Raynaud's phenomenon

Raynaud’s phenomenon (Raynaud’s syndrome) is a condition where sometimes blood doesn’t flow as it should to your hands and feet, and sometimes other parts of your body. When it’s cold, or sometimes if you’re anxious or stressed, your fingers and toes may feel numb and cold, and look pale or white.

About Raynaud’s phenomenon

When it’s cold, your body reacts by restricting blood flow to your skin to prevent more heat-loss from your body to maintain your core body temperature. This is normal. But if you have Raynaud’s phenomenon, the small blood vessels in extremities, such as your hands, feet, fingers or toes, are over-sensitive to even the slightest changes in temperature.

You have a more extreme reaction to cold temperatures and sometimes stress. It can cause a noticeable change of colour in affected areas, and your skin may turn white, then blue and finally red as your circulation comes back. This is known as a Raynaud's attack. And your skin can feel different too.

Raynaud’s phenomenon, also known as Raynaud’s syndrome and Raynaud’s disease, is common and doesn’t usually cause serious problems. But sometimes it can be a sign of a more serious health condition.

You can often treat the symptoms yourself by keeping warm and avoiding cold temperatures (where possible).

Causes of Raynaud’s phenomenon

Raynaud’s phenomenon is caused by your body restricting blood flow to your extremities, most often your fingers and toes. The blood vessels in your fingers and toes, for example, constrict. Raynaud’s phenomenon can either be a condition on its own (primary), which is most common, or it develops as a result of having another condition (secondary Raynaud’s) .

The exact cause of primary Raynaud’s phenomenon isn’t known but some things can increase your risk, such as if you:

• were born female
• have another member of your family with Raynaud’s
• smoke
• have migraines

Secondary Raynaud’s phenomenon can be associated with other health conditions or actions, which include:

• taking certain types of medicines, such as medicines for migraines or beta-blockers
• inflammatory health conditions, such as rheumatoid arthritis , scleroderma or lupus
• carpal tunnel syndrome
• an underactive thyroid
• using vibrating tools at work

Things that can trigger Raynaud’s phenomenon are:

• cold temperatures
• emotional stress
• vibration

Symptoms of Raynaud’s phenomenon

Symptoms of Raynaud's include the following.

• Pale or white fingers (not usually your thumb), or toes, usually starting at the tip and then spreading down. Your skin may then turn blue, and finally red when the blood returns.
• You may feel cold in the affected area, for example you may have cold fingers.
• Numbness in the affected area.
• Pins and needles when the blood starts to flow again.
• Pain – this can feel like a burning pain as the blood starts to come back.

These symptoms may last from a few minutes to a few hours.

While the symptoms of Raynaud's usually affect your fingers and toes, they can also affect your hands, feet, ears, nose, lips, tongue and nipples.

Diagnosis of Raynaud’s phenomenon

Your GP will ask about your symptoms and medical history of you and your family (including if you take any medicines). They’ll also examine the affected area. They may look at your fingers, for example, using a type of magnifying scope.

Nailfold capillaroscopy is a non-invasive imaging test used to examine the tiny blood vessels (capillaries) at the base of the fingernail, which can help diagnose the condition.

Your GP may try to create the conditions when you get Raynaud’s by putting your hands in cold water or cool air for one minute. It can also help to take a photo of when you get an attack of Raynaud’s to show your doctor. They may take your blood pressure too.

You may need to have a blood test and other tests to rule out other health conditions. Raynaud’s disease can sometimes be a sign of a more serious condition, such as scleroderma. Your GP will explain these to you, and may refer you to a specialist doctor, such as a rheumatologist.

Self-help for Raynaud’s phenomenon

Raynaud’s phenomenon can be reversed if you remove the trigger, for example you warm your hands up. This will speed up your recovery so your fingers (if these are affected) return to a normal colour and feel back to normal.

There are also some things you can do to help with Raynaud’s disease, which may be all you need to do if you have mild Raynaud’s. For example:

• try to avoid exposure to the cold and sudden changes in temperature
• keep your whole body warm at home and wear warm clothes in cold weather, including warm mittens and socks
• use hand and foot warming devices, such as pocket hand warmers
• get plenty of exercise
• try to manage stress with relaxation techniques, such as breathing exercises
• eat a healthy diet
• don’t smoke

Complications of Raynaud’s phenomenon

Primary Raynaud’s phenomenon doesn’t usually lead to complications. But it’s possible secondary Raynaud’s phenomenon can lead to the below complications.

• Digital ulcers. A digital ulcer is a break in the skin of your finger. They can be very painful and can get infected.
• Tissue death (gangrene). If you have severe Raynaud’s phenomenon and your finger, for example, doesn’t get enough oxygen, the tissue may die. It would need to be amputated, but this is rare.