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Raynaud's phenomenon. This term refers to color changes (blue, white and red) that occur in fingers and, sometimes, toes. Raynaud’s often occurs after exposure to cold temperatures. It occurs when the blood flow to the hands, fingers or toes is temporarily reduced. Raynaud's can lead to finger swelling, color changes, numbness, pain, skin ulcers and gangrene on the fingers and toes. People with have Raynaud's may have other diseases, and some people with Raynaud's do not have any other disease.
Raynaud's occurs in two main types:
At this time, we do not completely understand what causes Raynaud's. However, doctors do know that blood vessels in the hands and feet appear to overreact to cold temperatures or stress:
In Raynaud's, arteries to your fingers and toes go into a state called vasospasm. Vasospasm occurs when a blood vessel’s spasm causes blood vessels to narrow, dramatically and temporarily limiting blood supply. Over time, these same small arteries may thicken slightly, further limiting blood flow. Affected skin turns a pale and dusky color due to the lack of blood flow to the area. Once the spasms go away and blood returns to the area, the tissue may turn red before returning to the skin’s normal color.
Cold temperatures are most likely to trigger an attack. Exposure to cold can be as simple as putting your hands under a faucet of running cold water, taking food out of the freezer or exposure to cold air. For some people, exposure to cold temperatures isn't necessary. Emotional stress alone can cause an episode of Raynaud's. Raynaud's may be partly an inherited disorder.
Causes of secondary Raynaud's include:
Primary Raynaud's affects women more than men. Although anyone can develop the condition, primary Raynaud's often begins between the ages of 15 and 30. Additionally, a family history appears to increase your risk of primary Raynaud's. About one-third of people with primary Raynaud's have a first-degree relative — a parent, sibling or child — with the disorder. The disorder is also more common in people who live in colder climates.
Certain conditions, such as scleroderma and lupus, increase your risk for developing Raynaud’s syndrome. People in occupations that cause repetitive trauma, such as workers who operate tools that vibrate, also may be more vulnerable to secondary Raynaud's.
Smoking, medications that affect the blood vessels and exposure to chemicals such as vinyl chloride are associated with an increased risk of Raynaud's.
To diagnose Raynaud's, your doctor will ask detailed questions about your symptoms and medical history, and conduct a physical examination. Your doctor may also run tests to rule out other medical problems that may cause similar signs and symptoms, such as a pinched nerve.
To distinguish between primary and secondary Raynaud's, your doctor may perform an in-office test called nail fold capillaroscopy. During the test, the doctor examines your nail fold — the skin at the base of your fingernail — under a microscope. Tiny blood vessels (capillaries) near the nail fold that are enlarged or deformed may indicate an underlying disease. However, some secondary diseases can't be detected by this test.
If your doctor suspects that another condition, such as an autoimmune or connective tissue disease, underlies Raynaud's, he or she may order blood tests, such as:
There's no single blood test to diagnose Raynaud's. Your doctor may order other tests, such as those that rule out diseases of the arteries, to help pinpoint a disease or condition that may be associated with Raynaud's.
Self-care and prevention steps, such as dressing in layers or wearing gloves or heavy socks, usually are effective in dealing with mild symptoms of Raynaud's. If these are inadequate, medications are available to treat more-severe forms of the condition. The goals of treatment are to:
Depending on the cause of your symptoms, medications may help treat Raynaud's. To widen (dilate) blood vessels and promote circulation, your doctor may prescribe:
You and your doctor may find that one drug works better for you than another. Some drugs used to treat Raynaud's have side effects that may require you to stop taking the medication. A drug may also lose effectiveness over time. Work with your doctor to find what works best for you.
In cases of severe Raynaud's, medications may be inadequate, so your doctor may explore other treatment options:
A variety of steps can decrease Raynaud's attacks and help you feel better overall:
If you're experiencing an attack of Raynaud's, the first and most important action is to warm your hands or feet or any other affected areas of skin. The following steps can help you gently warm your fingers and toes:
Reviewed May 2015. Reviewed by the American College of Rheumatology Committee on Communications and Marketing.
This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.
© 2015 American College of Rheumatology