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OVERVIEW

What is Raynaud’s disease?

Raynaud’s disease is a rare condition. It is a temporary narrowing of your blood vessels caused by spasm. The condition affects the blood to your skin, mainly to your fingers and toes. It is sometimes called Raynaud’s phenomenon or syndrome.

SYMPTOMS

What are the symptoms of Raynaud’s disease?

The reduced blood flow causes your skin to turn white or blue. Affected areas may feel cold, numb, or painful. In rare cases, Raynaud’s may affect your nose, ears, nipples, or lips.

Raynaud’s episodes can last several minutes or hours. They can be frequent or spread out.

Certain events or environments may trigger them. The disease may affect one finger or toe or may spread to others. Once it’s over, your skin turns red as the blood rushes back. It may tingle or throb as it warms up again. It can take up to 15 minutes for blood flow to return to normal.

Some people who have Raynaud’s may develop skin sores or infections. These occur over long periods of time or repeat episodes. Few people have long-term tissue damage from the disease.

CAUSES & RISK FACTORS

What causes Raynaud’s?

There are two types of Raynaud’s disease:

Primary Raynaud’s disease is the most common type, making up about 80% of the cases. Primary Raynaud’s occurs when the blood vessels in the hands or feet overreact to stress or cold temperatures. Often, people who have primary Raynaud’s have mild symptoms that can be treated with lifestyle changes.

Secondary Raynaud’s disease is more serious. It may require both medicine and lifestyle changes.  Other health issues can cause this type, including:

• Connective tissue disorders, such as polymyositis/dermatomyositis, rheumatoid arthritis, scleroderma, Sjögren’s syndrome, lupus
• Glandular disorders, such as hypothyroidism
• Blood disorders, such as cold agglutinin disease, Polycythemia vera
• Neoplastic (cell growth) disorders, such as carcinoid syndrome, paraneoplastic syndrome
• Problems that affect the nervous system, such as carpal tunnel syndrome
• Vascular disorders, such as thoracic outlet syndrome
• Artery diseases, such as atherosclerosis (hardening of the arteries), Buerger’s disease, pulmonary hypertension

Some medicines also can trigger Raynaud’s:

• Certain beta blockers used to treat high blood pressure
• Migraine medicines that contain ergotamine
• Medicines that contain estrogen, such as birth control pills
• Chemotherapy medicine, such as cisplatin and vinblastine
• Certain cold medicines that cause blood vessels to narrow, such as those containing pseudoephedrine

Raynaud’s disease affects about 3% to 5% of people. Primary Raynaud’s usually occurs between 15 and 25 years of age. People who have a family history of the disease are at a greater risk. Secondary Raynaud’s occurs later in life, usually in people 30 years of age and older.

DIAGNOSIS & TESTS

How is Raynaud’s diagnosed?

Your healthcare provider may do a physical exam and review your symptoms. Tell your healthcare provider if episodes occur more when you are cold and/or stressed. Your healthcare provider may trigger an episode using cold water or air to see your response. They may also ask if Raynaud’s or related health issues run in your family. Your healthcare provider may check the blood vessels in your fingernails. Blood tests can help identify the type of the disease or other issues that cause your symptoms.

PREVENTION

Can Raynaud’s disease be prevented or avoided?

You cannot avoid Raynaud’s disease. If you have a related health issue, talk to your doctor to see if you have Raynaud’s as well. Other factors that may affect your risk of Reynaud’s include:

• Family history
• Certain medicines (see list above)
• Injuries to your hands or feet
• Living in a colder climate
• Frostbite
• Chemical exposure
• Occupations that involve repetitive motion or vibration (This can damage certain nerves that control blood flow in your body.)

TREATMENT

How is Raynaud’s treated?

Talk to your healthcare provider about treatment options. They vary based on your type of Raynaud’s and overall health. Certain lifestyle changes may reduce episodes and symptoms. Try to:

• Reduce exposure to cold or temperature extremes, such as going outdoors in winter or removing items from a freezer.
• Wear extra warm clothing to protect yourself from the cold.
• Quit smoking.
• Limit caffeine and alcohol.
• Exercise to increase blood flow, especially for primary Raynaud’s disease.
• Avoid wearing clothing or jewelry that is too tight.
• People who have secondary Raynaud’s, intense symptoms, and/or frequent episodes may need medicine. Types of medicines that can help include:
• Certain calcium channel blockers (These medicines relax the small blood vessels so they can open up again They also help reduce the frequency and length of episodes.)
• Alpha blockers can be helpful. (They block a hormone called epinephrine that constricts blood vessels).
• Medicine that helps blood cells flow through small channels better,
• ACE inhibitors
• Intravenous (IV) prostaglandins

For symptoms that can’t be controlled using these methods, talk to your healthcare provider about new medicines that may help. They may be able to inject medicine in the affected area. This can help block the nerves that trigger the blood vessel changes. You may need this treatment more than once.

Severe episodes (complete lack of blood flow) can lead to losing a finger or toe. Surgery can improve blood flow to your fingers and toes or block certain nerves. In rare cases, the doctor may need to remove damaged or destroyed tissue.

 Living with Raynaud’s disease

There is no cure for Raynaud’s disease. Both types are lifelong conditions. Research is underway to improve diagnosis and treatment. Lifestyle changes and other treatment help to manage your symptoms. If a health issue is causing secondary Raynaud’s, you will need treatment for that condition as well. Below are tips on how best to cope with Raynaud’s episodes.

• Get warm: Move inside if it’s cold outside or move to warmer place. Warm your hands or feet with warm water or chemical warmers. These are small packets that you can put in your gloves, pockets, or shoes.
• Move around: Wiggle your fingers and toes. Move your arms in wide circles.
• Promote blood flow. Massage your fingers and toes.
• De-stress.