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Raynaud phenomenon
Raynaud's phenomenon
Raynaud phenomenon is a condition in which cold temperatures or strong emotions cause blood vessel spasms. This blocks blood flow to the fingers, toes, ears, and nose.
Causes
Raynaud phenomenon is called "primary" when it is not linked to another disorder. It most often begins in women younger than age 30. Secondary Raynaud phenomenon is linked to other conditions and usually occurs in people who are over age 30.
Common causes of secondary Raynaud phenomenon are:
-
Diseases of the arteries (such as
atherosclerosis
and
Buerger disease
)
Atherosclerosis
Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in the walls of arteries. These ...
ImageRead Article Now Book Mark ArticleBuerger disease
Thromboangiitis obliterans is a rare disease in which blood vessels of the hands and feet become blocked.
ImageRead Article Now Book Mark Article - Drugs that cause narrowing of arteries (such as amphetamines, certain types of beta-blockers, some cancer drugs, certain drugs used for migraine headaches)
-
Arthritis and autoimmune conditions (such as
scleroderma
,
Sjögren syndrome
,
rheumatoid arthritis
, and
systemic lupus erythematosus
)
Scleroderma
Scleroderma is a disease that involves the buildup of scar-like tissue in the skin and elsewhere in the body. It also damages the cells that line th...
ImageRead Article Now Book Mark ArticleSjögren syndrome
Sjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The...
ImageRead Article Now Book Mark ArticleRheumatoid arthritis
Rheumatoid arthritis (RA) is a long-term disease. It leads to inflammation of the joints and surrounding tissues. It can also affect other organs....
ImageRead Article Now Book Mark ArticleSystemic lupus erythematosus
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the body's immune system mistakenly attacks healthy tissue. It can af...
ImageRead Article Now Book Mark Article - Repeated injury or usage (such as from typing, playing the piano, or heavy use of hand tools)
- Smoking
-
Frostbite
Frostbite
Frostbite is damage to the skin and underlying tissues caused by extreme cold. Frostbite is the most common freezing injury.
ImageRead Article Now Book Mark Article -
Thoracic outlet syndrome
Thoracic outlet syndrome
Thoracic outlet syndrome is a rare condition that involves:Pain in the neck and shoulderNumbness and tingling of the fingersA weak grip The thoracic ...
ImageRead Article Now Book Mark Article
Symptoms
Exposure to the cold or strong emotions bring on the changes.
- First, the fingers, toes, ears, or nose become white, and then turn blue.
- When blood flow returns, the area becomes red and then later returns to normal color.
- The attacks may last from minutes to hours.
People with primary Raynaud phenomenon have problems in the same fingers on both sides. Most people do not have much pain.
People with secondary Raynaud phenomenon are more likely to have pain or tingling in the fingers. The pain is rarely severe. However, painful ulcers may form on the affected fingers if the attacks are very bad.
Exams and Tests
Your health care provider can often discover the condition causing Raynaud phenomenon by asking you questions and doing a physical exam.
Tests that may be done to confirm the diagnosis include:
- Examination of the blood vessels in the fingertips using a special lens called nailfold capillary microscopy
-
Vascular ultrasound
Vascular ultrasound
A duplex ultrasound is a test to see how blood moves through your arteries and veins.
ImageRead Article Now Book Mark Article - Blood tests to look for arthritic and autoimmune conditions that may cause Raynaud phenomenon
Treatment
Taking these steps may help control Raynaud phenomenon:
- Keep the body warm. Avoid exposure to cold in any form. Wear mittens or gloves outdoors and when handling ice or frozen food. Avoid getting chilled, which may happen after any active recreational sport.
- Stop smoking. Smoking causes blood vessels to narrow even more.
- Avoid caffeine.
- Avoid taking medicines that cause blood vessels to tighten or spasm.
- Wear comfortable, roomy shoes and wool socks. When outside, always wear shoes.
Your provider may prescribe medicines to relax the walls of the blood vessels. These include topical nitroglycerin cream that you rub on your skin, calcium channel blockers, sildenafil (Viagra), and ACE inhibitors.
It is vital to treat the condition causing Raynaud phenomenon.
Outlook (Prognosis)
The outcome varies. It depends on the cause of the problem and how bad it is.
Possible Complications
Complications may include:
-
Gangrene
or
skin ulcers
may occur if an artery becomes completely blocked. This problem is more likely in people who also have arthritis or autoimmune conditions.
Gangrene
Gangrene is the death of tissue in part of the body.
ImageRead Article Now Book Mark ArticleSkin ulcers
An ulcer is a crater-like sore on the skin or mucous membrane. Ulcers form when the top layers of skin or tissue have been removed. They can occur ...
ImageRead Article Now Book Mark Article - Fingers may become thin and tapered with smooth shiny skin and nails that grow slowly. This is due to the poor blood flow to the areas.
When to Contact a Medical Professional
Call your provider if:
- You have a history of Raynaud phenomenon and the affected body part (hand, foot, or other part) becomes infected or develops a sore.
- Your fingers change color when they are cold.
- Your fingers or toes turn black or the skin breaks.
- You have a sore on the skin of your feet or hands which does not heal.
- You have a fever, swollen or painful joints, or skin rashes.
References
Bakst R, Merola JF, Franks AG Jr, Sanchez M. Raynaud's phenomenon: pathogenesis and management. J Am Acad Dermatol . 2008;59(4):633-53. PMID: 18656283 www.ncbi.nlm.nih.gov/pubmed/18656283 .
Herrick AL. Contemporary management of Raynaud's phenomenon and digital ischaemic complications. Curr Opin Rheumatol . 2011;23(6):555-61. PMID: 21885977 www.ncbi.nlm.nih.gov/pubmed/21885977 .
James WD, Berger TG, Elston DM. Cutaneous vascular diseases. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin . 12th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 35.
Spencer-Green G. Outcomes in primary Raynaud phenomenon: a meta-analysis of the frequency, rates, and predictors of transition to secondary diseases. Arch Intern Med . 1998;158(6):595-600. PMID: 9521223 www.ncbi.nlm.nih.gov/pubmed/9521223 .
Swanson KE, Bartholomew JR, Paulson R. Hypothenar hammer syndrome: a case and brief review. Vasc Med . 2012;17(2):108-15. PMID: 22169157 www.ncbi.nlm.nih.gov/pubmed/22169157 .
-
Raynaud's phenomenon - illustration
Raynaud's phenomenon is characterized by fingers becoming white due to lack of blood flow, then blue due to oxygen consumption, and finally red as blood flow returns.
Raynaud's phenomenon
illustration
-
Systemic lupus erythematosus - illustration
Systemic lupus erythematosus is a chronic inflammatory autoimmune disorder which may affect many organ systems including the skin, joints and internal organs. The disease may be mild or severe and life-threatening. African-Americans and Asians are disproportionately affected.
Systemic lupus erythematosus
illustration
-
Circulatory system - illustration
Blood used by the body is brought back to the heart and lungs by the veins of the body. Once the blood has gathered more oxygen from the lungs, it is pumped back out to the body through the arteries.
Circulatory system
illustration
-
Raynaud's phenomenon - illustration
Raynaud's phenomenon is characterized by fingers becoming white due to lack of blood flow, then blue due to oxygen consumption, and finally red as blood flow returns.
Raynaud's phenomenon
illustration
-
Systemic lupus erythematosus - illustration
Systemic lupus erythematosus is a chronic inflammatory autoimmune disorder which may affect many organ systems including the skin, joints and internal organs. The disease may be mild or severe and life-threatening. African-Americans and Asians are disproportionately affected.
Systemic lupus erythematosus
illustration
-
Circulatory system - illustration
Blood used by the body is brought back to the heart and lungs by the veins of the body. Once the blood has gathered more oxygen from the lungs, it is pumped back out to the body through the arteries.
Circulatory system
illustration
Review Date: 4/28/2015
Reviewed By: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
