Information From Your Health Care Provider

RAYNAUD DISEASE & PHENOMENON

Basic information

description

Raynaud disease (primary Raynaud) and Raynaud phenomenon (secondary Raynaud) are disorders of the circulatory system. Both types involve small blood vessels in the body. They usually affect blood circulation to the fingers, but may affect the toes, and rarely, nose, lips, nipples, knees, or ears.
- Primary Raynaud is not associated with an underlying cause. It is more common in females ages 20 to 40.
- Secondary Raynaud is associated with an underlying cause. It can affect anyone with that underlying cause.

FREQUENT SIGNS & SYMPTOMS

Symptoms may develop over a period of years. In secondary Raynaud, they may begin suddenly.
When exposed to cold or after emotional stress, fingers turn pale followed by a bluish tinge, then redness.
Numbness and tingling occur along with the color changes. Pain is not common, but can occur.
Symptoms may last from several minutes to a few hours.
Warmth helps relieves these symptoms. Hands may become swollen and painful when warmed.

causes

The exact cause is unknown. The blood vessels may constrict (narrow) due to cold or emotional stress, or there may be increased thickness to the blood.

risk increases with

Being female and under age 30 (for primary type).
Family history of Raynaud.
Living in a cold climate.
Personal history or family history of autoimmune disorders, such as scleroderma, lupus erythematosus, rheumatoid arthritis, or others.
Environmental factors, such as use of vibrating tools or exposure to certain chemicals or toxins.
Smoking (impairs circulation to hands and feet).
Certain drugs.

PREVENTIVE MEASURES

None specific. Avoid risk factors where possible. Don't smoke. It triggers symptoms. Avoid secondhand smoke.

expected outcomes

Self-care and other treatments can help prevent attacks. Symptoms may worsen at times (e.g., in cold weather). Symptoms may stop as person gets older. Secondary Raynaud is curable if underlying cause can be resolved.

possible complications

Fingertip or toe ulcers (open sores).
Smooth skin on fingertips or toes.
Development of an autoimmune disorder.
Gangrene and amputation (most severe cases only).

diagnosis & treatment

general measures

Your health care provider will do a physical exam of the affected areas and ask questions about your symptoms and activities. Medical tests may include blood studies and a cold challenge test (putting hands in cold water). A nailfold capillary test may be done to check tiny blood vessels in the skin at the base of a fingernail.
Treatment involves treating any underlying cause, lifestyle changes, and drugs if needed.
Stop smoking. Symptoms will improve if you do.
Avoid trigger factors, such as use of vibrating tools.
Avoid exposure to cold if possible. Wear mittens or gloves outdoors and when handling ice or frozen foods. Wear comfortable, roomy shoes and wool socks.
Avoid drugs that can worsen symptoms (such as ergot drugs, clonidine, and cyclosporine).
Use caution in handling iced drinks or being in air-conditioned rooms.
Avoid stressful situations. Learn relaxation techniques.
Biofeedback training to teach you how to raise skin temperature may be helpful.
Surgery to sever (cut) sympathetic nerves to the involved hands or feet (rare).
To learn more: Raynaud's Association, 94 Mercier Ave., Hartsdale, NY 10530; (800) 280-8055; website: www.raynauds.org.

medications

Vasodilator drugs may be prescribed. They help dilate (widen) blood vessels to improve blood circulation.
Topical drugs to be applied to the fingertips may be prescribed to protect them from skin ulcers.

activity

No limits, except to keep warm. A regular exercise program is recommended. Exercise improves circulation.