Vascular Disease Vascular Disease Basics

The Cold Facts About Seriously Cold Hands

Cold hands and feet are a common occurrence, usually blamed on the frigid weather, not dressing warmly enough or poor circulation. In most cases, a pair of mittens and some heavy socks will make you feel toasty again.

But at what point are cold hands a sign of more serious problems? Dr. Robert Spiera, director of vasculitis and scleroderma at the Hospital for Special Surgery in New York explains Raynaud's syndrome, a surprisingly common condition that underlies many cases of cold feet.

What is Raynaud's syndrome?
Raynaud's syndrome is a condition where people develop spasms in the blood vessels going to the hands or feet. These spasms are most often precipitated by exposure to cold, but they can also be caused by stressful situations.

It is something that is fairly common, especially in young women. Some estimates will say that as many as 10 percent of women have Raynaud's phenomena.

What are the symptoms of Raynaud's?
The hands or feet turn colors. The most typical thing would be first turning a whitish color, possibly followed by a phase where the hands can become very bluish and then a very reddish phase at the end. This is called the "French tricolor" changes of Raynaud's: white, blue and red.

These color changes are a result of the alterations in blood flow to the extremities. [The white color is caused by a lack of blood. The blue to red color is a result of a rush of blood to the hands.]

Should you be concerned about Raynaud's syndrome if you often get cold hands?
Raynaud's symptoms can fall within a spectrum in terms of the severity of the disease. There are people who are cold-sensitive, and their hands might turn a little white or feel a little bit cold in the cold weather; that's actually a normal physiologic response. But when people have Raynaud's, it's a more striking change, where they can actually see the color changes.

Why do people with Raynaud's get cold hands and feet?
Raynaud's is based on a normal physiologic response. If somebody is exposed to cold, the normal physiologic response is for your body to maintain core body temperature and prevent heat loss through the extremities. So, the body would clamp down on the peripheral vessels to have the blood go to the vital organs to maintain warmth.

But in people with Raynaud's, this normal response is exaggerated. For example, frostbite wouldn't be considered Raynaud's, but it's caused by the same response. In people who have Raynaud's, something like frostbite might happen much more readily or be more pronounced when it happens.

What causes Raynaud's phenomena?
There are families that are predisposed to having Raynaud's phenomena, but the symptoms of Raynaud's are usually indicative of some other disease. There are some autoimmune or connective tissue diseases that cause a higher rate and more severe form of Raynaud's.

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