Raynaud's Phenomenon


Raynaud’s Phenomenon (RP) results when there is a decrease in blood flow to the fingers and toes when someone is exposed to cold weather or stress, due to an exaggerated constriction in blood vessels. RP can also affect your ears, nose, and even nipples. The fingers or toes typically change color, and this can cause numbness, tingling, and pain. These symptoms occur intermittently and tend to resolve spontaneously on rewarming. RP can either be “primary” or “secondary”. Primary Raynaud’s is most common and typically affects women typically under the age of 30 and is not associated with any other condition. Secondary Raynaud’s is “secondary” to another condition such as lupus, scleroderma, rheumatoid arthritis, Sjogren’s syndrome, and thyroid disease. Rheumatologists help to differentiate whether Raynaud’s is primary or secondary in nature.

What Are the Signs/Symptoms?

One or multiple fingers/toes can initially turn white due to decreased blood flow, and subsequently blue due to lack of oxygenation of the tissues. Upon rewarming, there is a sudden rush of blood to the affected areas causing the fingers/toes to become red in color. This is known as a triphasic color change which is classic for Raynaud’s. Symptoms can last for seconds to many minutes. If symptoms last for hours or are persistent despite attempts at rewarming, this can suggest more serious disease. Patients with severe Raynaud’s can develop ulcerations on their fingertips or toes due to tissue death resulting from lack of blood flow.

What Are Common Treatments?

Raynaud’s can be managed with both lifestyle modifications and medications. Patients can use mittens/gloves, thick socks, and insertable warmers to help keep their hands and feet warm. Stress reduction and smoking cessation are also recommended to help decrease Raynaud’s attacks. Medications such as calcium channel blockers (amlodipine, nifedipine, felodipine, and others) and angiotensin-receptor blockers increase blood flow to the fingers and toes. For patients with more severe symptoms or who have developed complications such as ulcers, other medications can be used including sildenafil or prostacyclins.

Living with Raynaud's Phenomenon

Wear warm, protective clothing like socks, boots, mittens or gloves in the fall and winter. In the summer months, avoid keeping the temperature of the AC too low. Wear oven mitts or gloves when taking food out of the freezer or refrigerator. Exercise regularly as this can boost healthy circulation and try to decrease stressful triggers. If symptoms occur, rewarm your body, place hands under the armpits, wiggle fingers and toes, run fingers or toes under warm (not hot) water, or massage the hands and feet.

Updated February 2023 by Bhakti Shah, MD, and 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.

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