Doctor's Notes on Cold Hands and Feet
If your feet and hands feel cold, they are signs and symptoms of underlying problems. The underlying problems usually cause somewhat different signs and symptoms. With frostbite and frostnip, while developing, the extremities may tingle, start losing feeling, and/or feel like a block of wood. Hands and feet become white, hard, and/or waxy with some showing a whitish-purple or yellowish hue and eventually having no feeling. During the warming process, the hands and feet are often painful, swollen, and have blister development. Severe cold injury may cause some areas (fingers, toes) to turn a black color resulting in tissue loss and/or extremity loss.
Immersion (cold water) injury signs and symptoms cause extremities first to be red, then turn pale and swollen. Some people may have blisters, skin breakdown, or even skin liquefaction. Chilblains (pernio) are a reddish or bluish rash that itches and burns; it can develop after long exposures to cold and wetness without freezing. Other signs and symptoms may occur with diseases such as white- to blue- to red-colored fingertips (Raynaud's disease), deep-blue fingertips (cryoglobulin production), and cold urticaria that produces hives or raised red bumps when the person is exposed to cold temperatures.
Causes of cold feet and hands are caused by damage or loss of nerves and blood vessels due to exposure to cold temperatures. Underlying causes include frostbite, frostnip, chilblains, Raynaud's disease, cryoglobulin production (proteins that, when cold, become solids or gels and block circulation), and allergic reaction to cold temperatures (cold urticaria).
What Are the Treatments for Cold Hands and Feet?
The treatments for cold hands and feet depend on the underlying disease or condition that cause it. The diseases and conditions that produce cold hands and feet (some more common ones listed above) vary substantially, so the first treatments depend on an accurate diagnosis. You and your doctor then can address the cause with treatments for your condition. The various treatments for possible underlying causes are best determined once a diagnosis is made; rule out problems that are obvious and require immediate care like frostbite, gangrene (both wet and dry types), and new-onset nerve problems like numbness or Raynaud's disease. Meanwhile, a few lifestyle changes may help:
- Avoid tobacco and alcohol products.
- Wear protective clothing like mittens, insulated boots, and/or foot and hand warmers.
- Avoid abrupt temperature changes.
- Exercise and reduce stress.
- Avoid caffeinated fluids.
Some drugs may be helpful to increase blood flow:
- Alpha blockers
- ACE inhibitors
- Calcium channel blockers
Antibiotics may be used if infection develops. Nerve blocks (injections and/or surgical) may help some patients. Your doctor can help decide your best treatment options.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.