Then you could be suffering from Raynaud's phenomenon or other cold-related conditions. Dr Lesley Hickin explains

When we venture out of warm, centrally heated buildings into the cold outdoors, the small blood vessels near the surface of the skin immediately contract to slow blood flow and preserve the body's heat. However, people with a condition known as Raynaud's phenomenon have an extreme sensitivity to cold that causes their blood vessels to contract too much.

When this happens the skin gets progressively colder - from pale to white and then to blue. The affected parts also feel very cold (or hot and tingly), and are numb and painful during an attack, and this unpleasant sensation can last 10-20 minutes. As blood flows back, the area starts to feel hot and the skin goes bright red. During an attack there is also a marked colour difference between the affected area and normal skin.

The areas of the body most susceptible to Raynaud's phenomenon are extremities where restricted blood flow is more obvious, such as fingers, toes and occasionally the ears, nose or jaw. Some people also find that they are much more prone to attacks when physically or emotionally stressed, and in some cases emotion alone can affect the blood vessels.

Why 'Raynaud's' phenomenon?
The condition is named after Maurice Raynaud, a French doctor who described the condition in the mid-1800s. The syndrome affects between three and ten per cent of 15-40 year olds and is more common in women, and about half of those who suffer from Raynaud's have an underlying medical disorder. In fact some people have the disease for several years before any underlying illness becomes apparent, although there are tests that can predict who's at risk.

Raynaud's is a feature of some autoimmune illnesses, including scleroderma, rheumatoid arthritis and Buerger's disease. Raynaud's phenomenon is present in almost all people with scleroderma and 35 per cent of those with Sjogren's syndrome. It can also be caused by some medications, including beta-blockers used for high blood pressure and heart trouble, and some migraine drugs.

Can it turn into something more serious?
In severe and prolonged episodes, long-term oxygen deprivation causes the skin to undergo permanent changes. It may look permanently discoloured and shiny, and ulcers or scabs may develop. The tips of the fingers and toes are particularly prone to these problems, resembling the changes caused by frostbite. This is called dry gangrene and may need surgery.

If you suffer from Raynaud's phenomenon it's wise to see your GP. You will get a physical examination to make sure there are no associated illnesses, but blood tests will be more useful as they can predict the future onset of, for example, scleroderma. However, despite the available tests the down side of this is that there are, as yet, no known cures for these illnesses.

How can I prevent attacks?
Protect yourself from cold and keep all parts of your body warm, not just the extremities. When outdoors in winter, wear hats, scarves, warm socks and fur-lined boots. Wear mittens over your gloves and wristlets to cover the gap between sleeves and gloves. While indoors, wear socks and comfortable shoes.

Avoid reaching into the freezer or refrigerator without protective insulated gloves or an oven-mitt. If you smoke ask for help to stop, as nicotine causes constriction of small blood vessels, which can cause an attack.

Can it be treated with drugs?
There are some drugs available that can dilate the affected small blood vessels. This group of drugs is called calcium channel blockers and includes nifedipine, amlodipine and felodipine.

There is evidence that biofeedback techniques can also alter the sensitivity of the small blood vessels. With this technique people are taught to visualise their fingers and toes as feeling warm.

Vibration white finger
Raynaud's symptoms can be caused by long-term exposure to intense vibration from machinery, such as a chainsaw or drilling equipment. This vibration causes constriction of the small blood vessels in the part of the body involved, leading to nerve damage. Smoking and cold exposure may trigger or aggravate symptoms.

Unlike Raynaud's, it is mainly men who suffer from vibration white finger (also known as hand-arm syndrome). The condition can develop insidiously over many years and by the time it has been recognised the damage may be irreversible. Sufferers experience pale-blue fingers, which are painful, numb and tingling. The symptoms may extend up the arms, and are at first intermittent then constant. The condition is recognised as a preventable industrial injury.

Chilblain pain
Although less serious, chilblains are no less painful than Raynaud's. They are itchy, painful reddish-purple swellings occurring on the fingers and toes after exposure to the cold. They are more common in children and the elderly, and are a result of excessive narrowing of blood vessels under the skin in cold weather. They are painful in the cold and intensely itchy in the warm. They do disappear without treatment but tend to recur. Proprietary treatments have not been proven to work, so prevention really is the only way. Like Raynaud's, this is achieved by wearing many layers of warm clothing, including socks, gloves and thermal underwear.