Raynaud's Disease: Types, Symptoms and Treatment

Raynaud's disease (also known as Raynaud's phenomenon, Raynaud's syndrome or simply Raynaud's) is a blood vessel disorder that causes the vessels in the body's extremities to constrict more than necessary when experiencing stress or cold temperatures. The constricted vessels prevent blood from reaching the surface of the skin. This causes the affected areas, typically fingers and toes, to turn white, blue, then red, according to the U.S. National Library of Medicine.

About 5% of the U.S. population and 3 to 5% of people worldwide have Raynaud's, according to the National Heart, Lung and Blood Institute.

The disorder was first detailed by Maurice Raynaud, a French physician, in 1862, according to a 2016 article published in the journal JAMA Dermatology. Raynaud described a group of 25 patients, 20 of whom were female, who experienced color changes in their hands and feet when exposed to cold or stress.

Types, causes and diagnosis

There are two variations of Raynaud's: primary and secondary, according to the Mayo Clinic. Primary Raynaud's is more common and typically less severe than secondary.

"Primary Raynaud's starts at a younger age [under 30], is more common in women and associates with family history and smoking," said Dr. Natalie Azar, a rheumatologist and clinical assistant professor at New York University Langone Health. Scientists aren't sure what causes primary Renaud's, but about 75% of those diagnosed with the disease are women between ages 15 and 40, according to the Cleveland Clinic. People who live in colder climates are also more susceptible to primary Raynaud's.

Secondary Raynaud's occurs as a result of another disease or health condition, such as lupus, rheumatoid arthritis or carpal tunnel syndrome. Smoking and exposure to certain medications such as beta blockers, chemotherapy drugs or some cold medications may also initiate secondary Raynaud's, according to the Mayo Clinic.

Doctors diagnose Raynaud's by considering the patient's history and symptoms and by performing a physical exam. Some doctors may decide to continue with blood tests to rule out other conditions. The doctor may closely examine the skin at the base of the fingernail — called a nail fold capillaroscopy — to look for deformities such as thick-walled blood vessels that could constrict too easily.

Symptoms and complications

The common symptoms of Raynaud's are extreme sensitivity to cold or stress, numbness and pain from the lack of blood going to the extremities, tingling and throbbing when the blood returns to the extremities, and skin color changes, according to the Arthritis Foundation. First, the skin turns white (called pallor) due to lack of blood flow to fingers and toes, and sometimes the ears, nose and lips. The skin then turns blue (cyanosis) as the oxygen leaving the blood remains at the site. This often leads to pain in the affected extremity. When the blood flow resumes, it causes a tingling or throbbing sensation and the skin turns bright red.

Severe cases of Raynaud's are rare, but can lead to complications such as tissue damage, skin ulcers (sores) or even gangrene (dead tissue) if an artery is completely blocked, according to the Mayo Clinic. In the most severe cases, nerve surgery or amputation of the affected area may be required.

Treatments

There is no cure for primary Raynaud's, and secondary Raynaud's is often relieved by treating the underlying health problem. Primary Raynaud's may be controlled by keeping the body warm, reducing stress, exercising and avoiding smoking, caffeine and medications that restrict blood flow. People with Raynaud's should avoid direct contact with the cold and use potholders when removing items from the freezer or refrigerator, cover cold beverages with an insulated sleeve and wear wool or synthetic socks.

When a patient starts experiencing symptoms of Raynaud's, the Mayo Clinic recommends the following remedies: moving to a warmer location, wiggling fingers and toes, increasing the heart rate and blood flow with movements such as wide arm circles (windmills), soaking hands or feet in warm water, gently massaging hands and feet, or practicing a stress-reducing technique such as deep breathing.

If keeping warm and reducing stress aren't enough to relieve symptoms, medications such as calcium channel blockers or angiotensin receptor blockers, which relax and widen blood vessels, may be prescribed to increase blood flow to our hands and feet, Azar said.

Additional information:

• Learn more about Raynaud's syndrome from the Raynaud's Association.
• Watch this video explainer about Raynaud's syndrome from Osmosis.
• Read more about Raynaud's from Johns Hopkins Medicine.

This article is for informational purposes only, and is not meant to offer medical advice. 

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