate medical attention.

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.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Society for Surgery of the Hand. Frostbite in hands.

  2. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Raynaud's phenomenon.

  3. The Raynaud's Association. New research on drug-induced Raynaud's.

  4. American Surgery of the Hand. Vascular disease.

  5. The Raynaud's Association. What is the treatment for raynaud's?

  6. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Raynaud's phenomenon: diagnosis, treatment, and steps to take.

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.