Why are your fingers blue?
The weather has turned colder, which means that it’s time to bundle up before you head outside. For most people, this is enough to keep them warm. For some, despite doing this, it’s not enough to keep their fingers and toes warm, which can result in them feeling numb and turning blue until they’re warm again. Why does this happen? Can it be prevented?
Raynaud’s disorder is when some parts of your body feel numb and cold as the result of cold temperatures or stress because the smallest arteries of your blood vessels overreact and narrow (vasospasm), which limits the amount of blood reaching the affected area. The reason they do this in response to cold temperatures or stress is unclear. There are two main types. Primary is also called Raynaud’s disease and is the most common form. It usually isn’t associated with other medical conditions and is typically mild. This version appears between the ages of 15–30. Secondary is also called Raynaud’s phenomenon and is usually caused by an underlying problem. While it’s less common, it’s usually more severe. The onset of this type is usually in people 40 and older. Some of the conditions that cause secondary Raynaud’s include scleroderma, lupus, rheumatoid arthritis, Sjogren’s syndrome, atherosclerosis, primary pulmonary hypertension, carpal tunnel syndrome, repetitive action/motion, smoking, injuries to hands/feet and certain medications, like those to treat high blood pressure, ADHD, migraines, colds (over-the-counter) and chemotherapy agents. Risk factors for developing Raynaud’s depends on the type. For primary, being a woman, living in a colder climate and having a family member who has the disease increase your risk. For secondary, having any of the diseases associated with it, working in a job that requires repetitive trauma and exposure to certain substances, such as smoking or medications intensify your risk level.
Symptoms are the same for either type and include cold fingers/toes, color changes to your skin in response to cold/stress and numb/prickly feeling/stinging sensation upon warming or stress relief. While Raynaud’s usually affects fingers and toes, it can impact other parts of your body, like your nose, lips, ears and nipples. When an attack occurs, the affected parts of your body usually turn white and then blue. The areas will feel cold and numb. As you warm them and circulation increases, the areas will turn red and throb/tingle. Also, the areas may swell. It can take up to 15 minutes for blood flow to be restored to normal. If the diminished blood circulation to your body parts is severe, it could cause damage to the tissue. This is rare and usually only seen in those with secondary Raynaud’s.
The goal of treatment is to reduce the number and severity of attacks in order to prevent tissue damage. For those with underlying medical conditions, treating them is also key. If you do have an attack, it’s essential to warm the area slowly so you don’t cause damage to the tissue. The first step is to go inside or to a warmer area. It can be helpful to wiggle your fingers/toes, place your hands in your armpits and/or make wide circles with your arms. You can try putting your hands/feet in warm (not hot) water. Also, gently massaging the area can be beneficial. All of these steps are designed to increase circulation to the affected body parts. If your Raynaud’s is triggered by stress, when an attack occurs, remove yourself from the stressful situation and find ways to relax.
If you have a severe form of Raynaud’s, there are several options for treatment. There are different medications that can dilate blood vessels, which helps to improve circulation. Calcium channel blockers, like nifedipine, amlodipine, felodipine or isradipine, are great a doing this and they help to heal skin ulcers that can appear on your fingers and toes as a result of disease. Other vasodilators help with circulation, but don’t help with ulcer healing, are nitroglycerin, losartan, sildenafil and fluoxetine. For the most severe cases, you doctor will probably recommend surgery. One type is injecting chemicals, like local anesthetics or Botox, to block the sympathetic nerves, which control the opening and narrowing of the blood vessels that go to your skin in your hands and feet. Sometimes, the procedure needs to be repeated if symptoms don’t go away or return. Another option is cutting the sympathetic nerves. By doing this, it interrupts their exaggerated responses. It might not be 100% effective, but it should significantly reduce the number and severity of attacks.
There are several things that you can do to prevent a Raynaud’s attack. For those with mild symptoms, dressing in layers and wearing gloves/heavy socks, even indoors, is critical. Make sure that your coat cuffs come down over the top of your mittens so cold air can’t get inside. There are hand/foot warming packets that use chemicals inside to generate heat. These packets are designed to be worn inside gloves and shoes. If your face and ears are sensitive, wearing a face mask and earmuffs can help. Take the time to warm up your car before you get in it to drive somewhere. Using insulated drinking glasses can be a good way to keep your hands away from touching cold beverages. Avoiding going from a hot environment to a cold one, which causes a rapid shift in temperature. During warmer months when using your air conditioning, don’t set the temperature too low. Not smoking or being around those who smoke is a good way to avoid having constricted blood vessels. Exercising and eating a healthy diet are helpful in improving circulation throughout your entire body. Controlling stress is key to preventing it from triggering an attack.
Raynaud’s disease isn’t something that you’d want to experience, but by taking the steps necessary to prevent it, you’ll decrease the severity of it. If you have any questions or concerns about Raynaud’s disease, please speak with your doctor. If you would like more information, please visit the American College of Rheumatology’s Raynaud’s Phenomenon page at https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Raynauds-Phenomenon