Why Are My Fingertips Blackening?

There are several reasons why your fingers are blackening or turning darker. Blackening fingertips is often the result of blood vessels narrowing or exposure to cold weather.

Avoiding cold environments and stress may prevent blackening fingertips. In some cases, a health condition that causes inflammation or narrows your blood vessels may lead to color changes in your fingers. A healthcare provider may prescribe medicines to treat the underlying health condition. 

Read on to find out what causes blackening fingertips, when to see a healthcare provider, and how to prevent color changes in your fingers.

1. Buerger's Disease

Buerger's disease, or thromboangiitis obliterans, happens if something blocks the blood vessels in your hands and feet. As a result, those blood vessels inflame and swell. 

People with Buerger's disease often have fingers or toes that appear blue, red or become pale and cold to the touch.  

Other Buerger's disease symptoms include:

• Arthritis in the knees or wrists
• Burning or tingling sensation in the hands and feet
• Pain in the lower extremities while walking, especially in the arch of the foot
• Painful small ulcers on the fingers or toes
• Severe pain in the hands and feet that worsens during times of emotional stress or in the cold
• Skin changes

There is no cure for Buerger's disease, but you can manage symptoms. For example, people who smoke are likelier to develop Buerger's disease than others. A healthcare provider may advise stopping smoking to control symptoms.

Other treatments include medicine, such as aspirin, to open your blood vessels. In severe cases, amputation of infected fingers or toes may be necessary.

2. Cold Weather

You may notice that your fingers change color in cold environments.

For example, in cold environments, chilblains, or pernio, causes reddish-blue lesions on the hands and feet. Chilblains typically flares within 24 hours and goes away after a few weeks.

Other chilblains symptoms include:

• Blisters or ulcers on the hands and feet
• Burning
• Itching
• Tenderness

Avoid cold environments if you have chilblains. Certain medicines, such as calcium channel blockers, help treat lesions during a chilblains flare.

Frostbite is another cause of blackening fingertips due to cold weather. Frostbite causes tissue damage at temperatures below 32 degrees. People with frostbite may notice that their fingertips become dark purple if the blood vessels cannot function properly and blood pools in the area.

Healthcare providers treat frostbite by recovering as much of the affected tissue as possible. 

3. Raynaud's Disease

Raynaud's disease is a rare blood vessel disorder that flares if you are cold or stressed. 

Small vessels that supply the skin with blood narrow so much that affected areas turn blue or white. Your skin may appear red when blood flow returns. Sometimes, Raynaud's disease may cause sores or tissue death.

A healthcare provider may prescribe medicine to widen your blood vessels.

At-home treatments for Raynaud's disease include:

• Avoiding stress
• Keeping your hands warm in cold environments
• Soaking your hands in warm water

4. Scleroderma

Scleroderma is an autoimmune disease that causes fibrous tissue to build up in the skin. That build-up damages your small arteries, causing poor blood supply. 

Scleroderma affects several body parts, causing an array of symptoms. For example, people with scleroderma may notice their fingers becoming blue or white in cold environments.  

Other scleroderma symptoms include:

• Abnormal heart rhythm
• Digestive problems (e.g., constipation, diarrhea, and heartburn)
• Dry cough
• Erectile dysfunction
• Hair loss
• Kidney failure
• Painful, stiff, or swollen joints
• Skin that appears darker or lighter than usual
• Vaginal dryness

Scleroderma treatment depends on your symptoms. A healthcare provider may prescribe hydroxychloroquine, immune-suppressing drugs, or steroids.

5. Vasculitis

Vasculitis causes your immune system to attack your blood vessels. As a result, inflammation gradually thickens and weakens your blood vessel walls. 

Blood to your feet and hands becomes restricted, causing blackened fingertips and toes. In severe cases, blood vessels stretch to the point that they bulge, known as an aneurysm.  

A case report published in 2018 described an 84-year-old man with polyarteritis nodosa (PAN), a rare form of vasculitis. PAN affects medium-sized blood vessels. The man presented with worsening discoloration and pain in his fingers and toes.

The man's other symptoms included:

• A 100-degree fever
• Necrosis, or the death of body tissue in his fingers and toes 
• Weakness

Healthcare providers tested the man for various health conditions, all of which came back negative. Lab tests showed that the man had high C-reactive protein levels, indicating inflammation.

Treatments for vasculitis include medicines that reduce inflammation, such as steroids.

When To Reach Out to a Healthcare Provider

Consult a healthcare provider right away if you see that your fingers are changing colors, especially for unknown reasons. A healthcare provider will likely ask about your health history and symptoms, then perform a physical exam.

Depending on your symptoms, a healthcare provider may order tests like:

• Antineutrophil cytoplasmic antibodies (ANCA) test: This blood test measures ANCAs, which target neutrophils (white blood cells) in people with vasculitis.
• Antinuclear antibody (ANA) blood test: Your immune system produces ANAs, which bind to your tissues. Sometimes, your body produces antibodies if it mistakenly targets and attacks your healthy tissues.
• Blood differential: This test detects abnormal cells and measures the percentage of white blood cells in your blood.
• Biopsy: A healthcare provider will remove a small sample of your skin to test the cells for abnormalities. A biopsy may help detect scleroderma if you have hard, thickened skin.
• Complete blood count (CBC): This blood test records the amount of hemoglobin, platelets, and red and white blood cells. A CBC measures the percentage of your blood made up of red blood cells.
• Comprehensive metabolic panel: This group of blood tests measures your metabolism, or all of the chemical and physical functions that use energy.
• Duplex Doppler ultrasound: This detects how your blood moves through your body.
• Serum cryoglobulins: These antibodies respond to temperature changes. For example, cryoglobulins become solid at low temperatures. Cryoglobulins commonly occur with health conditions that affect the joints, kidneys, nervous system, and skin.
• Serum protein electrophoresis: This examines the types of protein in your blood serum.
• Urinalysis: This includes a series of tests that looks at and measures compounds in your urine.
• X-rays of your hands: A healthcare provider will have you place your hands on an X-ray table to obtain images.

Ultimately, do not hesitate to get medical attention for anything abnormal with your body, even if it's just your fingers or toes.

How To Prevent Blackening Fingertips

Preventing blackening fingertips depends on the underlying cause. Follow a healthcare provider's instructions for preventing and treating health conditions that cause your fingertips to change colors.

Some ways to prevent blackening fingertips may include:

• Avoiding cold environments
• Keeping your hands warm in cold environments by wearing mittens
• Not handling ice or frozen food
• Preventing chills, which may occur after vigorous physical activity or with a fever
• Quitting smoking

A Quick Review

One of the most common causes of blackening fingertips is exposure to cold weather or stress in people with Raynaud's disease. Other health conditions that cause color changes in your fingers include Buerger's disease and vasculitis. 

Consult a healthcare provider right away if you notice your fingers are blackening or turning darker. Sometimes, those color changes mean that your blood vessels are too narrow. A healthcare provider may prescribe medicines to keep your blood vessels wide, improving blood flow.