Raynaud's Phenomenon

What is Raynaud's phenomenon?

Raynaud's phenomenon is a disorder of the small blood vessels that feed the skin. During an
attack of Raynaud's, these blood vessels contract briefly, limiting blood flow. The skin first turns
white, then blue. The skin turns red as the vessels relax and blood flows again. Hands and feet
are most commonly affected, but Raynaud's phenomenon can affect other areas such as the
nose and ears.
Women between the ages of 15 and 50 are most often affected, but anyone can have the
problem.
How does it occur?
For most people, an attack is usually triggered by exposure to cold or emotional stress. For
example, reaching into a refrigerator may trigger an attack.
There are 2 forms of Raynaud's phenomenon. Most people who have Raynaud's phenomenon
have the primary form (the milder version). Primary Raynaud's usually affects both hands and
both feet. Its cause is not known.
Secondary Raynaud's phenomenon is caused by another disease or condition and is a more
serious disorder. It usually affects either both hands or both feet. Connective tissue diseases are
the most common cause. Medical conditions that may cause secondary Raynaud's phenomenon
include:
Scleroderma (a thickening and hardening of the skin and other body tissues). Raynaud's
phenomenon is seen in approximately 85 to 95% of people with scleroderma and mixed
connective tissue disease.
Systemic lupus erythematosus (a chronic inflammation of the skin and organ systems).
Rheumatoid arthritis (a chronic inflammation and swelling of tissue in the joints).
Blood flow reduction (problems that slow or stop blood flow in a vessel, such as
inflammation and hardening of the arteries).
Nerve problems (problems that affect the nerves supplying the muscles).
Pulmonary hypertension (a condition in which the blood pressure rises in the blood
vessels of the lungs).
Sjogren's syndrome (a disorder in which immune cells attack and destroy the glands that
produce tears and saliva).
Polymyositis (a chronic disease that causes inflammation and weakness of the muscles).
Dermatomyositis (a related disease in which a specific type of skin rash occurs along with
the muscle problems of polymyositis).
Carpal tunnel syndrome (a painful disorder of the hand and wrist caused by pressure on
a nerve in the wrist).
Some drugs may cause Raynaud's phenomenon. Examples of such drugs are beta blockers
used to treat high blood pressure, ergotamine medicines used for migraine headaches,
anticancer drugs, nonprescription cold medicines, and narcotics. Smoking can also cause
Raynaud's phenomenon.
Injuries from frostbite, surgery, or some jobs may also cause Raynaud's phenomenon. Some
workers in the plastics industry who are exposed to vinyl chloride develop a sclerodermalike
illness and have Raynaud's phenomenon. Regular use of machinery such as chain saws and
vibrating drills can hurt blood vessels.
What are the symptoms?
Symptoms include changes in skin color (white to blue to red) and skin temperature (the area
feels cooler). Usually there is no pain, but it is common for the area to feel numb or prickly, as if it
has fallen asleep.
How is it diagnosed?
Your health care provider will ask about your symptoms and examine you. You may have blood
tests and a nailfold capillaroscopy. In nailfold capillaroscopy, your provider puts a drop of oil on
the skin at the base of your fingernail. Your provider will then look at your skin under a
microscope to see if the capillaries are enlarged or deformed. If they are deformed, you may have
a connective tissue disease.
How is it treated?
Most health care providers recommend nondrug treatments and self-help measures first, as
described below in the section on taking care of yourself.
Several kinds of medicines are sometimes used to treat severe Raynaud's symptoms. They all
improve circulation. Types of drugs that might be prescribed are calcium channel blockers, alpha
blockers, and vasodilators. Nitroglycerin paste, which is applied to the fingers, helps heal skin
sores.
A drug may become less effective over time. Women of childbearing age should know that the
medicines used to treat Raynaud's phenomenon might affect the baby. If you are pregnant or are
trying to become pregnant, talk with your health care provider before taking these medicines.
If you are taking a medicine that appears to be causing Raynaud's phenomenon, your health care
provider may change your medicine or dosage.
How long do the effects last?
Raynaud's phenomenon cannot be cured, but most people are able to manage the symptoms.
How can I take care of myself?
Protect yourself from cold and keep all parts of your body warm. When you are outdoors
in the winter, wear scarves, warm socks, boots, and mittens. (Mittens are better than
gloves, which allow too much heat to escape.) Make sure your wrists are covered.
Indoors, wear socks and comfortable shoes. When taking food out of the refrigerator or
freezer, use mittens, oven mitts, or potholders.
Guard against cuts, bruises, and other injuries to the areas affected by Raynaud's
phenomenon.
If you smoke, quit.
You may be able to prevent or stop attacks using biofeedback, a technique in which you
are taught to "think" your fingers or toes warm.
Control stress.
Exercise regularly, according to your health care provider's recommendations.
See your health care provider if you have questions or concerns.

For more information, you may wish to contact:
National Institute of Arthritis and Musculoskeletal and
Skin Diseases Information Clearinghouse
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484 or
877-22-NIAMS (226-4267) (free of charge)
TTY: 301-565-2966
Fax: 301-718-6366
Published by McKesson Health Solutions LLC.
This content is reviewed periodically and is subject to change as new health information becomes
available. The information is intended to inform and educate and is not a replacement for medical
evaluation, advice, diagnosis or treatment by a healthcare professional.
Developed by McKesson Health Solutions LLC.
Copyright 2003 McKesson Health Solutions LLC. All rights reserved.
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