What is Raynaud’s Phenomenon?
Raynaud’s phenomenon is a condition where blood flow to your fingers, toes, ears or nose is restricted or interrupted. This occurs when the blood vessels in your hands or feet constrict. Episodes of constriction are called vasospasms.
Cold temperatures and emotional stress can trigger episodes of Raynaud’s phenomenon.
Raynaud’s phenomenon can accompany underlying medical conditions. It can also occur on its own. Vasospasm episodes that are provoked by other conditions like arthritis, frostbite, or autoimmune disease are called secondary Raynaud’s. People who experience Raynaud’s and are otherwise healthy are said to have primary Raynaud’s.
Who Gets Raynaud’s Phenomenon?
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), women are more likely than men to develop Raynaud’s phenomenon. Young adults between the ages of 15 and 25 have an increased risk of the primary form of the condition. The onset of secondary Raynaud’s is more common in adults in their 30s and 40s. Those who live in colder geographic regions are more likely to be affected by Raynaud’s phenomenon than inhabitants of warmer climates (NIAMS).
Secondary Raynaud’s is usually related to medical conditions affecting the blood vessels or connective tissue, such as:
- atherosclerosis—hardening of the arteries
- use of medications and drugs that narrow the arteries, such as beta blockers and amphetamines
- autoimmune conditions, such as lupus, scleroderma, rheumatoid arthritis, and Sjogren’s disease
Symptoms of Raynaud’s Phenomenon
The most common symptom of Raynaud’s phenomenon is discoloration of the fingers, toes, ears, or nose. When the blood vessels carrying blood to your extremities become blocked, the affected areas turn white and feel cold. You may have a dulled sense of touch. The skin may also take on a blue tinge.
People with primary Raynaud’s usually feel a drop in body temperature in the affected region, but little pain. Those who have the secondary form of the condition often experience pain, numbness, and tingling in the fingers or toes. Episodes may last a few minutes or up to several hours.
When the vasospasm is over, your fingers and toes may throb and appear red. The rewarming process begins after circulation improves. Your fingers and toes may not feel warm for 15 minutes or more after circulated is restored.
Individuals with primary Raynaud’s may find that the same fingers or toes on each side of the body are affected at the same time. Those with the secondary form may have symptoms on one or both sides of the body. No two vasospasm episodes are exactly alike, even in the same person.
Common triggers of Raynaud’s symptoms include:
- chilly temperatures
- emotional stress
- working with hand tools that emit vibrations
Construction workers who use jackhammers, for example, may have an increased risk of vasospasm. However, not everyone with the condition will have the same triggers. It is important to pay attention to your body, and learn what your triggers are.
Diagnosing Raynaud’s Phenomenon
Your doctor will perform a physical exam, take your medical history, and perform blood work to diagnose Raynaud’s phenomenon. He or she will ask you about your symptoms and may request a microscopic examination of the nail folds near your fingernails to determine if you have primary or secondary Raynaud’s. This procedure is called capillaroscopy.
According to the Mayo Clinic, people with secondary Raynaud’s often have enlarged, disorganized patterns of blood vessels as well as loss of blood vessels and capillary loops in the nail folds (Mayo Clinic). This is in contrast to primary Reynaud’s where there is an orderly, normal appearing array of capillaries present when vasospasm is not occurring.
Blood tests can reveal whether or not you test positive for antinuclear antibodies (ANA). The presence of ANAs can mean you are more likely to experience autoimmune or connective tissue disorders. Such conditions put you at risk for secondary Raynaud’s.
Coping with a Raynaud’s Phenomenon Attack
If you have an attack, it is important to keep yourself warm. To help cope with an attack, you can:
- Cover your hands or feet with socks or gloves.
- Get out of the cold and re-warm your entire body
- Run your hands or feet under lukewarm water.
- Massage your extremities.
Staying calm can help reduce the severity of an attack. Try to remain as relaxed and stress-free as possible. It may help to physically remove yourself from stressful situations. Concentrating on your breathing can also help you calm down.
Treating Raynaud’s Phenomenon
Lifestyle changes are a large part of the treatment process for Raynaud’s phenomenon. Avoiding substances that cause the blood vessels to constrict is the first-line of treatment. This includes avoiding caffeine and nicotine products.
Staying warm and exercising can also prevent or reduce the intensity of some attacks. Exercise is particularly good for promoting circulation and managing stress.
Your doctor may prescribe medication if you have frequent, long-lasting, or intense vasospasm episodes. Drugs that cause vasodilation help your blood vessels relax. These include:
- anti-hypertension medications
- erectile dysfunction drugs
Some medications can also make your condition worse because they constrict blood vessels. Examples include:
- beta blockers
- estrogen-based drugs
- migraine medicines
- birth control pills
- pseudoephedrine-based cold medicines
Outlook for Patients With Raynaud’s
Outlook for people with Raynaud’s phenomenon varies according to their overall health. Secondary Raynaud’s is much more of a concern over the long-term than the primary form. People who have secondary Raynaud’s are more likely to suffer from infection, skin ulcers, and gangrene (NIAMS).