Raynaud’s phenomenon can occur with episodes where blood vessels constrict and reduce blood flow to your extremities. Treatment can include medications to widen your blood vessels.

Raynaud’s phenomenon is a condition where blood flow to your fingers, toes, ears, or nose is restricted or interrupted. Also known as Raynaud’s syndrome, it occurs when the blood vessels in your hands or feet constrict. Episodes of constriction are called vasospasm.

Raynaud’s disease is a primary condition that isn’t linked to any other underlying condition. Symptoms of Raynaud’s disease can also be caused by different underlying conditions. This is known as a secondary condition and is colloquially known as Raynaud’s syndrome, Raynaud’s phenomenon, or just Raynaud’s. For example, vasospasms provoked by other conditions, such as arthritis, frostbite, or autoimmune disease, are called secondary Raynaud’s.

Raynaud's phenomenon, Raynaud's syndrome on lighter skinShare on Pinterest
Raynaud’s phenomenon causes the fingers to turn white from reduced blood flow. Shown on a lighter skin tone.
WaltFletcher, CC BY-SA 4.0, via Wikimedia Commons

There are two types of Raynaud’s phenomenon: primary and secondary.

Primary Raynaud’s disease

Per a 2020 study, most individuals with these symptoms have primary Raynaud’s disease making up 80-90 percent of cases. This type doesn’t have a known cause or is idiopathic.

Secondary Raynaud’s syndrome

An underlying medical condition or specific medications cause secondary Raynaud’s syndrome. For example, systemic sclerosis can cause Raynaud’s phenomenon and is often the first sign of the disease.

Those diagnosed may experience moderate to severe symptoms.

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Raynaud’s phenomenon Shown on a darker skin tone.
Numstocker/Shutterstock

Raynaud’s syndrome occurs in episodes or attacks from the disease. Certain body areas can become affected, but the fingers and toes are common.

When it takes hold, you may find the following progression of symptoms:

  1. Affected area turns pale or white due to lack of blood flow.
  2. The affected area turns blue while feeling cold and numb since the tissue has lost oxygen.
  3. When you warm up, and circulation restores, you can experience redness, swelling, and discomfort.
  4. You can develop skin ulcers and gangrene in severe cases.

At first, you may only experience symptoms in one finger or toe. Then, however, it can move to your other digits, and each attack can last anywhere from a few minutes to hours.

Raynaud’s syndrome typically affects the fingers. With primary, your thumb doesn’t experience any symptoms. However, if the thumb becomes affected, this could signify secondary Raynaud’s phenomenon.

Secondary may also start to move to other areas of your body such as:

  • face
  • ears
  • knees
  • nipples

No two episodes are precisely alike, even in the same person.

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Raynaud’s phenomenon causes pallor of the distal fingers from decreased blood flow, then bluish discoloration of the distal fingers from decreased oxygen, then rubor (redness) when blood flow returns. Shown on lighter skin tones.
Tcal at English Wikipedia, CC BY-SA 3.0, via Wikimedia Commons

Primary Raynaud’s disease

Doctors don’t fully understand the cause of primary Raynaud’s. Your body responds to cold temperatures or emotional stress by restricting the blood flow to the skin.

Even though it is the natural way the body controls its temperature, Raynaud’s phenomenon prolongs the reaction by not immediately restoring blood flow. You then start to experience symptoms.

Even though the cause isn’t known, some factors appear to impact when it occurs. These factors include:

  • Genetics. An estimated 50 percent of those with Raynaud’s have close family members with the same condition.
  • Impaired circulation. If you have increased vascular tone, also known as the amount of constriction your blood vessels create, you are prone to Raynaud’s phenomenon.
  • Nervous system miscommunication. Your nervous system controls your body’s automatic temperature regulation response, but it may not be responding to stress and temperature changes as it should, leading to delayed vasoconstriction.
  • Blood thickness. Our blood consists of different cells that affect its viscosity and consistency. Any abnormalities or blood disorders may make you more prone to primary Raynaud’s syndrome.

Secondary Raynaud’s syndrome

Secondary Raynaud’s is usually related to medical conditions, medications, or lifestyle habits that affect your blood vessels or connective tissue, such as:

Common triggers of Raynaud’s symptoms are cold temperatures and emotional stress. So, it is best to listen to your body and what it tells you when experiencing stressful times or sudden drops in temperature.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Raynaud’s phenomenon has the following risk factors:

  • Family history of Raynaud’s syndrome. As previously mentioned, if a parent or sibling is diagnosed with Raynaud’s, you are more likely to receive the same diagnosis at some point.
  • Women experience Raynaud’s phenomenon more than men. For example, a 2020 study finds Raynaud’s affecting 2-20 percent of women but only 1-12 percent of men.
  • Teenagers and young adults are affected the most. It is found mainly in people younger than 30 years of age.
  • Frequent exposure to cold temperatures. People who work or live in colder environments have a higher risk of Raynaud’s phenomenon.
  • Workplace exposures. You could be at risk if your job requires the repeated use of vibrating tools and machinery, like a jackhammer, or frequent work with certain chemicals.

When you visit your doctor, they will first perform a physical exam, take your medical history, and review any test results.

Physical exam

The doctor will want to inspect your fingers and toes while also looking at your skin and nailbeds.

For example, they may apply some mild pressure to your nailbeds. Measuring your capillary refill time offers a visual assessment of your circulation, and it’s a good indicator of your blood vessel health.

To determine the type of Raynaud’s disease, your doctor may also do a more thorough exam to determine if other medical conditions may be causing secondary Raynaud’s.

Medical history

When discussing your symptoms, the doctor may ask about specific risk factors for Raynaud’s syndrome. Then, they might want to know your typical response to stress or cold temperatures and if you’ve noticed any changes.

For example, if you’ve recently started to notice color changes in your fingers when you work outside in the winter, you’ll want to make sure they know about that.

Diagnostic testing

There are different tests your doctor may offer to make their definitive diagnosis and includes:

  • cold stimulation test: a small device measures your finger’s temperature when exposed to cold and then removed from cold
  • nail fold
  • capillaroscopy
  • capillaroscopy: a drop of oil on your nail is examined via microscope in order to detect abnormalities
  • antinuclear antibody (ANA): checks for autoimmune proteins in the blood
  • erythrocyte sedimentation rate (ESR): measures inflammation levels in the body
  • C-reactive protein (CRP): assesses the liver’s response to inflammation

There is no cure for primary or secondary Raynaud’s. However, different treatments and lifestyle changes may help manage your symptoms and reduce the number of attacks experienced. Treatment options for symptoms are the same for both.

Lifestyle changes

Lifestyle changes are a large part of the treatment process for Raynaud’s phenomenon. Avoiding substances that cause your blood vessels to constrict is the first line of treatment, such as caffeine and nicotine products.

Staying warm and exercising can also prevent or reduce the intensity of some attacks. In addition, exercise is perfect for promoting circulation and managing stress.

Vasospasms

If you are experiencing vasospasms, it’s essential to keep yourself warm. To help cope with an attack, you can:

  • Cover your hands or feet with socks or gloves.
  • Get out of the cold and wind and rewarm your entire body.
  • Run your hands or feet under lukewarm (not hot) water.
  • Massage your extremities.

Staying calm can help reduce the severity of your attack. Try to remain as relaxed and stress-free as possible. It may help to remove yourself from stressful situations physically. Concentrating on your breathing can also help you calm down.

Lifestyle changes alone may help alleviate symptoms of secondary Raynaud’s, but it often isn’t enough to manage the severity of the disease. Other treatments needed include medication, surgery, and infusions.

Medication

Medications used to treat Raynaud’s work to dilate or widen your blood vessels. These drugs include:

Infusions

Your doctor may recommend prostaglandin infusions when the lack of oxygen supply to the affected tissues is severe. Intravenous therapy of the drug works to dilate your blood vessels and prevent blood clots.

Surgery

Severe cases of Raynaud’s can be distressing, though it may not last long. If severe Raynaud’s phenomenon is impacting your life, your doctor could recommend a sympathectomy in rare cases. The surgery blocks the nerves causing the blood vessels to constrict. After a few years, you may need a repeat procedure.

Surgery is typically a rare option without much clinical research to support it. Speak with your doctor to discuss all of your treatment options.

If you have Raynaud’s phenomenon, your outlook largely depends on your overall health. Over the long term, secondary Raynaud’s poses more significant concerns than the primary form. People with secondary Raynaud’s are more likely to get an infection, skin ulcers, and gangrene.