Raynaud's Disease
Raynaud’s disease is when blood vessels in your fingers and toes temporarily overreact to low temperatures or stress. For most people, it isn’t a serious health problem. But for some, the reduced blood flow can cause damage.
Causes
When it’s cold, your body tries to conserve heat. One way it does that is to slow down blood flow to the areas farthest from your heart your hands and feet.
To do that, the network of small arteries that carry blood to those points gets narrower, moving them away from your skin.
This is called the vasomotor response.
If you have Raynaud’s, your response is off. Those arteries shrink more than normal, and faster than normal.
That can make your fingers and toes feel numb and change color to white or blue.
This usually lasts about 15 minutes. When the arteries relax and your body warms back up, your fingers feel tingly and turn red before returning to normal.
You might have changes to genes that control your response, but doctors haven’t found a link between this and Raynaud’s.
Types
Primary Raynaud’s(or Raynaud’s disease)
It happens without any other illness behind it. The symptoms are often mild.
Secondary Raynaud’s (Raynaud’s syndrome, Raynaud’s phenomenon)
It results from another illness. It’s often a condition that attacks your body’s connective tissues, like lupus or rheumatoid arthritis. It’s less common, but it’s more likely to cause serious health problems. This can include things like skin sores and gangrene. These happen when cells and tissue in your toes and fingers die from lack of blood.
Symptoms
Cold fingers and toes
Your skin might turn white or blue when it’s cold or when you’re stressed. As you warm up, it could turn red.
Your fingers and toes feel tingly or prickly when they start to warm up.
Risk factors
Women are up to nine times more likely to get it than men.
People of all ages can get primary Raynaud’s, but it usually shows up between ages 15 and 25.
People with secondary Raynaud’s tend to get it after 35.
People with illnesses like rheumatoid arthritis, scleroderma, and lupus are more likely to get secondary Raynaud’s.
People who use some medicines to treat cancer, migraines, or high blood pressure may be more likely to get Raynaud’s.
Also, people who have carpal tunnel syndrome or use vibrating tools like jackhammers may be more likely to get Raynaud’s.
Diagnosis
If your doctor thinks you have Raynaud’s, they’ll ask questions about your symptoms and look at your fingers and toes.
They might also use a special magnifying glass called a dermoscope to check the blood vessels around your fingernails to see if they’re larger than normal or oddly shaped.
If the doctor thinks your condition results from another health problem, they might take some of your blood to test in a lab.
This lets them check for signs of an autoimmune disorder like lupus or rheumatoid arthritis.
Treatment
Medication
Your doctor might ask you to avoid some drugs, including over-the-counter cold medicines that contain pseudoephedrine. They can make your symptoms worse by causing your blood vessels to narrow.
If you have secondary Raynaud’s, your doctor might prescribe medicines to control your blood pressure and relax your blood vessels. If you get sores on your skin as a result, you might need to apply a cream that contains one of these drugs. They include:
Calcium channel blockers - Examples include nifedipine (Afeditab CR, Procardia), amlodipine (Norvasc), felodipine, and isradipine.
Vasodilators - These include the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra, Revatio), the antidepressant fluoxetine (Prozac, Sarafem), and a class of medications called prostaglandins. Others include a nitroglycerin cream you can put on the base of your fingers to help heal sores.
Surgery
If your condition doesn’t improve after these steps and you’re at risk of severe problems, like losing parts of your fingers or toes, your doctor might consider surgery.
These procedures involve cutting the nerves to the blood vessels in your skin to limit how much they open and close. The doctor might also inject drugs into your hands or feet to block those nerves.