What is Raynaud Phenomenon

Raynaud phenomenon is a condition that affects the blood vessels (arteries) that carry blood to your fingers and toes. The arteries that supply blood to your ears, lips, nipples, or the tip of your nose might also be affected.

Raynaud phenomenon causes the arteries to become narrow temporarily (spasm). As a result, the flow of blood to the affected areas is temporarily decreased. This usually occurs in response to cold temperatures or stress.

During an attack, the skin in the affected areas turns white, then blue, and finally red. You may also feel tingling or numbness in those areas.

Attacks usually last for only a brief period, and then the blood flow to the area returns to normal. In most cases, Raynaud phenomenon does not cause serious health problems.

What are the causes?

In many cases, the cause of this condition is not known. The condition may occur on its own (primary Raynaud phenomenon) or may be associated with other diseases or factors (secondary Raynaud phenomenon).

Possible causes may include:

• Diseases or medical conditions that damage the arteries.
• Injuries and repetitive actions that hurt the hands or feet.
• Being exposed to certain chemicals.
• Taking medicines that narrow the arteries.
• Other medical conditions, such as lupus, scleroderma, rheumatoid arthritis, thyroid problems, blood disorders, Sjogren syndrome, or atherosclerosis.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Being 20–40 years old.
• Being female.
• Having a family history of Raynaud phenomenon.
• Living in a cold climate.
• Smoking.

What are the signs or symptoms?

Symptoms of this condition usually occur when you are exposed to cold temperatures or when you have emotional stress. The symptoms may last for a few minutes or up to several hours. They usually affect your fingers but may also affect your toes, nipples, lips, ears, or the tip of your nose. Symptoms may include:

• Changes in skin color. The skin in the affected areas will turn pale or white. The skin may then change from white to bluish to red as normal blood flow returns to the area.
• Numbness, tingling, or pain in the affected areas.

In severe cases, symptoms may include:

• Skin sores.
• Tissues decaying and dying (gangrene).

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam. During the exam, you may be asked to put your hands in cold water to check for a reaction to cold temperature.
• Tests, such as:
  • Blood tests to check for other diseases or conditions.
  • A test to check the movement of blood through your arteries and veins (vascular ultrasound).
  • A test in which the skin at the base of your fingernail is examined under a microscope (nailfold capillaroscopy).

How is this treated?

Treatment for this condition often involves making lifestyle changes and taking steps to control your exposure to cold temperatures. For more severe cases, medicine (calcium channel blockers) may be used to improve blood flow. Surgery is sometimes done to block the nerves that control the affected arteries, but this is rare.

Follow these instructions at home:

Avoiding cold temperatures

Take these steps to avoid exposure to cold:

• If possible, stay indoors during cold weather.
• When you go outside during cold weather, dress in layers and wear mittens, a hat, a scarf, and warm footwear.
• Wear mittens or gloves when handling ice or frozen food.
• Use holders for glasses or cans containing cold drinks.
• Let warm water run for a while before taking a shower or bath.
• Warm up the car before driving in cold weather.

Lifestyle

• If possible, avoid stressful and emotional situations. Try to find ways to manage your stress, such as:
  • Exercise.
  • Yoga.
  • Meditation.
  • Biofeedback.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Avoid secondhand smoke.
• Limit your use of caffeine.
  • Switch to decaffeinated coffee, tea, and soda.
  • Avoid chocolate.
• Avoid vibrating tools and machinery.

General instructions

• Protect your hands and feet from injuries, cuts, or bruises.
• Avoid wearing tight rings or wristbands.
• Wear loose fitting socks and comfortable, roomy shoes.
• Take over-the-counter and prescription medicines only as told by your health care provider.

Contact a health care provider if:

• Your discomfort becomes worse despite lifestyle changes.
• You develop sores on your fingers or toes that do not heal.
• Your fingers or toes turn black.
• You have breaks in the skin on your fingers or toes.
• You have a fever.
• You have pain or swelling in your joints.
• You have a rash.
• Your symptoms occur on only one side of your body.

Summary

• Raynaud phenomenon is a condition that affects the arteries that carry blood to your fingers, toes, ears, lips, nipples, or the tip of your nose.
• In many cases, the cause of this condition is not known.
• Symptoms of this condition include changes in skin color, and numbness and tingling of the affected area.
• Treatment for this condition includes lifestyle changes, reducing exposure to cold temperatures, and using medicines for severe cases of the condition.
• Contact your health care provider if your condition worsens despite treatment.