Fingers that go white then blue in the cold. Usually benign, but the features that suggest otherwise are worth knowing.
Assessed and treated by a GMC-registered GP
Prescriptions, sick notes and referral letters included
A written treatment plan after every appointment
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Raynaud's phenomenon is an exaggerated narrowing of the small blood vessels in the fingers and toes in response to cold or stress. Blood flow to the digit temporarily shuts down, then returns.
The classic sequence is three colours: the finger goes white as the vessels clamp shut, then blue as the remaining blood loses its oxygen, then red and often painful as blood floods back in. Not everyone gets all three, but a clear, sharply demarcated white phase is the most useful clue.
The great majority of cases are primary Raynaud's — a nuisance rather than a disease, common in young women, running in families, and not a sign of anything sinister.
A minority are secondary, where Raynaud's is the first visible sign of an underlying autoimmune condition such as scleroderma or lupus — sometimes appearing years before anything else. Separating the two is the entire clinical task on this page.
The colour changes are harder to see and are frequently missed. Look at the nail beds and palm creases, and rely more on the pattern of numbness, pain on rewarming, and the sharp demarcation than on colour itself.
Raynaud's is diagnosed clinically. There is no single confirmatory test, and by the time you are being examined the hands are usually a normal colour.
The questions that matter: how old were you when it started, does it affect both hands equally, is there a sharp line between the white and normal skin, and has the skin of the fingers changed.
A clear photograph of the hand during an attack, taken on a phone in good light, settles the diagnosis better than anything else available. Take one, and include both hands in the frame for comparison.
Primary — young onset, both hands symmetrically, no skin damage, normal blood tests, family history common.
Secondary — later onset, asymmetric, fingertip ulcers or pitted scars, tight skin, abnormal autoantibodies.
Simply having cold hands is not Raynaud's — the distinguishing feature is the sharply demarcated colour change, not the temperature. Chilblains, carpal tunnel syndrome and arterial disease are the other considerations.
Raynaud's assesses well remotely, because the diagnosis rests almost entirely on the history and on photographs — and photographs taken during an attack are far more useful than any examination between attacks.
Take a picture next time it happens. It is genuinely the most valuable thing you can bring.
Seek urgent assessment if:
Book a consultation soon if:
Routine advice is fine for: longstanding, symmetrical, cold-triggered colour changes that started young and are not causing skin damage.
The instruction people miss: keep your whole body warm, not just your hands. Cooling of the core triggers the reflex that clamps down the fingers, so a warm coat and hat prevent more attacks than gloves alone.
Moisturise the hands daily and protect against cuts. In secondary Raynaud's, small breaks in fingertip skin heal slowly and can ulcerate.
Do not use very hot water to rewarm — numb skin burns easily without you noticing.
For straightforward primary Raynaud's, the self-care advice above is most of the treatment, and it costs nothing at all. We would rather say that than sell a consultation for cold hands.
This page follows NICE Clinical Knowledge Summaries on Raynaud's phenomenon, alongside British Society for Rheumatology guidance on systemic sclerosis.
Hand-arm vibration syndrome is a prescribed industrial disease in the UK. Where regular vibrating tool use is the cause, it should be documented, reported under RIDDOR by the employer where applicable, and the person advised about Industrial Injuries Disablement Benefit.
Reviewed against NICE CKS and British Society for Rheumatology guidance current at the date shown above.
Usually not. Primary Raynaud's — the large majority — is a nuisance rather than a disease and does not damage the fingers.
Secondary Raynaud's matters more, because it can be the first sign of an underlying autoimmune condition and can cause fingertip ulcers.
Age at onset and symmetry are the most useful clues. Starting young, affecting both hands equally, with no skin damage, points strongly to primary.
Starting after 30, one hand worse than the other, or fingertip sores warrant blood tests and probably a rheumatology opinion.
No. The defining feature is a sharply demarcated colour change, not temperature.
If there is no clear white phase with a visible line, it is probably not Raynaud's — though on darker skin the changes are harder to see, so judge by numbness and rewarming pain instead.
Keep your core warm, not just your hands. Cooling the body triggers the reflex, so a warm coat and hat prevent more attacks than gloves alone.
Most people focus entirely on gloves and miss this.
Quite possibly — beta blockers are the commonest culprit.
It is fully reversible on switching, and the connection is regularly not made. Worth raising if you take one.
Yes — it is the most useful thing you can bring. By the time you are seen, your hands look normal.
Include both hands in the frame, in good natural light, during an attack.
Yes, more than people expect. Nicotine constricts small blood vessels directly, which is precisely the mechanism of the problem.
Very. Hand-arm vibration syndrome is a recognised industrial disease in the UK.
It should be documented properly, your employer has legal obligations, and you may be entitled to Industrial Injuries Disablement Benefit.
Most people with primary Raynaud's manage with warmth and avoiding triggers alone.
Where attacks are frequent or limiting, a calcium channel blocker such as nifedipine is first-line and works well for many.
August 30, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews
