What is Raynaud's phenomenon?
Raynaud’s phenomenon (also called Raynaud’s disease, Raynaud’s syndrome or Raynaud’s) is a disorder that affects the blood vessels in your fingers and toes. It can also involve blood vessels in your nose, lips and ear lobes.
Patients with Raynaud’s have spasms, called vasospastic attacks. When these spasms happen, small blood vessels in the fingers and toes get tighter. When this happens, there is less blood flow to those areas, and they turn white or blue and get cold and numb. The spasms can be caused by cold temperatures, stress and working with hand tools that vibrate.
There are two types of Raynaud’s: Primary, which means it happens on its own, and secondary, which means it is related to another medical condition.
How common is Raynaud's?
Three to five percent of Americans have Raynaud’s. The most common type is primary. The condition is more common in women. It is also more common among people who live in colder climates. But, people with Raynaud’s who live in mild climates may have more attacks during colder weather. About 25% of people with Raynaud’s have a family history of the condition.
Symptoms of Raynaud's
Patients with Raynaud’s may have three stages of skin color changes: white (pallor), blue (cyanosis) and red (rubor). The changes can happen in any order, and not everyone with Raynaud’s has all three changes.
- When skin turns white, it may be caused by a collapse of the arteries in an affected body part.
- When skin turns blue, it means the fingers or toes are not getting enough oxygen-rich blood. The affected body parts can also feel cold and numb.
- When skin turns red, it means the blood is returning to the affected areas.
- A Raynaud’s attack can last less than a minute to several hours. After an attack is over, the affected body parts may throb and tingle.
What causes Raynaud's?
Primary Raynaud's Phenomenon
Patients with primary Raynaud’s do not have other diseases or medical problems that can cause Raynaud’s symptoms. Most patients (75%) with primary Raynaud’s are women between the ages of 15 and 40.
Secondary Raynaud's Phenomenon
Secondary Raynaud’s phenomenon is less common, but often more serious, than primary Raynaud’s. Patients with this type of Raynaud’s have another medical condition that causes Raynaud’s symptoms. Most patients (85% - 95%) with scleroderma (a connective tissue disease) also have secondary Raynaud’s. The condition also affects about one-third of patients with lupus.
Other possible causes of secondary Raynaud’s include:
- Using vibrating tools or repeated pounding with the palm of the hand.
- Carpal tunnel syndrome.
- Obstructive arterial disease (blood vessel disease).
- Medications that affect your blood flow.
- Thyroid disorders.
How is Raynaud's diagnosed?
Raynaud’s is often easily diagnosed. But, it may be more difficult to figure out what is causing it. If your doctor thinks you may have Raynaud’s, you will have a complete physical exam and your doctor will review your medical history to rule out other medical problems.
Doctors often test the tiny blood vessels in your nail to help make a diagnosis. This involves putting a drop of oil on the skin at the base of your fingernail and looking at the area with a microscope or a hand-held tool. Larger-than-normal blood vessels can be a sign of a connective tissue disease.
Your doctor may also order blood or urine tests to get more information about the type of Raynaud’s you have and to find out the cause.
What treatment options are available for patients with Raynaud's?
Treatment for Raynaud’s is meant to prevent tissue damage and limit the number and intensity of the attacks you have. It is important to:
- Take action during an attack: Do not ignore a Raynaud’s attack. Taking action can reduce the length and severity of the attack. The first and most important thing you can do is to warm your hands and feet. If you are in cold weather, go indoors. Run warm water over your fingers and toes or soak them in a bowl of warm water. It is also helpful to relax. Ask your doctor about relaxation techniques you can practice.
- Keep warm: It is important to keep your whole body warm. If you go out in the cold, dress in several layers of loose clothing. Wear a hat and gloves or mittens. Much of your body heat is lost through your scalp, so a hat will help keep you warm. Use warmers in your pockets, mittens, boots or shoes. Other tips to stay warm: Don’t touch cold metals. Don’t put your hands in cold water or hold iced drinks. Avoid air-conditioned rooms and the frozen food sections of grocery stores as much as possible.
- Practice good skin care: Prevent dry and cracked skin by using moisturizer or hand cream, especially after washing your hands.
- If you smoke, quit: Nicotine causes your skin temperature to drop and blood vessels to constrict, which may cause an attack.
- Learn to manage stress: Stress may cause an attack, especially if you have primary Raynaud’s. Learn to recognize and avoid stressful situations as much as possible. Relaxation and biofeedback exercises can help reduce the number and severity of attacks you have.
- Exercise: Regular exercise helps your overall well-being, increases your energy level, helps control weight and helps you sleep better. If you have secondary Raynaud’s, talk to your doctor about how to safely exercise outdoors in cold weather. Talk to your doctor before you start any exercise program.
- See your doctor: See your doctor if you are worried or scared about attacks or if you have questions about caring for yourself. It is important to see your doctor if you have attacks on only one side of the body (one hand or one foot) or if an attack causes any sores on your fingers or toes.
- Medications: Your doctor may talk to you about medications that can help control your Raynaud’s attacks and/or heal problems caused by the condition.
If you do start medication, it is important to see your doctor for regular follow-up visits to see how well the medication is working.
