Fingers or toes may change color when they are exposed to cold temperatures or stress, or when there is a problem with their blood supply.

Blanching of the fingers; Fingers - pale; Toes that change color; Toes - pale

These conditions can cause fingers or toes to change color:

• Buerger disease
• Chilblains (painful inflammation of small blood vessels)
• Cryoglobulinemia
• Frostbite
• Necrotizing vasculitis
• Peripheral artery disease
• Raynaud phenomenon (sudden change in the finger color ranges from pale to red to blue)
• Scleroderma
• Systemic lupus erythematosus

Things you can do to help prevent this problem include:

• Avoid smoking.
• Avoid exposure to cold in any form.
• Wear mittens or gloves outdoors and when handling ice or frozen food.
• Avoid getting chilled, which may happen following any active recreational sport or other physical activity.
• Wear comfortable, roomy shoes and wool socks.
• When outside, always wear shoes.

Contact your health care provider if:

• Your fingers change color and the cause is not known.
• Your fingers or toes turn black or the skin breaks.

Your provider will perform a physical exam, which will include close examination of your hands, arms, and fingers.

Your provider will ask questions about your medical history and symptoms, including:

• Did the fingers or toes suddenly change color?
• Has the color change occurred before?
• Does the cold or changes in your emotions cause your fingers or toes to turn white or blue?
• Did the skin color changes occur after you had anesthesia?
• Do you smoke or use tobacco?
• Do you have other symptoms such as finger pain? Arm or leg pain? A change in the texture of your skin? Loss of hair on your arms or hands?

Tests that may be done include:

• Antinuclear antibody blood test
• Blood differential
• Complete blood count (CBC)
• Comprehensive metabolic panel
• Duplex Doppler ultrasound of the arteries to the extremities
• Serum cryoglobulins
• Serum protein electrophoresis
• Urinalysis
• X-ray of your hands and feet

Treatment depends on the underlying cause.

Jaff MR, Bartholomew JR. Other peripheral arterial diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 72.

Melville AR, Belch JJF. Raynaud phenomenon. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 154.