Raynaud’s Syndrome

Raynaud’s (pronounced "ray-nodes") syndrome is a common disorder that restricts blood flow to your fingers and toes. It may also affect blood vessels in your nose, lips or ear lobes. Raynaud’s causes episodic spasms (vasospastic attacks) in response to cold temperatures or stress.

During a Raynaud’s attack, the small blood vessels in your fingers and toes tighten more than they should. As a result, the affected skin turns white and then sometimes blue. This color change happens because your blood lacks oxygen. Your skin may also feel cold or numb. As your blood vessels relax and open again, your skin may look red or feel tingly.

What is the difference between Raynaud’s disease, Raynaud’s phenomenon and Raynaud’s syndrome?

There are two main types of Raynaud’s — primary (Raynaud’s disease) and secondary (Raynaud’s phenomenon.) Most people use all of these terms to describe either type. But experts use them to set apart the types.

• Raynaud’s disease (primary Raynaud’s): Occurs on its own and isn’t connected with another disease or condition
• Raynaud’s phenomenon (secondary Raynaud’s): Occurs due to an underlying condition, medication or lifestyle factor
• Raynaud’s syndrome: Refers to either primary or secondary Raynaud’s

Symptoms of Raynaud’s

A typical episode, or attack, lasts 20 minutes. But attacks may be shorter or longer. Symptoms are usually mild in people with primary Raynaud’s, but more severe for people with Raynaud’s phenomenon.

Raynaud’s symptoms affect your skin and may include:

• Color changes: As blood flow stops and then returns, your skin color may change from white to blue to red. You may not experience all three changes in skin color. It’s common for the skin to change to only one or two of these colors.
• Coldness or numbness: This happens when your finger or other affected body part isn’t receiving oxygen-rich blood. It feels like that part of your body has “fallen asleep.”
• Warmth, tingling or throbbing: This happens as blood flow returns to your affected body part.

Raynaud’s causes

Primary Raynaud’s syndrome has no clear underlying cause.

Secondary Raynaud’s syndrome (Raynaud’s phenomenon) causes include:

• Buerger’s disease
• Cancer
• Carpal tunnel syndrome
• Connective tissue diseases, which may reduce blood flow to your fingers and toes
• CREST syndrome
• Frostbite
• Repetitive motions (like from playing piano or using vibrating tools)
• Medications, like chemotherapy, beta-blockers and various stimulants
• Hypothyroidism
• Peripheral artery disease
• Pulmonary hypertension
• Thoracic outlet syndrome
• Vasculitis

Risk factors

Primary Raynaud’s syndrome usually affects:

• Females
• People under age 30, often starting in the teenage years
• People who have a history of Raynaud’s in their biological family

Secondary Raynaud’s (Raynaud’s phenomenon) risk factors include:

• Having another disease or condition
• Having a job that puts repetitive pressure on your hands

How to lower your risk

You can’t prevent Raynaud’s syndrome. But with lifestyle changes, like avoiding tobacco products, you can prevent some of the conditions that cause it.

You can help prevent attacks by learning your triggers (like anxiety or cold places) and taking action to avoid them. Also, ask your healthcare provider if any of your current medications could cause your condition to flare up.

It’s also important to visit your provider for yearly checkups. Doing so can help your provider diagnose and treat underlying conditions that may cause Raynaud’s phenomenon.

Complications

Complications of Raynaud’s may include:

• Pain in your toes or fingers
• Sores (skin ulcers) on your fingertips
• Tissue death (gangrene) from lack of oxygen to tissues (rare)
• Problems from an underlying condition

How doctors diagnose Raynaud’s

Healthcare providers can usually diagnose Raynaud’s from your symptoms. Your provider may ask you to take photos of your skin changes when they happen. They may also perform a physical exam and talk with you about your medical and family history.

Raynaud’s is typically easy to diagnose. But the type you have may not be obvious. That’s where testing, like nail fold capillaroscopy, can help. This involves looking at the base (nail fold) of your fingernail under a microscope. If your capillaries in the area are enlarged or abnormal, you may have a connective tissue disease. This could mean you have Raynaud’s phenomenon.

Other tests your provider may order include:

• Antinuclear antibody (ANA) test: Blood test that checks for autoimmune disorders
• Thyroid stimulating hormone (TSH) test: Blood test that checks for hypothyroidism
• Complete blood count (CBC): Blood test that checks for a range of conditions
• Erythrocyte sedimentation rate (ESR) test: Blood test that detects inflammation in your body and helps diagnose rheumatoid, autoimmune and other disorders
• Urinalysis: Urine test that checks for a range of conditions
• Pulse volume recording: Noninvasive test that checks blood flow in your arms and legs
• Rheumatoid factor (RF) test: Blood test that checks for autoimmune disorders

How is it treated?

Raynaud’s treatment depends on whether you have the primary or secondary form and its severity. For many people (including children), lifestyle changes are enough to manage the condition.

Your healthcare provider will help you prevent attacks and reduce their severity. They’ll also help you prevent skin ulcers and tissue damage. Raynaud’s phenomenon treatment involves caring for the underlying disease or condition.

Raynaud’s syndrome treatments include:

• Changes to daily habits: It may help to avoid cold spaces, avoid touching cold objects, manage stress and wear warm clothes.
• Medications: Your provider may recommend taking calcium channel blockers or medications that block alpha receptors. They may suggest using nitroglycerin skin ointment.
• Procedures: A sympathectomy can keep tiny nerves from sending signals that make your blood vessels get too narrow. Some people need surgery to remove dead tissue.

When should I see my healthcare provider?

If your child or teen starts to have symptoms of primary Raynaud’s disease, take them to see their healthcare provider. They may want to run tests to rule out an underlying condition.

Call your provider if you:

• Have attacks that occur on just one side of your body
• Have sores or ulcers on your fingers or toes
• Lose function in the affected hand or foot
• Notice new or worsening symptoms
• Have side effects from medications

You may want to ask your provider these questions:

• Which type of Raynaud’s do I have?
• How quickly can changing daily habits improve my symptoms?
• What’s the treatment for the disease that’s causing Raynaud’s?

What can I expect if I have Raynaud’s?

Primary Raynaud’s syndrome may disrupt some of your daily activities, but it’s not dangerous. It doesn’t damage your blood vessels. For most people with this type, the outlook is positive. Symptoms may bother you off and on, but the condition isn’t serious or life-threatening.

Secondary Raynaud’s syndrome can be more serious. It may lead to skin ulcers and, rarely, tissue death (gangrene). It may also impact your quality of life. Your outlook depends on the underlying disease, which may be severe in and of itself. Talk with your provider about what you can expect and how to manage Raynaud’s phenomenon.

Is there anything I can do to feel better?

Self-care is essential for managing Raynaud’s syndrome. If an attack happens, warm up by going to a warmer space, moving your arms in circles or running warm water over your fingers or toes. Meditation or deep breathing may also help.

The following tips can also help you avoid Raynaud’s triggers:

• Avoid caffeine and tobacco products.
• Avoid touching cold metals or putting your hands in cold water. Use a beverage holder to hold cold drinks and oven mitts to reach into the freezer.
• Get regular physical activity to improve your overall well-being. Check with your provider before starting.
• Keep your whole body warm, but especially your hands, feet and head. Wear several layers of loose clothing. Don’t forget mittens (warmer than gloves) and a hat.
• Learn new ways to manage stress.
• Limit the use of tools (like jackhammers) that vibrate.
• Limit your time in air conditioning and in cold spaces.
• Practice good skin care. Apply lotion to prevent dry or cracked skin.
• Wear wicking fabrics when you’re physically active to move sweat away from your skin.