Raynaud's Phenomenon

Symptoms and complications of Raynaud’s phenomenon are due to constriction and narrowing of the capillaries of the fingers and toes. This can result in an insufficient supply of blood, oxygen and nutrients to cells and tissues. Less commonly, Raynaud’s phenomenon can also cause symptoms and complications in the nose, lips and earlobes.

Symptoms of Raynaud’s phenomenon include:

• Pale, grey or bluish (cyanotic) coloring of the fingers, toes, nose, lips or earlobes

• Pain, throbbing, burning or numbness in fingers, toes, nose, lips or earlobes

• Unusually cold hands and feet

Advanced cases of Raynaud’s phenomenon can lead to serious symptoms that include:

• Black coloring and shedding of necrotic (dead) skin

• Ulcers and lesions of the fingers, toes, nose, lips, or earlobes

Seek immediate medical care if you have any of these symptoms.

Raynaud’s phenomenon is linked to some autoimmune disorders, but the exact cause is not clear. If the underlying cause of the symptoms is unknown, the condition is called Raynaud’s disease or primary Raynaud’s.

Known underlying diseases and disorders that can cause Raynaud’s phenomenon include:

• Polymyositis
• Rheumatoid arthritis
• Scleroderma
• Sjogren syndrome
• Systemic lupus erythematosus

Certain factors can trigger symptoms of Raynaud’s phenomenon. Triggers include:

• Exposure to cold air
• Exposure to cold water
• Stress

A number of factors are thought to increase your chances of developing Raynaud’s phenomenon. People at risk for Raynaud’s phenomenon include women between the ages of 15 and 40 years of age and people with underlying diseases or behaviors that cause damage or narrowing of the blood vessels. These include:

• Diabetes
• High cholesterol and atherosclerosis
• Hypertension (high blood pressure)
• Medications that cause constriction of the blood vessels including beta blockers, certain migraine medications, cold and allergy drugs, birth control pills, and certain cancer drugs
• Smoking

Not all people with risk factors will develop Raynaud’s phenomenon, but you can lower your risk of developing Raynaud’s phenomenon by :

• Not smoking
• Notifying your health care provider promptly of side effects of medications, such as a change in skin coloring and pain or numbness of the fingers and toes  
• Seeking regular medical care and following your treatment plan for high cholesterol,  atherosclerosis, hypertension, diabetes, and other medical conditions

Raynaud’s phenomenon is treatable with regular medical care and consistent compliance with your treatment plan. The most effective treatment plan for Raynaud’s phenomenon employs a multifaceted approach that begins with lifestyle and medication changes and may require surgery in severe cases.

Treatment of Raynaud’s phenomenon includes:

• Adjusting or changing certain medications that may cause symptoms of Raynaud’s phenomenon, such as beta blockers, certain migraine medications, cold and allergy drugs, birth control pills, and certain cancer drugs. It is very important to not change or discontinue medications without first consulting with your health care provider.

• Diagnosing and treating any underlying or associated diseases, such as diabetes, hypertension, scleroderma, systemic lupus erythematosus, and rheumatoid arthritis

• In rare cases, surgery to block the nerves that control the capillaries to prevent them from constricting 

• In some cases, medications to keep the blood vessels open, such as calcium channel blockers, alpha blockers, prescription skin creams, and ACE inhibitors

• Keeping hands and feet warm, including wearing sufficient protective clothing in cold weather, soaking the hands and feet in warm water, and frequently wiggling the fingers and toes

• Meticulous foot and skin care to prevent the development of lesions and infections. This includes keeping your skin and feet clean, warm, and dry. Avoiding injury to the feet and wearing shoes that are comfortable and protective is important. People with Raynaud’s phenomenon should also inspect their feet daily and seek prompt medical care for any sores or ulcers that develop.

• Minimizing stress with lifestyle interventions, such as exercise or meditation

• Smoking cessation program

• Gingko biloba may reduce the frequency of attacks

Advanced cases of Raynaud’s phenomenon that are untreated or do not respond to treatment can lead to serious complications due to ongoing decreased blood flow to certain areas of the body. These include the fingers, toes, nose, lips and earlobes. Complications include:

• Infections of ulcers and lesions that are difficult to treat

• Necrosis (death) of tissues and gangrene, which may require removal of the dead tissues or amputation

• Ulcers and lesions that do not heal