Raynaud’s phenomenon, or Raynaud's syndrome, is a narrowing of blood vessels in the body’s extremities that restricts blood flow and causes discoloration and numbness. It is usually temporary and reversible.
Typically, these episodes, or attacks, occur in the fingers or toes, but they can also affect the nose, ears, or tongue. Exposure to cold or stress are the primary triggers for a Raynaud’s episode.
On this page:
What Is Raynaud’s Phenomenon?
Raynaud’s phenomenon is a condition that causes blood vessels in the body’s extremities to spasm and narrow, restricting blood flow. These spasms, or attacks, commonly happen in the fingers and toes, but they can also occur in the nose, ears, tongue, or nipples.
Raynaud attacks are usually triggered by cold or stress, last a few minutes to a few hours, and follow a predictable pattern:
- The blood vessels in the fingers or toes narrow in response to cold or stress. The reduced blood flow causes the tips of the fingers or toes to turn white.
- Because of the persistent reduced blood flow, the fingers and toes turn blue. They may feel cold or numb.
- The fingers and toes turn red as they begin to warm up and blood flow returns to normal. Sometimes, they swell, tingle, or burn.
Not everyone experiences all three color changes, and symptoms can vary from person to person.
Primary Raynaud phenomenon occurs without an identifiable cause or underlying condition and it tends to be mild. The more severe form of Raynaud’s, known as secondary Raynaud’s, can occur from vascular disease, medications, occupational exposure, nicotine use and connective tissue diseases like lupus and scleroderma that damage the blood vessels, leaving people vulnerable to attacks. This type of Raynaud’s is more likely to result in tissue damage.
Medical providers can treat Raynaud's with lifestyle changes. However, if symptoms are severe, they may recommend medication.
What are the types of Raynaud’s phenomenon?
- Primary — Primary Reynaud’s phenomenon has no known cause. It’s more common in women and typically begins between the ages of 15 and 30. Symptoms tend to be mild.
- Secondary — Secondary Raynaud’s phenomenon is linked to certain diseases, like lupus, scleroderma, and rheumatoid arthritis. It occurs later in life, usually after age 40, and symptoms can be severe, including tissue damage that leads to skin ulcers, infections, or tissue loss. People with secondary Raynaud’s often have deformed capillaries, which medical providers use to distinguish between the two types.
How common is Raynaud’s phenomenon?
Raynaud’s phenomenon is fairly common, affecting about an estimated 3% to 5% of the population and is more common in women and in colder climates. About a third of people who have Raynaud’s also have a close relative with the condition.
What causes Raynaud’s phenomenon?
Medical providers aren’t sure why some people develop Raynaud’s phenomenon, but they do understand what triggers an attack.
The top triggers are:
- Caffeine.
- Certain medications.
- Emotional stress.
- Exposure to cold.
- Repetitive motion.
- Nicotine use.
Secondary Raynaud's phenomenon has been linked to certain diseases, such as lupus, scleroderma, and rheumatoid arthritis. These diseases damage blood vessels, increasing the likelihood of attacks. Work-related factors, including vibrating tools or chemical exposures, can also damage blood vessels and put people at higher risk of attacks.
Raynaud’s phenomenon risk factors
Risk factors vary depending on the type of Raynaud’s phenomenon.
Risk factors for primary Raynaud’s phenomenon include:
- Age — Onset for primary Reynaud’s is typically between 15 and 30 years of age. Secondary Raynaud’s occurs later, often after 40.
- Sex — Women are more likely to develop the condition than men. It may be due to estrogen or hormonal changes.
- Family history of Raynaud’s phenomenon — About a third of those with Raynaud’s have a close family member with the condition.
Risk factors for secondary Raynaud’s phenomenon include:
- Certain diseases — People with diseases like lupus, scleroderma, or rheumatoid arthritis are more likely to develop Raynaud’s.
- Certain medications — Some drugs can trigger Raynaud’s attacks, including decongestants, appetite suppressants, beta blockers, and medications to treat migraines and attention deficit disorder.
- Work-related exposures — Exposure to vibrating tools or certain chemicals can put you at higher risk of developing Raynaud’s.
Raynaud’s phenomenon complications
In severe cases of Raynaud’s phenomenon, attacks can last for days and deprive tissues of oxygen-rich blood. If this lack of oxygen persists for too long, tissue damage or tissue death can occur. Doctors may perform surgery to remove the affected tissue or, in rare instances, amputate an extremity.
How can I prevent Raynaud’s phenomenon?
While you can’t always prevent Raynaud’s phenomenon from developing, you can prevent attacks by making certain lifestyle choices.
These choices include:
- Avoiding caffeine.
- Dressing warmly and using hand warmers or heated gloves when going out into the cold.
- Limiting the use of tools that vibrate your hands.
- Maintaining a healthy diet to support vascular health.
- Minimizing stress.
- Stopping smoking.
- Talking to your medical provider about limiting medications that trigger attacks.
What Are the Signs and Symptoms of Raynaud’s Phenomenon?
Some of the symptoms that are common to Raynaud’s include:
- Discoloration of the extremities — especially the fingers and toes — for extended periods of time.
- Persistent numbness or pain in the extremities.
- Skin ulcers on the fingers or toes.
When should I see a doctor about my Raynaud’s phenomenon symptoms?
You should seek evaluation if Raynaud symptoms begin later in life, are painful, occur in just one part or side of your body, or are accompanied by joint pain, rashes, skin thickening, shortness of breath, or muscle weakness, as they may suggest an underlying autoimmune disease.
If you notice prolonged discoloration, numbness, or pain in your fingers or toes, you should see a medical provider. Primary Raynaud’s can often be successfully treated with simple lifestyle changes. If you have secondary Raynaud’s, your medical provider can prescribe medication or therapy to help avoid attacks and tissue damage.
Most people initially see their primary care doctors about their symptoms. However, if you have secondary Raynaud’s caused by an autoimmune or rheumatic disease like lupus, you will need to see a rheumatologist. You may also be referred to a cardiologist or dermatologist, since Raynaud’s involves the blood vessels and the skin.
How Do You Diagnose Raynaud’s Phenomenon?
Most medical provider diagnose Raynaud’s phenomenon based on symptoms. However, your provider is likely to order tests to determine which type of Raynaud’s phenomenon you have, as the treatment can vary.
Tests to diagnose Raynaud’s phenomenon
- Blood test — If your medical provider suspects you have secondary Raynaud’s, they will likely order a blood test and other laboratory studies to evaluate for autoimmune or connective tissue diseases.
- Nailfold capillaroscopy — Using a magnifying instrument to examine the tiny blood vessels of your fingernails or toenails. Changes or abnormalities in the nail's capillaries are a sign of secondary Raynaud’s phenomenon.
How Do You Treat Raynaud’s Phenomenon?
Treatment for Raynaud’s phenomenon aims to ease symptoms and prevent attacks.
Short-term relief for a Raynaud’s attack
If you are experiencing a Raynaud’s phenomenon attack, the following actions may help to shorten the attack or alleviate symptoms:
- Gently warm the affected areas.
- Massage the affected areas.
- Soak in warm water.
- Tuck your hands into your armpits.
- Wiggle your fingers and toes.
- Windmill your arms.
Lifestyle changes for Raynaud’s phenomenon
In many cases, Raynaud’s phenomenon can be treated with lifestyle changes to prevent attacks.
Those changes include:
- Diet and nutrition — Medical providers recommend avoiding caffeine, which can constrict blood vessels, and maintaining a healthy diet to support vascular health.
- Environment — Exposure to cold is a primary trigger for Raynaud’s. If you spend time outdoors in cold weather, be sure to dress in layers and wear warm clothing. Also, using hand warmers or heated gloves can help to prevent attacks.
- Smoking and vaping — Smoking and vaping, including secondhand exposure, can trigger Raynaud’s attacks. If you smoke, you should speak with your medical provider about ways to quit.
- Stress management — Because anxiety and stress can trigger Raynaud’s attacks, minimizing stress with relaxation techniques, such as meditation and yoga, is recommended.
Medicine to treat Raynaud’s phenomenon
For those with secondary Raynaud’s phenomenon, medical providers often prescribe medication to treat the underlying condition — such as lupus — that is causing Raynaud’s. In other cases, medication helps to lessen the severity of attacks.
Those medications include:
- Alpha-blockers — Relax and widen blood vessels.
- Calcium channel blockers — Relax and open the small blood vessels in the hands and feet. These are often the first medications used to reduce the frequency and severity of the attacks.
- Vasodilators — Widen blood vessels. Reserved for severe cases, especially to improve the blood flow.
Surgery for Raynaud’s phenomenon
- Removal of damaged tissue — In severe cases of Raynaud’s phenomenon, attacks can last for days and deprive tissues of oxygen-rich blood. If this goes on too long, tissue damage or tissue death can occur. Doctors may perform surgery to remove the affected tissue or, in rare instances, amputate an extremity.
- Sympathectomy — In this procedure, doctors use incisions or injections to destroy the nerves that trigger blood vessel spasms in the affected area. While this procedure is effective, it isn’t permanent and may need to be repeated every few years. It provides temporary relief in severe cases that do not respond to other treatments.
Emerging treatments for Raynaud’s phenomenon
- Botox — Botox injections are being studied as a possible treatment for severe Raynaud's phenomenon. It is thought to relax muscles in the blood vessel walls, helping to improve blood flow.
- Laser therapy — Laser therapy can treat damaged cells.
- Nitric oxide creams — These creams may improve blood flow, but have limited availability or use.
Which Raynaud’s phenomenon treatment right for me?
Your treatment plan for Raynaud’s phenomenon depends on the type of Raynaud’s you have and the severity of your attacks.
- Primary Raynaud’s can often be treated with lifestyle changes alone.
- Secondary Raynaud’s tends to be more severe, so your medical provider may recommend medication or emerging treatment methods to prevent attacks better.
