What Is Raynaud's Disease?
Raynaud’s disease is when blood vessels in your fingers and toes temporarily overreact to low temperatures or stress. For most people, it isn’t a serious health problem. But for some, the reduced blood flow can cause damage.
Types of Raynaud’s
This condition is named for the French doctor who first identified it in 1862. You may hear it called by many names. There are two types:
- Primary Raynaud’s(or Raynaud’s disease) happens without any other illness behind it. The symptoms are often mild.
- Secondary Raynaud’s (Raynaud’s syndrome, Raynaud’s phenomenon) results from another illness. It’s often a condition that attacks your body’s connective tissues, like lupus or rheumatoid arthritis. It’s less common, but it’s more likely to cause serious health problems. This can include things like skin sores and gangrene. These happen when cells and tissue in your toes and fingers die from lack of blood.
You might notice:
- Cold fingers and toes
- Your skin might turn white or blue when it’s cold or when you’re stressed. As you warm up, it could turn red.
- Your fingers and toes feel tingly or prickly when they start to warm up.
What Causes Primary Raynaud’s?
When it’s cold, your body tries to conserve heat. One way it does that is to slow down blood flow to the areas farthest from your heart -- your hands and feet. To do that, the network of small arteries that carry blood to those points gets narrower, moving them away from your skin. This is called the vasomotor response.
If you have Raynaud’s, your response is off. Those arteries shrink more than normal, and faster than normal. That can make your fingers and toes feel numb and change color to white or blue. This usually lasts about 15 minutes. When the arteries relax and your body warms back up, your fingers feel tingly and turn red before returning to normal. You might have changes to genes that control your response, but doctors haven’t found a link between this and Raynaud’s.
What Causes Secondary Raynaud’s?
Secondary Raynaud’s works the same, but you get it as the result of another disease. Conditions that make you likely to get secondary Raynaud’s include:
- Connective tissue diseases. If you have scleroderma, a rare disease that causes your skin to harden and scar, you’ll probably have Raynaud's. Lupus, rheumatoid arthritis, and Sjogren's syndrome also make it more likely.
- Artery disease. This includes atherosclerosis, or plaque buildup in the blood vessels that feed your heart; Buerger's disease, which causes inflammation in the blood vessels of your hands and feet; and a primary pulmonary hypertension, a type of high blood pressure that affects the arteries in your lungs.
- Carpal tunnel syndrome. Pressure on a major nerve to your hand can cause numbness, pain, and make you more sensitive to the cold.
- Repetitive action or vibration. Any movement you make over and over, like typing or playing the piano, can cause an overuse injury. So can using tools that vibrate, like jackhammers.
- Smoking. It narrows your blood vessels.
- Injuries: This includes damage to your hands or feet from breaks, surgery, or frostbite.
- Certain medications. These include high blood pressure treatments like beta-blockers; migraine meds with ergotamine or sumatriptan; ADHD medications; some types of chemotherapy; and drugs that narrow your blood vessels, like over-the-counter cold medications.
Risk Factors for Raynaud’s
As many as one in 10 people may have some form of Raynaud’s. Most have primary Raynaud’s. About one person in 100, or fewer, will have secondary Raynaud’s.
- Women are up to nine times more likely to get it than men.
- People of all ages can get primary Raynaud’s, but it usually shows up between ages 15 and 25.
- People with secondary Raynaud’s tend to get it after 35.
- People with illnesses like rheumatoid arthritis, scleroderma, and lupus are more likely to get secondary Raynaud’s.
- People who use some medicines to treat cancer, migraines, or high blood pressure may be more likely to get Raynaud’s.
- Also, people who have carpal tunnel syndrome or use vibrating tools like jackhammers may be more likely to get Raynaud’s.
How Is Raynaud’s Diagnosed?
If your doctor thinks you have Raynaud’s, they’ll ask questions about your symptoms and look at your fingers and toes. They might also use a special magnifying glass called a dermoscope to check the blood vessels around your fingernails to see if they’re larger than normal or oddly shaped.
If the doctor thinks your condition results from another health problem, they might take some of your blood to test in a lab. This lets them check for signs of an autoimmune disorder like lupus or rheumatoid arthritis.
What Are Treatments for Raynaud’s?
Treatment goals will include preventing attacks or limiting them when they do happen. That usually means keeping your hands and feet warm and dry, controlling stress, and getting regular exercise.
Your doctor might ask you to avoid some drugs, including over-the-counter cold medicines that contain pseudoephedrine. They can make your symptoms worse by causing your blood vessels to narrow.
If you have secondary Raynaud’s, your doctor might prescribe medicines to control your blood pressure and relax your blood vessels. If you get sores on your skin as a result, you might need to apply a cream that contains one of these drugs. They include:
- Calcium channel blockers. Examples include nifedipine (Afeditab CR, Procardia), amlodipine (Norvasc), felodipine, and isradipine.
- Vasodilators. These include the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra, Revatio), the antidepressant fluoxetine (Prozac, Sarafem), and a class of medications called prostaglandins. Others include a nitroglycerin cream you can put on the base of your fingers to help heal sores.
If your condition doesn’t improve after these steps and you’re at risk of severe problems, like losing parts of your fingers or toes, your doctor might consider surgery. These procedures involve cutting the nerves to the blood vessels in your skin to limit how much they open and close. The doctor might also inject drugs into your hands or feet to block those nerves.
Home Treatment for Raynaud’s
These steps can also help you control your condition:
- Avoid smoke: Don’t smoke, and stay away from secondhand smoke, too. It can make your blood vessels close up, which lowers your skin temperature.
- Exercise: It’ll boost your circulation. If you have secondary Raynaud’s, check with your doctor before you try an outdoors workout in cold weather.
- Manage stress: Keeping it under control could help cut the number of attacks.
- Keep your temperature constant: Don’t go straight from a chilly space to a warm space if you can help it. Avoid the frozen-food section of the grocery store as much as possible.
- Dress for the cold: Wear layers, gloves, and heavy socks. Buy chemical warmers for your pockets, gloves, and socks.
- Avoid some medications:Decongestants with phenylephrine, diet pills, migraine medications with ergotamine, herbal medications with ephedra, and the blood pressure medication clonidine (Catapres) can all narrow your blood vessels.
- Soak your hands: Or run warm water over them when you feel an attack starting.
Can Raynaud’s Kill You?
No, but serious cases can cut off the blood flow to your skin and lead to tissue damage. A completely blocked artery can lead to skin sores (ulcers) or dead tissue (gangrene). It’s rare, but if this happens, the doctor might have to remove a finger or toe.