Raynaud's Disease

What is Raynaud's disease?

Raynaud's disease is a problem with small blood vessels in the skin. During an attack of Raynaud's, these blood vessels get narrower, which means that less blood flows to the skin. The skin first turns white, then blue. Then the skin turns red as the vessels relax and blood flow is better again. Hands and feet are most commonly affected, but Raynaud's disease can affect other areas, such as the nose and ears.

Women between the ages of 15 and 50 are most likely to have the problem, but it can affect anyone.

How does it occur?

For most people, an attack is usually triggered by emotional stress or exposure to cold. For example, reaching into a refrigerator may trigger an attack.

There are 2 forms of Raynaud's disease.

• Most people who have Raynaud's disease have the milder primary form. Its cause is not known.
• Secondary Raynaud's disease is caused by another disease or condition. It is a more serious problem. Connective tissue diseases are the most common cause. Medical conditions that may cause secondary Raynaud's include:
  • Scleroderma (a thickening and hardening of the skin and other body tissues). Most people who have scleroderma have Raynaud's.
  • Systemic lupus erythematosus (a chronic inflammation of the skin and organ systems also called lupus).
  • 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).
  • Pulmonary hypertension (high blood pressure in the lungs).
  • Sjögren’s syndrome (a disease in which immune cells attack and destroy the glands that make tears and saliva).
  • Polymyositis (a chronic disease that causes inflammation and weakness of the muscles).
  • Dermatomyositis (a form of polymyositis with skin symptoms).
  • Carpal tunnel syndrome (a painful disorder of the hand and wrist caused by pressure on a nerve in the wrist).

  Smoking and drugs can also cause secondary Raynaud’s disease. Examples of drugs that might cause it are beta blockers used to treat high blood pressure, ergotamine medicines used for migraine headaches, anticancer drugs, nonprescription cold medicines, and narcotics.

  Also, injuries from frostbite, surgery, or some jobs may cause Raynaud's disease. Some workers in the plastics industry who are exposed to vinyl chloride develop a scleroderma-like illness and have Raynaud's disease. Regular use of machinery such as chain saws, jackhammers, and vibrating drills can hurt blood vessels.

What are the symptoms?

Symptoms include:

• changes in skin color (pale to blue to red)
• changes in skin temperature (the area feels cooler).

It is common for the area to throb or feel numb, tingly, or painful as it warms up again or as stress is relieved.

How is it diagnosed?

Your healthcare provider will ask about your medical history and examine you. You may have blood tests. Depending on your history and exam, your provider may check for diseases or other conditions that cause secondary Raynaud's.

How is it treated?

Most healthcare providers recommend trying nondrug treatments and self-help measures first, as described below in the section on taking care of yourself.

Several kinds of medicines may be 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 put on the fingers, helps improve your circulation and heal any sores on the skin (caused, for example, by cuts or bug bites).

Drugs that help at first may get less effective over time. Women of childbearing age should know that the medicines used to treat Raynaud's disease might affect the baby. If you are pregnant or are trying to become pregnant, talk with your healthcare provider before taking these medicines.

If you are taking a new medicine that seems to be causing Raynaud's disease or making your existing Raynaud’s disease worse, let your provider know. You may need to change your medicine or dosage.

How long do the effects last?

Each attack of symptoms usually lasts for just a few minutes, but some may last more than an hour.

Raynaud's disease 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 will keep your hands warmer than gloves.) Make sure your wrists are covered. When you are indoors, wear socks and comfortable shoes. When you take food out of the refrigerator or freezer, use mittens, oven mitts, or potholders. Avoid very cold air conditioning.
• Guard against cuts, bruises, and other injuries to the areas affected by Raynaud's.
• If you smoke, quit. When you smoke, even less blood will reach your fingers. In some cases smoking itself can cause Raynaud’s.
• 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. This can improve your circulation.
• Try not to have too much stress in your life.
• Exercise regularly, according to your healthcare provider's recommendations.
• Keep your regular follow-up appointments with your provider. See your provider sooner if you have questions or concerns.

For more information, you may wish to contact:

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Phone: 877-22-NIAMS (226-4267)
Web site: http://www.niams.nih.gov