What is Raynaud’s phenomenon?
Raynaud’s phenomenon (also called Raynaud’s disease or Raynaud’s syndrome) is a disorder that affects the blood vessels in the fingers and toes. Blood vessels in the nose, lips or ear lobes may also be affected.
This disorder is characterized by episodic spasms, called vasospastic attacks, which cause the small blood vessels in the fingers and toes to constrict (tighten or close) in response to temperature extremes, certain occupational exposures, or excitement. With Raynaud’s, the skin on the affected areas becomes white or bluish and cold or numb.
Raynaud’s phenomenon can occur on its own (primary Raynaud’s phenomenon), or it can be related to another medical condition (secondary Raynaud’s phenomenon).
Primary Raynaud’s Phenomenon
Also known as Raynaud’s disease, primary Raynaud’s phenomenon is the most common and the milder of the two types. A person who has primary Raynaud’s has no other diseases or associated medical problems that may cause Raynaud’s symptoms. About 75 percent of all cases of primary Raynaud’s phenomenon are diagnosed in women between ages 15 and 40. People with the primary form rarely develop the other diseases associated with Raynaud’s such as lupus or scleroderma.
Secondary Raynaud’s Phenomenon
Less common than the primary form, however, secondary Raynaud’s phenomenon is often a more serious disorder. Secondary Raynaud’s is caused by an underlying disease or condition. It is especially common in people with connective tissue diseases. Some of these diseases reduce blood flow to the fingers and toes by causing the blood vessel walls to thicken and the vessels to constrict too easily. Raynaud’s phenomenon occurs in about 85 to 95 percent of patients with scleroderma and is present in about one-third of patients with systemic lupus erythematosus (lupus). Raynaud’s also can occur in patients who have other connective tissue diseases, including Sjögren’s syndrome, dermatomyositis and polymyositis.
Other possible causes of secondary Raynaud’s phenomenon include:
- Traumatic vasospasm from vibrating tools or repeated pounding with the palm of the hand (hyothenar hammer syndrome)
- Carpal tunnel syndrome
- Obstructive arterial disease (blood vessel disease)
- Some medications, including beta-blockers, ergotamine preparations, certain chemotherapy drugs, and those that cause vasoconstriction (such as some over-the-counter cold medications and narcotics)
- Thyroid disorders
Who is affected by Raynaud’s?
Although estimates vary, recent surveys show that Raynaud’s phenomenon may affect 3 to 5 percent of the general population in the United States. Women are more likely than men to have the disorder. Raynaud’s phenomenon also appears to be more common in people who live in colder climates. However, people with the disorder who live in mild climates may have more attacks during colder weather. About 25 percent of people with Raynaud’s have a family history of the condition.
What causes Raynaud’s?
An attack of Raynaud’s is usually triggered by exposure to cold or emotional stress.
Under normal circumstances, when a person is exposed to cold, his or her body’s response is to slow the loss of heat. The body does this by causing the blood vessels that control blood flow to the skin’s surface to move blood from the surface arteries to veins deeper in the body.
For people who have Raynaud’s, however, this normal body response is intensified by contractions of the small blood vessels that supply blood to the fingers and toes.
In some cases, this causes the arteries of the fingers and toes to collapse or constrict. The result is a greatly decreased supply of blood to the affected body areas, causing skin discoloration.
Symptoms of Raynaud's
A person with Raynaud's phenomenon can experience three phases of skin color changes: white (pallor), blue (cyanosis) and red (rubor). There is not a set order to the changes in skin color and not all people experience all three skin colorations.
- Pallor (whiteness) may occur in response to the collapse of the arteries in an affected body part.
- Cyanosis (blueness) appears because the fingers or toes are not getting enough oxygen-rich blood. Other symptoms that occur during cyanosis are feeling cold and numbness.
- Rubor (redness) occurs as the blood returns to the affected areas. After an attack is over, throbbing and tingling may occur in the fingers and toes. Attacks of Raynaud's Phenomenon can last from less than a minute to several hours.