Definition

Raynaud phenomenon is a problem with the blood vessels. It causes blood flow problems to the fingers ears, nose, and lips.

Constriction of Blood Vessels

Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Primary Raynaud phenomenon is the most common form. It is not linked to another medical issue.

Secondary Raynaud phenomenon is linked to another disease. It is most often linked to systemic scleroris, a joint disease, blood disorder, or blocked arteries.

Causes

Blood vessels should narrow with cold temperatures or emotional stress. In Raynaud, the blood vessels narrow too much. Blood flow to tissue past this area is severely slowed. Fingers are affected most often.

The exact cause of this overreation is not known. Primary Raynaud may be caused by a problem of the nervous system. Secondary Raynaud is thought to be caused by the linked disease.

Risk

Raynaud is more common in females. It tends to show between ages 15 to 40 years old. Factors that may increase your chance of Raynaud include:

  • Activities that involve repeated stress to hands such as:
    • Typing
    • Playing piano
    • Regular operation of vibrating tools, as in construction
    • Exposure to certain chemicals
  • A connective tissue disease, such as scleroderma
  • Diseases of the arteries, including atherosclerosis
  • Injury of the hands or feet, such as wrist fractures or frostbite
  • Smoking
  • Certain medications, such as:
    • Beta-blockers
    • Cancer chemotherapy
    • Cold remedies
    • Migraine medications containing ergotamine
    • Estrogen-containing medications

Symptoms

Raynaud symptoms occur in attacks. They may last a few minutes to a few hours. It is often a reaction to cold or emotional distress. During an attack, symptoms may include:

  • Change in skin color to white then to blue—as blood flow is slowed
  • Skin color change to red once blood is flowing again
  • Throbbing and tingling sensations, stinging, pain, and swelling of the area—at the end of the attack as blood flow returns

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. Tests may include:

  • Nailfold capillaroscopy—study of the small blood vessels under a microscope
  • Thermography—scan that reads temperature on body
  • Blood tests—to help distinguish between Primary and Secondary Raynaud

Treatment

Treatment can lower the number of attacks. It may also decrease how severe they are. Treating the related medical issue will help to manage secondary Raynaud.

Other steps for primary or secondary include:

Home care

Home care steps can help to ease symptoms during an attack:

  • Warm (not hot) water can be run over fingers and toes. Avoid hot water or wrap. It can cause damage to skin.
  • Move inside, out of cold areas.
  • Use of warm areas of the body to warm hands. Armpits or belly are good choices.
  • Movement can help to encourage blood flow. May be as small as wiggling fingers or toes or wide circles with arms.

Steps can also help to prevent attacks:

Medicine

Medicine may help to ease symptoms that do not respond to home care. Blood vessel size can be increased with one of the following:

  • Calcium channel blockers
  • Alpha-blockers
  • Vasodilators:
    • PDE5 inhibitors
    • IV prostanoids

Medicine that is causing problems may need to be stopped or switched.

Nerve procedures

Nerves control the size of blood vessels. Procedures to destroy or stop the nerves may be needed if other steps have not worked. Options include:

  • Chemical injection—chemical stops nerves from working well.
  • Surgery—nerves are cut. Not a common treatment step.

Prevention

There are no current guidelines for preventing Raynaud phenomenon.