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Raynaud's phenomenon

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Fast facts

What is Raynaud's phenomenon?

The body's normal response to cold exposure is to reduce the blood flow to the extremities. Raynaud's phenomenon is a disorder in which the body over-reacts to cold conditions. Small muscles in the arteries that supply the fingers and other extremities to suddenly constrict. This temporarily cuts off the blood supply to these areas.

In some people, Raynaud's can also be caused by stress or emotional upset.

Causes

In most cases, Raynaud's phenomenon has no underlying cause. This is also known as primary Raynaud's disease.

When it occurs because of an underlying medical condition, this is known as secondary Raynaud's phenomenon. This is more likely to develop after 30 years of age, and can be more serious.

A wide range of factors have been linked to an increased risk of Raynaud's phenomenon.

Underlying medical conditions can include:

Injuries that can increase the risk include:

Medications and substances that can increase the risk include:

Risk factors

For primary Raynaud's disease, risk factors include:

  • Being aged between 15-30 years old, although Raynaud's can develop at any point in life;
  • Being female - women are at an increased risk;
  • Cold, wet weather and climate, and;
  • Having a family history of primary Raynaud's disease.

For secondary Raynaud's disease, risk factors include:

  • Having an underlying medical condition associated with Raynaud's disease;
  • Smoking;
  • Some medications (as noted above in 'Causes'), and;
  • Using heavy vibrating equipment.

Signs and symptoms

Most commonly, Raynaud's phenomenon affects the fingers, with symptoms usually starting in one finger before appearing in the others.

Other parts of the body that are more rarely affected include the toes, ears, nose, nipples, face, lips and tongue.

The skin of the affected areas generally changes color over the course of an 'attack' of Raynaud's phenomenon. Initially, the area goes white as blood flow reduces to the area and then the skin can turn blue or purple. Finally, as blood flow returns, usually after 15-20 minutes, the skin becomes red.

As blood flow returns, other symptoms in the affected areas include:

The fingers are commonly affected by Raynaud's phenomenon. 

Methods for diagnosis

To diagnose Raynaud's phenomenon, your doctor will perform a physical examination and ask you questions about your symptoms.

It is important to rule out other causes for the symptoms and identify any underlying causes for Raynaud's phenomenon, and tests may be recommended for this reason.

Tests that can help to identify autoimmune disorders include:

A blood test can be used to identify if an underlying medical condition is causing Raynaud's phenomenon. 

Types of treatment

The most effective way to manage Raynaud's phenomenon is to take steps to prevent attacks from occurring.

Learning what triggers your attacks is a good first step. For some people, an attack may occur only during cold weather, while for others it may be exposure to relatively small changes in temperature, such as when entering an air-conditioned building when it is hot outside, or handling frozen items out of the freezer.

Steps to avoid triggers include:

The link between caffeine and Raynaud's phenomenon is not clear. Some experts recommend avoiding coffee, while others do not. If you find that drinking coffee appears to trigger attacks, you may wish to avoid it.

Wearing warm clothing can help to avoid attacks of Raynaud's phenomenon. 

Managing Raynaud's attacks

To encourage the blood vessels to open up and blood flow to return to the affected areas, it is best to try to warm them gradually.

You can:

Medications

If the symptoms of Raynaud's phenomenon cannot be managed well with the measures above, medications may be recommended.

The most common medications are calcium-channel blockers, such as nifedipine or amlodipine, which help to relax the muscle cells in arteries and open them up.

If these are not effective, other medications may be substituted, or added to help open up the arteries. These can include:

Stress management

It is not clear whether psychological treatment is effective for treating Raynaud's attacks. If stress or emotional upset trigger Raynaud's attacks, counselling or using relaxation techniques may be helpful.

More intensive treatment

For people with severe symptoms, or complications such as ulcers, more intensive treatment may be required. This usually only occurs in people who have serious underlying medical conditions such as scleroderma.

More intensive treatments include:

Complementary and alternative medicines

A range of complementary therapies such as acupuncture, biofeedback, wearing therapeutic gloves, or various herbs such as Ginkgo biloba, have been suggested for treating Raynaud's phenomenon, but there is currently not enough evidence to support the effectiveness of any of these therapies.

Potential complications

Primary Raynaud's disease is normally a minor complaint; complications are extremely rare.

In severe secondary Raynaud's disease, if blood flow cannot be restored to the affected area (usually the fingers or toes) this can lead to ulceration and gangrene.

If this cannot be managed with more intensive treatments, amputation of the affected area may be necessary.

Prognosis

Most people who have Raynaud's attacks have the less serious primary form that can be managed well by avoiding triggers. In some cases, the symptoms will improve over time, with women often finding that symptoms noticeably reduce with menopause. However, some people have lifelong symptoms.

Secondary Raynaud's disease can be much more serious and may require more intensive treatment. It can lead to ulceration and, in very severe cases, may require amputation.

Prevention

If you have Raynaud's attacks, learning about your triggers and avoiding them can help to reduce your symptoms.

9 Most frequently asked questions (FAQs)

What is Raynaud's phenomenon?
Raynaud's phenomenon is a disorder in which blood vessels suddenly narrow, temporarily cutting off blood supply to the fingers or other extremities, such as the toes, lips, nose, tongue, ears and nipples.
What are the symptoms of Raynaud's phenomenon?
Most commonly the affected areas, such as the fingers, change color to white and then to blue/purple and finally to red as blood flow returns. Numbness, tingling, pins and needles, pain and discomfort can also occur as blood flow returns.
What causes Raynaud's phenomenon?
In many cases, there is no underlying cause for Raynaud's phenomenon; rather, it is thought to be caused by an exaggerated response of the blood vessels to cold temperatures or stress. In some cases, it can occur due to underlying medical conditions, exposure to certain medications and chemicals, or injury.
Who gets Raynaud's phenomenon?
Anyone can get Raynaud's phenomenon, although it most commonly develops in the late teens or 20s. Women are more likely to be diagnosed with the condition.
How is Raynaud's phenomenon diagnosed?
There is no single test for Raynaud's phenomenon. A doctor will examine affected areas and ask about your symptoms in order to diagnose it. Further tests may be recommended if there is concern that an underlying medical condition may be causing the symptoms.
How is Raynaud's phenomenon treated?
In most cases, Raynaud's phenomenon is treated by learning about your personal triggers for an attack and avoiding them. Gently warming an affected area during an attack can help to restore blood flow. Rarely, further treatments such as medications or surgery may be required in severe cases.
Can Raynaud's phenomenon be cured?
Raynaud's phenomenon cannot be cured, but symptoms can be managed and attacks can be limited by avoiding known triggers.
Will Raynaud's phenomenon clear on its own?
For some people, Raynaud's phenomenon will become less of a problem over time. Women may find that it improves at menopause. If Raynaud's phenomenon is caused by an underlying medical condition, it is more likely to be severe and require ongoing treatment and management.
Is Raynaud's phenomenon serious?
Most people who have Raynaud's attacks have the less serious primary form that can be managed well by avoiding triggers. In some cases, the symptoms will improve over time, with women often finding that symptoms noticeably reduce with menopause. However, some people have lifelong symptoms. Secondary Raynaud's disease can be much more serious and may require more intensive treatment. It can lead to ulceration and require amputation in very severe cases.

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About this article

Title: Raynaud's phenomenon

Author: Dr Bow Tauro PhD, BSc (Hons)

First Published: 15 Jul 2015

Last reviewed: 17 Jan 2022

Category: Information on Raynaud's phenomenon

Average rating: 4.7 out of 5 (1556 votes)

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