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Raynaud's disease

Raynaud's (ray-NOHZ) disease causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress. In Raynaud's disease, smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas (vasospasm).

Women are more likely than men to have Raynaud's disease, also known as Raynaud or Raynaud's phenomenon or syndrome. It appears to be more common in people who live in colder climates.

Treatment of Raynaud's disease depends on its severity and whether you have other health conditions. For most people, Raynaud's disease isn't disabling, but can affect quality of life.

Symptoms Causes Risk factors Complications Prevention

Signs and symptoms of Raynaud's depend on the frequency, duration and severity of the blood vessel spasms that underlie the disorder. Raynaud's disease signs and symptoms include:

  • Cold fingers or toes
  • Color changes in your skin in response to cold or stress
  • Numb, prickly feeling or stinging pain upon warming or stress relief

During an attack of Raynaud's, affected areas of your skin usually first turn white. Then, the affected areas often turn blue and feel cold and numb. As you warm and circulation improves, the affected areas may turn red, throb, tingle or swell. The order of the color changes isn't the same for everyone, and not everyone experiences all three colors.

Although Raynaud's most commonly affects your fingers and toes, the condition can also affect other areas of your body, such as your nose, lips, ears and even nipples. After warming, it may take 15 minutes for normal blood flow to return to the area.

When to see a doctor

See your doctor right away if you have a history of severe Raynaud's and develop a sore or infection in one of your affected fingers or toes.

Doctors don't completely understand the cause of Raynaud's attacks, but blood vessels in the hands and feet appear to overreact to cold temperatures or stress.

Blood vessels in spasm

With Raynaud's, arteries to your fingers and toes go into vasospasm when exposed to cold or stress, narrowing your vessels and temporarily limiting blood supply. Over time, these small arteries may thicken slightly, further limiting blood flow.

Cold temperatures are most likely to trigger an attack. Exposure to cold, such as putting your hands in cold water, taking something from a freezer or encountering cold air, is the most likely trigger. For some people, emotional stress can cause an episode of Raynaud's.

Primary vs. secondary Raynaud's

There are two main types of the condition.

  • Primary Raynaud's. Also called Raynaud's disease, this most common form isn't the result of an underlying associated medical condition that could provoke vasospasm.
  • Secondary Raynaud's. Also called Raynaud's phenomenon, this form is caused by an underlying problem. Although secondary Raynaud's is less common than the primary form, it tends to be more serious. Signs and symptoms of secondary Raynaud's usually appear later in life — around age 40 — than they do for primary Raynaud's.

Causes of secondary Raynaud's include:

  • Connective tissue diseases. Most people who have a rare disease that leads to hardening and scarring of the skin (scleroderma) have Raynaud's. Other diseases that increase the risk of Raynaud's include lupus, rheumatoid arthritis and Sjogren's syndrome.
  • Diseases of the arteries. Raynaud's phenomenon can be associated with various diseases that affect arteries, such as the buildup of plaques in blood vessels that feed the heart (atherosclerosis) or a disorder in which the blood vessels of the hands and feet become inflamed (Buerger's disease). A type of high blood pressure that affects the arteries of the lungs (primary pulmonary hypertension) can be linked to Raynaud's.
  • Carpal tunnel syndrome. This condition involves pressure on a major nerve to your hand (ulnar nerve) producing numbness and pain in the affected hand. The hand may become more susceptible to cold temperatures and episodes of Raynaud's.
  • Repetitive action or vibration. Typing, playing piano or doing similar movements for long periods and operating vibrating tools, such as jackhammers, can increase your risk of developing Raynaud's.
  • Smoking. Smoking constricts blood vessels and is a potential cause of Raynaud's.
  • Injuries. Injuries to the hands or feet, such as wrist fracture, surgery or frostbite, can lead to Raynaud's phenomenon.
  • Certain medications. Some drugs — including beta blockers, which are used to treat high blood pressure; migraine medications that contain ergotamine or sumatriptan; attention-deficit/hyperactivity disorder medications; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications — have been linked to Raynaud's.

Risk factors for primary Raynaud's include:

  • Sex. Primary Raynaud's affects women more than men.
  • Age. Although anyone can develop the condition, primary Raynaud's often begins between the ages of 15 and 30.
  • Climate. The disorder is also more common in people who live in colder climates.
  • Family history. A family history appears to increase your risk of primary Raynaud's. About one-third of people with primary Raynaud's have a first-degree relative — a parent, sibling or child — with the disorder.

Risk factors for secondary Raynaud's include:

  • Associated diseases. These include conditions such as scleroderma and lupus.
  • Certain occupations. People in occupations that cause repetitive trauma, such as operating tools that vibrate, may be more vulnerable to secondary Raynaud's.
  • Exposure to certain substances. Smoking, medications that affect the blood vessels, and exposure to certain chemicals, such as vinyl chloride, are associated with an increased risk of Raynaud's.

If Raynaud's is severe — which is rare — blood circulation to your fingers or toes could permanently diminish, causing deformities of your fingers or toes.

If an artery to an affected area becomes blocked completely, sores (skin ulcers) or dead tissue (gangrene) may develop. Ulcers and gangrene can be difficult to treat. In extreme untreated cases, your doctor may need to remove the affected part of your body (amputation).

To help prevent Raynaud's attacks:

  • Bundle up outdoors. When it's cold, don a hat, scarf, socks and boots, and two layers of mittens or gloves before you go outside. Wear a coat with fairly snug cuffs to go around your mittens or gloves, to prevent cold air from reaching your hands. Use chemical hand warmers. Wear earmuffs and a face mask if the tip of your nose and your earlobes are sensitive to cold.
  • Warm your car. Run your car heater for a few minutes before driving in cold weather.
  • Take precautions indoors. Wear socks. When taking food out of the refrigerator or freezer, wear gloves, mittens or oven mitts. Some people find it helpful to wear mittens and socks to bed during winter.

    Because air conditioning can trigger attacks, set your air conditioner to a warmer temperature. Use insulated drinking glasses.

  • Consider relocating. Moving to a warmer climate may help people with severe Raynaud's. However, Raynaud's can occur even in warmer climates when temperatures decrease.
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