Why Do Your Hands Get Cold?

You’re cold as ice. Or at least your hands are, and anyone you touch has something to say about it. But are your cold hands a real problem?  

Time and again, people arrive in the office of vascular surgeon Nicholas Morrissey, MD, and declare: My hands are always cold, I must have bad circulation.  

Morrissey, who surgically repairs circulatory issues, says that’s almost always not the case.  

“People often think that temperature is a sign of circulation and so that’s true to some extent, but having cold hands and feet is almost always benign,” says Morrissey.  

Why Your Hands Are Cold

Cold hands generally occur when someone is exposed to a cold environment or is handling a cold object. The circulation of blood to the hands and feet helps warm your extremities. But when the exposure to cold is prolonged, the body does what it can to preserve warmth in its core (heart, brain, vital organs). To maintain core body temperature in cold conditions, blood circulating to the hands (and feet) is reduced to prevent heat loss at the extremities.  

If you’re like most people, cold hands are a normal reaction and will resolve after the exposure ends. 

If cold hands are constant and bothersome, ask yourself: Is it related to the time of year and the temperature? If yes, try your best to control the environmental circumstances and avoid the cold. 

“If you can solve your cold-hands problem by wearing gloves,” Morrissey says, “you don’t have a problem with cold hands.” 

When to See a Doctor if You Always Have Cold Hands (or Feet) 

The time to see a medical professional is when the cold hands, or other body parts, persist.  

Cold hands that do not warm up after time in a warm environment can be a sign of a health condition: anemia, autoimmune disease, blood or thyroid disorder, reaction to medication, or smoking. In some people, including those with lupus, scleroderma, or Raynaud’s disease, cold hands stem from hypersensitive nerves. When the skin senses cold, nerves in hands and feet tell nearby blood vessels to constrict, which shunts blood back to the body’s core.  

But when the nerves are too sensitive, the response is more exaggerated: fingers can turn white or blue and pain can be prolonged. If necessary, your doctor may refer you to a vascular specialist or a rheumatologist to rule out, identify, and/or treat these or other conditions.   

Even for people with these conditions, however, the solution to their cold hands is usually gloves.  

“Gloves are almost always the answer,” says Morrissey. “If gloves solve the problem, we don’t give people medications. We don't want to talk about surgery.”  

When Cold Hands Are an Emergency 

So when are cold hands and feet a sign of an emergency? Only when there’s a sudden onset of severe pain, numbness, and coldness. This usually happens to an entire hand, foot, arm, or leg all at once, and the symptoms are unrelenting.  

This situation is rare, but when cold is this serious you need to be seen in an emergency department.