Cold hands? Don't blame it on the weather: How icy fingers could be a sign of something more serious...

Cold hands are not only a sign that the weather's bitter - they could be a symptom of something more serious. There are at least a dozen conditions which cause chronic cold hands, including peripheral vascular disease and ME.

But for an estimated nine million Britons, cold hands are a sign they have Raynaud's.

The condition causes the small blood vessels in the fingers, toes, ears and nose to constrict when their temperature drops. Although it's usually worse in the winter, even in warm weather patients can suffer in the slightest temperature drop, such as moving into an air-conditioned atmosphere.

During an attack the skin visibly whitens and the area becomes numb or extremely painful. Sufferers often develop sores and patches of hard skin, which makes walking painful; because of poor blood flow their skin is also prone to ulceration and infection.

Even a moment's exposure to the cold can leave sufferers in agonising pain. Just opening the front door is enough to start an attack - you could feel as if glass is being scrunched in your hands. People assume Raynaud's is "just" about numb hands, in fact, you're unable to use your fingers at all. Getting coins out of your purse, keying in your pin number, unscrewing jars or putting the key in the door become impossible.

Don't blame the cold weather is not the only reason you may get icy fingers. Having cold hands could be a symptom of something more than the bitterly cold weather.

Nine out of every ten sufferers are female - it's thought that oestrogen makes the blood thicker, slowing down its flow in the tiny vessels, the symptoms often first appear with puberty and attacks can be worse at certain times in the monthly cycle, sometimes tailing off after the menopause.

The severity of the condition varies with the patient. But the key is that the condition is diagnosed early, Not only because patients can be given treatment to reduce the debilitating effects - but, more importantly, to identify if it's secondary Raynaud's, which is potentially far more serious.

An astonishing half a million Britons are thought to have the secondary form - where their symptoms are a sign of an underlying problem. It can be a side-effect of certain medication, such as migraine treatments, betablockers or the pill, or exposure to chemicals or a virus.

More worrying, their symptoms could be caused by an auto-immune disease, such as rheumatoid arthritis, lupus or scleroderma. Some of these conditions are potentially fatal; one form of scleroderma, for instance, is linked to lung disease and problems with the kidneys, gastrointestinal system and the heart.

Raynaud's symptoms are often the first sign of the more serious health problem, for this reason it's important anyone with symptoms should be tested. By being screened for these serious complications at the earliest stage, it means they can be treated. Some can develop secondary Raynaud's, although this may not be discovered until the condition rapidly worsens.

Don't blame the cold weather is not the only reason you may get icy fingers.
If you go into the chiller section at the supermarket, and do your hands go white from fingers to palms. At the cashier can you barely pick up the food from your trolley let alone get money out of your purse. Even getting from the car to the house can bring on an attack so bad you could cry out with pain. The practicalities of daily life with a condition which means you cannot use your hands.

Raynaud's used to be treated with surgery to the sympathetic nervous system (the nerves from the brain to the hands and feet). But because the effects are temporary and there is the high risk of complications, such as nerve damage, surgery is rarely offered these days.

The most common drug treatment is with vasodilators such as an inhibitors or calcium channel blockers - these work by relaxing the blood vessels. Some drugs which are used can block the hormone serotonin, which constricts blood vessels.

There are risks of unpleasant side-effects with drug treatments - including severe headaches - means that those with a mild version of the condition are advised to keep fingers and feet warm with silver gloves and socks as well as keeping warm generally.

But unfortunately for those with more severe Raynaud's, there are other problems. An infection or cut can be more serious as poor blood flow means these take longer to heal. Also any ulcers on the fingers or toes will not heal on their own and can require other medical treatment, even then healing will be slow.
But as sufferers with severe Raynaud's find, medication cannot prevent the attacks.

RAYNAUD'S and Scleroderma Association, 0800 917 2494
Visit: www.raynauds.org.uk

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