Raynaud’s disease: Treatment, causes, and symptoms

A person with Raynaud’s disease experiences pain in the extremities, for example, the fingers, when temperatures drop.

Blood vessels narrow and almost completely shut down. Fingers or toes turn from white to blue and, then, as the blood returns, they flush red.

Also known as Raynaud’s syndrome or Raynaud’s phenomenon, Raynaud’s disease affects 5 to 10 percent of Americans, but only 1 in 10 seek treatment. Females are an estimated nine times more likely to be affected than males.

Fast facts on Raynaud’s disease

Here are some key points about Raynaud’s disease. More detail and supporting information is in the main article.

Raynaud’s disease is caused by peripheral blood vessels overreacting to cold.

The condition affects 5-10 percent of Americans.

Maurice Raynaud first described the disease in 1862.

Females and people living in colder climates are more often affected.

A capillaroscopy can help diagnose Raynaud’s disease.

Treatment

Hands numb from the cold.
People with Raynaud’s disease should take care to wrap up before leaving the house on a cold day.

There is no cure for Raynaud’s disease, but there are ways to manage symptoms.

For mild forms of Raynaud’s disease, covering exposed skin before leaving the house can help. If an attack occurs, soaking the affected parts in warm, not hot, water can alleviate symptoms and prevent them from worsening.

If stress is a factor, learning to manage stress can help.

For moderate to severe cases, medication may be necessary.

Alpha-1 blockers can counter the effect of norepinephrine, which constricts blood vessels. Examples include doxazosin and prazosin.

Dihydropyridine calcium channel blockers relax the smaller blood vessels of the hands and feet. Examples include amlodipine, nifedipine, and felodipine.

Topical nitroglycerin ointment applied to the affected area appears to relieve the symptoms by improving blood flow and cardiac output and decreasing blood pressure.

Other vasodilators dilate the veins, easing symptoms. Examples include losartan, sildenafil (Viagra), fluoxetine (Prozac), and prostaglandin.

In very severe cases, more invasive procedures are an option:

Nerve surgery: Sympathectomy

The vasoconstriction that causes Raynaud’s is controlled by sympathetic nerves in the affected areas. A surgeon can make small incisions and strip the nerves away from the blood vessels, to decrease the frequency or severity of attacks. This is not always successful.

Chemical injections

Injecting certain chemicals that block sympathetic nerve fibers from carrying out vasoconstriction can be effective. Local anesthetics or onabotulinumtoxin type A, or Botox, work well for some people. However, the effect will wear off, and treatment will need repeating.

Living with Raynaud’s

People who are prone to Raynaud’s can take measures to avoid some triggers.

The National Heart, Lung, and Blood Institute (NHLBI) suggest:

wrapping up and keeping the house warm when temperatures are cold

as far as possible, avoiding emotional stress

exercise to promote a healthy lifestyle and reduce stress

avoiding medicines and substances that trigger the symptoms

limiting consumption of caffeine and alcohol

not smoking

They also suggest following up with a physician, especially if sores develop on the extremities. Getting medical help may prevent a worsening of symptoms and serious complications.

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Causes

Exactly what causes Raynaud’s remains unclear, but a hyperactivation of the sympathetic nervous system is known to cause an extreme narrowing of the blood vessels, known as vasoconstriction.

It can happen when the person enters a cold place, opens a freezer, or puts their hands in cold water.

Some people experience symptoms when faced with stress, even without an associated drop in temperature.

In healthy individuals, the circulatory system in the extremities, such as the fingers and toes, reacts to conserve heat in cold conditions. The small arteries that supply the skin with oxygen narrow to minimize the amount of heat lost through the exposed skin surface.

In people with Raynaud’s disease, this narrowing is excessive. This is what causes the blood vessels almost to shut down.

Types

There are two types of Raynaud’s disease: Primary and secondary.

Primary Raynaud’s, or Raynaud’s disease, is more common, and it affects people who do not have a secondary medical condition.

Secondary Raynaud’s, or Raynaud’s phenomenon or syndrome, results from an underlying medical issue. It is less common and tends to be more serious.

Causes of secondary Raynaud’s

Causes of secondary Raynaud’s include:

Diseases of the arteries: Atherosclerosis, a build-up of plaque in blood vessels, or Buerger’s syndrome, a disorder where blood vessels in the hands and feet become inflamed, can cause Raynaud’s symptoms. Primary pulmonary hypertension has also been linked to the disease.

Diseases of the connective tissue: Most people with scleroderma, a disease leading to hardened skin, have Raynaud’s disease. The symptoms are commonly linked to lupus, rheumatoid arthritis, and Sjogren’s syndrome, an autoimmune disease affecting glands.

Repetition or vibration: People whose hobbies or jobs require repetitive movements, such as typing or playing the guitar or piano, are at risk of developing Raynaud’s symptoms. Those whose jobs involve using vibrating tools, such as a jackhammer, are also at risk.

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