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10 Causes of Cold and Clammy Skin

It may just mean you’re hot, but could signal an underlying medical problem
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Last updated April 24, 2024

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What is cold, clammy skin?

Your skin can get cold and clammy whenever your body temperature rises—from hot weather, exercise, or a fever. This causes your sympathetic nervous system (your “fight or flight” response) to send a signal to your body to produce sweat. As sweat evaporates, it helps cool your body, which can make your skin feel chilly and moist—“clammy.”

This is a natural response. But if you’re sweating excessively or sweating without an obvious cause (like a hot day or working out), cold and clammy skin can be a sign of a medical problem.

These include hyperhidrosis (excessive sweating disorder), menopause, or a fever from a common cold. But it can also be a sign of a life-threatening medical condition, such as internal bleeding or a heart attack.

If you’re not sure why you’re sweating, you may need to see a doctor to rule out more serious conditions. If you believe you’re experiencing a life-threatening condition, call 911 or go to the ER.

Why is my skin always cold?

Cold skin is caused by constriction (narrowing) of your blood vessels, which decreases blood flow to an area of the body. This normally happens when you’re in a cold environment. Any time that your body temperature becomes slightly cooler than normal, your body prioritizes blood flow to your organs, such as your heart, lungs, and brain. The blood vessels that supply your hands and feet, meanwhile, narrow, minimizing blood flow to these areas. Blockages in these blood vessels can also make your hands or feet feel cold.

People with Raynaud’s syndrome experience sudden constriction of the arteries in their fingers and toes when they’re exposed to the cold. The skin feels cool to the touch and may appear white or blue.

Cold intolerance can also happen when there are problems with the temperature-regulating part of your brain (the hypothalamus), the thyroid gland, or blood flow to the skin.  People with low body fat, anemia, or thyroid disorders may have cool skin.

What does a clammy forehead mean?

Mothers everywhere feel their child’s forehead when they’re concerned that their child has a fever. Because the forehead isn’t covered by clothing, it’s an easily accessible and somewhat reliable place to check for warm or sweaty skin. If a person with normal body temperature detects a clamminess on the forehead of another person, it may be a sign of fever or of another issue.

Should I go to the ER?

Clammy skin can sometimes be a sign of an emergency, so it’s important to monitor your symptoms closely. If you aren’t in a warm environment or exercising, sweating could be a sign of a medical problem. Try to lie down and remove extra clothing or tight garments to cool off.

Always go to the ER if you have clammy skin plus any of the following symptoms:

If you have any of these symptoms when you start to feel sweaty, call 911 or go to the ER immediately instead of attempting home treatments.

People with diabetes should also call 911 if they experience sweating and are alone at the time. But it’s sometimes okay to try some treatments for low blood sugar if another person is there to watch for worsening symptoms.

People who have a history of heart disease or allergic reactions should also go to the ER rather than monitoring their symptoms at home because clammy skin can be an early sign of a serious complication of these conditions.

Pro Tip

Women with cold, clammy skin should let their doctor know if there’s any chance of pregnancy. Sometimes this symptom could indicate internal bleeding related to an ectopic (tubal) pregnancy. If you already know or suspect pregnancy, mention it right away so your doctor will check for this serious condition as soon as possible. —Dr. Anne Jacobsen

What is clammy skin a symptom of?

1. Infection with fever

Symptoms

  • Elevated temperature (over 100.4℉)
  • Sweating
  • Chills
  • Fatigue
  • Other symptoms vary depending on type of infection (cough and cold symptoms, nausea and vomiting, or painful urination and back pain)

Any infection that causes a fever can make your skin feel cold and clammy. This includes common and mild illnesses, such as a cold or upper respiratory infection, and more serious illnesses, including pneumonia, appendicitis, or a kidney infection.

Your body responds to an infection by increasing your temperature to kill the virus or bacteria. You might also get chills because the surrounding air feels cold by comparison. Your muscles contract in response and cause you to shiver, which produces body heat.

Treating infections

Your doctor will treat the infection, depending on what you have. In most cases of everyday infections, it’s usually okay to rest and drink fluids to stay hydrated and take acetaminophen or ibuprofen to help bring down the fever. See your doctor for additional testing and treatment if you have fever and severe headache, stiff neck, chest pain, shortness of breath, abdominal pain, pelvic pain, or severe skin or joint pain.

2. Menopause

Symptoms

  • Irregular or absent periods
  • Hot flashes
  • Sweating, including night sweats
  • Vaginal dryness
  • Mood swings
  • Difficulty concentrating

Menopause occurs naturally in women as they age, typically around age 51. The ovaries become less active over time and eventually, monthly periods stop completely. You’re considered to have entered menopause when you haven’t had a period for 12 months.

When your ovaries stop releasing eggs, your estrogen and progesterone levels drop, which produces symptoms that affect the entire body. Hot flashes and sweating can occur when low estrogen levels make you more sensitive to temperature changes. The brain may get a signal to produce sweat even when you’re in a relatively cool environment, leading to cold and clammy skin.

Treating hot flashes from menopause

If your menopause symptoms are mild, you may not need or want to be treated. Sometimes lifestyle changes, such as dressing in layers, exercising, and reducing stress can help make the hot flashes more tolerable.

Your doctor may recommend hormone replacement therapy (HRT) if your symptoms are more severe. It can be given orally or topically in a patch or cream. HRT could increase your risk of cancer, blood clots, strokes, or a heart attack, so it’s important to discuss risks and benefits with your doctor. Taking antidepressants may also help with hot flashes and mood changes.

Pro Tip

Tell your doctor if symptoms related to menopause are affecting your quality of life. There are treatments and also lifestyle changes that your doctor can suggest. If you don’t let your doctor know how you’re feeling, you may miss out on really helpful treatments that can get you back to feeling like yourself. —Dr. Jacobsen

3. Hyperhidrosis

Symptoms

  • Excessive sweating even when you’re not in a hot environment
  • Sweat that soaks through your clothing
  • Cold and clammy hands

Hyperhidrosis is when you sweat excessively at times when your body doesn’t need to sweat to cool off. The most common areas for sweating are the armpits, face, hands, and feet. Excessive sweating is caused by overactive sweat glands in these areas.

Treating hyperhidrosis

Hyperhidrosis can be treated with prescription antiperspirant, steroid cream, or glycopyrronium cream. Prescription pills are also sometimes recommended. If these treatments don’t work, your doctor may recommend Botox injections, which temporarily block the nerve signal to the sweat glands.

Other treatments include microwave thermolysis, laser treatments, and armpit surgery or liposuction to remove sweat glands. If your emotions trigger excessive sweating, talk therapy may help reduce this response.

4. Hyperthyroidism

Symptoms

Overactive thyroid, also known as hyperthyroidism, occurs when you have high levels of the thyroid hormone thyroxine. Graves’ disease, an autoimmune disorder, is the most common cause.

Hyperthyroidism develops when antibodies made by your immune system cause your body to make an excess of thyroxine. It can also be caused by thyroid nodules or inflammation (thyroiditis). If your symptoms suggest a thyroid problem, your doctor will order blood tests, a thyroid scan, and a thyroid ultrasound to confirm the diagnosis.

Treating hyperthyroidism

An overactive thyroid can be treated with oral radioactive iodine, anti-thyroid medications, and blood pressure medications called beta-blockers (these can control a fast heart rate). If these treatments don’t work, you may need to have your thyroid gland removed surgically. Once it’s removed, you’ll need to take replacement hormones for the rest of your life.

5. Low blood sugar

Symptoms

  • Sweating
  • Fatigue
  • Confusion
  • Shakiness
  • Fast pulse

Low blood sugar can occur in people with diabetes and is referred to as diabetic hypoglycemia.  You can develop low blood sugar by taking too much medication (such as insulin or some oral treatments) or by changing your diet or activity patterns without adjusting the doses of your medication. Blood sugar can also drop in people with diabetes who become ill.

Low blood sugar causes the body to produce a “fight or flight” response, and the release of epinephrine activates sweat glands, which makes the skin become cold and clammy.

Treating low blood sugar

Eating something sugary, such as juice or a candy bar, will raise your blood sugar. If you use insulin, don’t give yourself another injection; instead, check your blood sugar frequently until it rises and stays up.

Call 911 if these treatments don’t work or if you have any other symptoms, including chest pain, shortness of breath, fever, lightheadedness, or ongoing confusion. Doctors in the ER may treat you with glucose given through an IV and will closely monitor your blood sugar. Lab tests may be ordered to check for other electrolyte problems or another cause of your symptoms (such as a heart attack or infection).

6. Anxiety attack

Symptoms

  • Heart racing
  • Shortness of breath
  • Feeling panic or fear
  • Sweating

If you experience a feeling of intense fear when you’re not in any danger, you may be having an anxiety attack, also referred to as a panic attack. The symptoms usually come on suddenly and go away within a few minutes. Anxiety attacks are caused by inappropriate activation of your body’s “fight or flight” response, which triggers sweating. You can also experience symptoms if you’re actually in serious danger.

It’s important to make sure that there isn’t a medical reason for your anxiety, since it can sometimes be a sign of something serious, such as a heart attack. See your doctor if you experience symptoms of an anxiety attack for more than a few minutes at a time or if attacks occur frequently.

Treating an anxiety attack

If you start to feel overwhelmingly stressed and anxious, try to remove yourself from the source of stress or overstimulation.

Your doctor or mental health professional can recommend treatments, such as cognitive behavioral therapy, to help you control your symptoms and prevent or manage anxiety attacks. In some cases, prescription anti-anxiety medication may be used to prevent or treat panic attacks.

Dr. Rx

It can be tempting to diagnose yourself with an anxiety attack.  But if you’ve never had anxiety before, your doctor will probably want to check for medical conditions that would need specific treatment, like heart attack, infection, or thyroid disease, for example. After eliminating those other possibilities, we can start to figure out how to help manage your anxiety. —Dr. Jacobsen

7. Heart attack

Symptoms

  • Chest pain that’s usually left-sided and feels like pressure
  • Pain that radiates to your jaw, back, or shoulder
  • Shortness of breath
  • Sweating
  • Nausea, sometimes with vomiting
  • Fatigue

Myocardial infarction, or heart attack, is a blockage of the arteries that supply blood to your heart muscle. The blockages develop over time as plaque builds up inside the artery, but the symptoms of a heart attack begin suddenly when the blockage limits blood flow.

Treating a heart attack

A heart attack is a life-threatening emergency, so you should always call 911 if you or someone else is having symptoms of a heart attack.

It is diagnosed with an EKG and blood tests to detect injury to the heart muscle. A chest X-ray may also be ordered to check for other causes of your symptoms.

You may be given aspirin to thin your blood, and you may get a heart catheterization. This is when a surgeon injects a dye into the arteries of your groin or wrist to identify blocked arteries. Balloons or stents can be used to open the blocked arteries. If you have multiple severe blockages, you may need to undergo heart bypass surgery.

8. Anaphylaxis

Symptoms

Anaphylaxis is a severe, life-threatening form of an allergic reaction. Multiple systems in your body react to the allergic trigger. It sometimes occurs when you have a known allergy to a food, medication, or insect sting, but sometimes anaphylaxis happens the first time you’re exposed to a trigger.

Your body responds with a sudden release of chemicals that can cause low blood pressure and fast heart rate. You may become sweaty as your body sends blood away from your skin to your heart, lungs, and brain.

Treating anaphylaxis

You should always call 911 if you develop symptoms of anaphylaxis because it needs to be treated as quickly as possible with a shot of epinephrine. People who have a known allergy may carry an EpiPen to use in this situation, and it should be given while you wait for the ambulance. Other medications can be given by mouth or injection to control your symptoms. You may need oxygen or tubes to help you breathe if you have severe mouth or throat swelling.

9. Heat exhaustion

Symptoms

  • Sweating
  • Cool skin or goosebumps, even if you’re in a warm environment
  • Fatigue
  • Lightheadedness or dizziness
  • Headache
  • Nausea
  • Muscle cramps

Heat exhaustion happens when your body overheats. It usually occurs when the weather is hot and humid and you participate in prolonged or intense physical activity. In these conditions, it’s harder for your body to cool off. Heat cramps, or muscle aches, are a mild heat-related condition that can develop before heat exhaustion.

If heat exhaustion isn’t treated, it can lead to a life-threatening condition called heatstroke, in which your body temperature is over 103℉. If you have heatstroke, you may stop sweating or faint.

Treating heat exhaustion

When it comes to heat illnesses, prevention is better than treatment. If you know you’ll be outdoors in the heat, drink plenty of fluids to stay hydrated, wear lightweight clothing, and take breaks indoors or in the shade.

Try to avoid being outdoors when a heat warning has been issued.  If you develop symptoms of heat exhaustion, stop physical activity and get out of the heat. Cool down by removing your clothing and placing cool, wet towels on your skin. Sipping water or sports drinks is also important. Go to the ER if you don’t feel better within about an hour, your temperature is over 103℉, or if you’re experiencing confusion, fainting, or vomiting.

10. Internal bleeding

Symptoms

  • Weakness
  • Lightheadedness
  • Sweating
  • Pale skin
  • Pain (the location varies depending on where the bleeding is occurring)
  • Nausea or vomiting
  • Shortness of breath

Internal bleeding refers to blood loss that occurs inside of your body and isn’t caused by a cut or an obvious injury. It may occur if you suffered a recent injury, such as a fall or a car accident. It can also be caused by a medical problem, such as a bleeding stomach ulcer, aortic aneurysm, or a ruptured ectopic (tubal) pregnancy.

You may not even realize you have one of these conditions until you develop symptoms of internal bleeding. Blood loss can lead to a fast pulse and low blood pressure, and the body compensates by sending blood to the heart, lungs, and brain and away from your skin.

Treating internal bleeding

Internal bleeding can be life-threatening if left untreated, so call 911 or go to the ER if you develop symptoms. If you had a recent injury and didn’t get medical care right away, you should be examined.

Treatment includes IV fluids and, in some cases, blood transfusion or surgery. Imaging tests like an ultrasound or CT scan may be performed to find the location of the bleeding.

When to see a doctor

Signs you should talk to your doctor for cold and clammy skin include:

  • Experiencing more than one episode of clammy skin that isn’t related to exercise, hot weather, or fever.
  • Excessive sweating that causes your clothing to become soaked or causes embarrassment.
  • Waking up at night in a cold sweat.

Here are some over-the-counter (OTC) options to manage your symptoms:

Antiperspirants for Hyperhidrosis: If excessive sweating is a concern, consider using a clinical-strength antiperspirant. This can help reduce sweat production in areas like hands, feet, and underarms.

Oral Rehydration Solutions: Staying hydrated is key, especially if sweating causes significant fluid loss. Electrolyte-rich drinks can help maintain your body's balance.

Cooling Towels: For immediate relief, especially in hot weather or after exercise, a cooling towel can be very helpful. It’s simple to use and can provide instant cooling.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Jacobsen is a board-certified Emergency Medicine physician and writer for Buoy Health. She received her undergraduate degrees in Chemistry and Biology from Macalester College (2006) and graduated from the University of Kansas School of Medicine (2010). She completed an Emergency Medicine residency program at the University of Missouri-Kansas City (2013). She practices community Emergency Medic...
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