Do your fingers turn white in the cold?

Cold hands and feet are sometimes more than just a winter nuisance.

Those who suffer from Raynaud’s Phenomenon, a hypersensitivity to cold that narrows blood vessels in fingers, toes and even ears and the nose, find that their extremities go numb and change color even when they step into an air-conditioned room or pick up a glass of cold water.

“It’s a pretty common issue and since I started here I’ve seen at least five or six patients with it,” said Rabia Nasir, MD, who joined Stoneman Primary Care in October 2022, having previously practiced at Strawberry Hill Primary Care. “The overall prevalence rate tends to be 3 to 5 percent in this country. I’m pretty sure most primary care doctors have encountered this.”

The syndrome is named after Dr. Maurice Raynaud, a French physician who described it in his 1862 doctoral thesis. He discovered spasms in the blood vessels restricted blood flow and, in extreme circumstances, could lead to gangrene.

Raynaud did not realize, however, that there are two forms: Primary Raynaud’s has no known cause, according to the National Institutes of Health. Secondary Raynaud’s is linked to another underlying condition, such as autoimmune disorders like lupus, scleroderma, and rheumatoid arthritis. The secondary form tends to be harder to treat, according to the NIH.

No matter the type, an attack can be triggered by sudden or extreme changes in temperature, or even stress, Dr. Nasir said. While that could be stepping outside on a cold day, sometimes it’s just the temperature difference between a hot day and a cool room.

Women are more likely to suffer from Raynaud’s than men, although the reasons aren’t yet clear, according to the Raynaud’s Association. Recent research suggests that the level of estrogen, which has an effect on the blood vessels, may be a factor. Premenopausal women or women on hormone replacement therapy are more likely to have the condition, according to a 2016 report in the journal Frontiers in Pharmacology.

Raynaud’s causes vasospasms – or sudden contractions – of the peripheral arteries, Dr. Nasir explained. As the blood is cut off, fingers become numb and turn white or red. In the worst cases, the fingers turn purplish blue because they aren’t getting enough oxygen. In a few rare instances, it can lead to ulcerations, or breaks in the skin. That calls for emergency care, she said.

Some medications, such as those for attention deficit disorder or migraines, may exacerbate Raynaud’s because they constrict blood vessels, Dr. Nasir said. Smoking can also aggravate it. “The nicotine and other chemicals in the cigarettes can cause a blood vessel to constrict,” she said.

Is There Any Treatment?

Raynaud’s is diagnosed through a clinical exam, not through imaging or labs, she said. “But we almost always do blood work when patients first present with it because it can be a sign of an underlying connective tissue disorder,” she said. “But usually clinicians are able to diagnose this clinically just by history and a physical exam.”

Other conditions may produce similar symptoms to Raynaud’s, Dr. Nasir said. For example, some chemotherapy agents can cause damage to your peripheral nerves, creating numbness, tingling, and discoloration. Chilblains are caused by poor circulation to the extremities, and cold urticaria is an allergic reaction triggered by cold. Both can cause swelling or itching and sufferers should check with a doctor, according to the Raynaud’s Association.

Unfortunately, there’s no medical treatment for Raynaud’s, although in severe cases, calcium channel blockers, such as those used for blood pressure, may reduce the frequency and severity of Raynaud’s attacks, Dr. Nasir said. The Raynaud’s Association also suggests regular exercise, which can improve overall circulation, and self-help techniques such as meditation to manage discomfort.