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Raynaud's phenomenon (also called Raynaud's disease, Raynaud's syndrome, or Raynaud's) is a disorder that affects the blood vessels in the fingers and toes. The condition can also affect blood vessels in the nose, lips and earlobes.
Patients with Raynaud's have spasms, called vasospastic attacks. When these spasms happen, the small blood vessels in the fingers and toes get tighter or close (constrict). The spasms can be caused by extreme changes in temperature (such as going outside in the cold), certain occupational exposures (such as vibration of the hands), or stress. When the blood vessels constrict, the skin in the affected areas becomes white or bluish and cold or numb.
There are two types of Raynaud's: primary, which means it happens on its own, and secondary, which means it is related to another medical condition.
Primary Raynaud's Phenomenon
Primary Raynaud's phenomenon is the most common and most mild type of the condition. Patients with this type of Raynaud's do not have other diseases or medical problems that can cause Raynaud's symptoms. The majority (75%) of patients with primary Raynaud's are women between the ages of 15 and 40. It is rare for patients with this type of Raynaud's to develop other diseases associated with the condition, such as lupus or scleroderma.
Secondary Raynaud's Phenomenon
Secondary Raynaud's phenomenon is less common, but often more serious, than primary Raynaud's. Patients with this type of the condition have another disease or medical condition that causes Raynaud's symptoms. In some cases, the condition causes the walls of the blood vessels to get thicker and constrict very easily. This causes the fingers and toes to get less blood than they normally do. Most patients (85%-95%) with scleroderma (a connective tissue disease) also have secondary Raynaud's. The condition also affects about one- third of patients with systemic lupus erythematosus (lupus). Other connective tissue diseases that can cause secondary Raynaud's are SjÃ¶gren's syndrome, dermatomyositis and polymyositis.
Other possible causes of secondary Raynaud's include:
Symptoms of Raynaud's
Patients with Raynaud's phenomenon may have three stages of skin color changes: white (pallor), blue (cyanosis) and red (rubor). The changes can happen in any order, and not everyone with Raynaud's has all three changes.
Raynaud's phenomenon may affect women more often than men. Raynaud's phenomenon also tends to be more common among people in colder climates.
However, people with the disorder who live in mild climates may have more attacks during colder weather. About 25 percent of people with Raynaud's have a family history of the condition.
An attack of Raynaud's is usually triggered by exposure to cold or emotional stress.
Under normal circumstances, when a person is exposed to cold, the body works to slow the loss of heat by causing the blood vessels that control blood flow to the skin's surface to move blood from the surface arteries to arteries deeper in the body.
For people who have Raynaud's, however, this normal body response is intensified by contractions of the small blood vessels that supply blood to the fingers and toes. The arteries in the fingers and toes can collapse or constrict, which reduces blood flow and causes changes in skin color.
If your doctor thinks you may have Raynaud's, you will have a complete physical exam and your doctor will review your medical history to rule out other medical problems. Many times the condition itself is easily diagnosed. But, it may be more difficult to figure out what is causing it.
Doctors often study the tiny blood vessels (capillaries) in the nail to help make a diagnosis.
The results of this test (nailfold capillaroscopy) are normal if the patient has primary Raynaud's. But, if the patient has the secondary form the results of this test will be abnormal.
The test involves putting a drop of oil on the skin at the base of the fingernail (nailfold). The doctor then looks at the nailfold under a microscope or a hand-held ophthalmoscope to check for problems with the capillaries. Enlarged or abnormal capillaries could be a sign of a connective tissue disease.
You may need other tests, such as a complete blood count (CBC), urinalysis, and chemistry profile to confirm secondary Raynaud's.
Your doctor may also order tests to help determine which type of Raynaud's you have. These tests can include an antinuclear antibody test (ANA), erythrocyte sedimentation rate (ESR) test and checking for the rheumatoid factor and complement levels.
The goals of treatment are to reduce the severity of attacks and protect the tissue in the fingers and toes by preventing damage and loss.
You may need to take medication, especially if you have secondary Raynaud's. However, many treatments do not involve medication.
The following prevention and treatment strategies are common steps your doctor will likely recommend:
You can follow these other tips to stay warm:
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This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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