As a child, Beth Smith thought of her cold hands as a quirk.
She could take things out of the microwave without a dish towel and clutch a cup of hot tea without using the handle.
‘My family all had cold hands – we said we had asbestos fingers,’ says Beth, 33, who is from Essex, England.
But as she got older, her cold hands grew more concerning.
Around the age of ten, they started to change color – turning white seemingly at random.
She says: ‘The doctor flippantly told me to bundle up and keep warm. But my hands gradually got worse. They would become pale and bloodless if I was sick or even stressed.’
Beth was later told she likely had Raynaud’s – a common condition in which small blood vessels in the fingers and toes temporarily spasm, reducing blood flow and causing painfully cold hands.
The fingers often turn white or blue due to the reduced circulation.
Beth Smith thought of her cold hands as a quirk. She could take things out of the microwave without a tea towel and clutch a cup of hot tea without using the handle
Beth was initially told she likely had Raynaud’s – a common condition that causes reduced circulation to the fingers and painfully cold hands
Affecting about one in 20 Americans, Raynaud’s is usually harmless and is generally managed by wearing gloves, thick socks and layers to avoid sudden changes in temperature.
But for some, the condition can be one of the first – and sometimes only – signs of a more serious health problem.
This is known as secondary Raynaud’s, where the symptoms are caused by another underlying condition.
For this group, Raynaud’s can be particularly severe – sometimes causing lasting tissue and circulatory damage – and treating the underlying disease can be crucial to bringing symptoms under control.
But experts warn that many people with secondary Raynaud’s are being missed by doctors – with potentially devastating consequences.
Samir Patel, a consultant rheumatologist at King’s College London, says: ‘Because cold fingers and toes are quite common, people don’t appreciate what it sometimes signifies.
‘In many people there’s no clear cause for it and it’s usually not severe. But, for others, it can be the first presenting feature of an autoimmune condition.’
For Beth, it took nearly a decade to get to the bottom of her Raynaud’s symptoms. By 25, they were ‘totally out of control.’
She explains: ‘I was getting blue and gray hands and feet – and the discoloration was starting to travel up to my elbows and knees.
‘Doctors had tried different medications and nothing worked.
‘I was scared because I had been told that not having a pulse in my hands for an extended period could cause tissue damage so severe that I could lose a limb.
‘Then, when I was 26, I was tested for and diagnosed with an autoimmune condition that had been causing my symptoms all these years.’
Beth had scleroderma – a rare disease that causes the body to produce too much collagen, leading to hard, thickened skin and, in severe cases, scarring within internal organs.
Some types can lead to severe and life-threatening problems.
Many of the condition’s symptoms mimic other, more common problems – such as patches of tight or sore skin, acid reflux or general fatigue – making diagnosis difficult.
But in about 95 percent of cases, scleroderma begins with Raynaud’s – often years before other symptoms appear.
As she got older, her cold hands grew more concerning. Around the age of ten they started to discolour – turning white seemingly at whim
In these cases, collagen builds up in the blood vessels in the fingers and toes, restricting blood flow even further when the vessels narrow in response to cold temperatures or stress.
Once diagnosed, the condition can be treated with blood pressure medications that help dilate blood vessels, as well as immunosuppressants that help slow skin thickening and reduce damage to internal organs.
The earlier treatment begins, the more effective it can be at managing symptoms and preventing permanent tissue damage.
There are several warning signs that can distinguish secondary Raynaud’s.
‘The red flags are people who develop it out of the blue, at an older age, and who are male,’ says Louise Parker, founder and director of The Raynaud’s Clinic in northwest London, England. ‘Raynaud’s is a predominantly female condition – so men developing it should be a cause for concern.’
Every six weeks, Beth has drug infusions over a five-day cycle that help open up her blood vessels and keep her scleroderma at bay – and this has massively improved her Raynaud’s.
But she wishes she had been seen earlier by doctors who properly understood the condition and were able to recognize the signs of her underlying disease.
‘I was always conditioned to believe that it was my own fault my Raynaud’s was bad, because I didn’t dress warmly enough,’ she says. ‘But wearing gloves and socks and pants never actually helped me – they actually cut off my circulation more.
‘I think that if I was put on the right medication sooner, I probably would have tolerated it better.’
