Raynaud's phenomenon

Overview

In Raynaud's phenomenon, small blood vessels in the fingers and toes tighten too much when you're cold or stressed. Less blood reaches the skin, so it turns white or blue and feels cold and numb. When blood returns, the skin turns red and may throb or tingle.

Primary Raynaud's has no known cause and is the more common, milder type. Secondary Raynaud's happens along with another disease, like scleroderma or lupus, and can be more serious.

Symptoms

Attacks usually last minutes and often start in one finger.

• Fingers turn white or blue in the cold
• Numb or tingling fingers
• Cold fingers or toes
• Red, throbbing skin as it warms up

Less common

• Toes, ears, nose, or lips affected
• Pain or burning as fingers rewarm
• Sores on fingertips (more likely in secondary Raynaud's)

How it usually goes

• Minutes: Skin turns white or blue in the cold.
• As it warms: Skin turns red and may throb.
• Long term: Attacks come and go, often worse in winter.

Look up a symptom: Fingers turn white or blue in the cold · Hand, finger, or wrist pain · Numb or tingling fingers

When to get medical care

Causes

The blood vessels overreact to cold or stress. Primary Raynaud's has no known cause. Secondary Raynaud's can come from diseases like scleroderma and lupus, some medicines, or using vibrating tools at work.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.
• It can run in families. Tell your doctor if a parent, brother, or sister has it.

Who is more likely to get it

• Being female, especially under age 30 for primary Raynaud's
• Family history of Raynaud's
• Autoimmune diseases, like scleroderma or lupus
• Using vibrating tools
• Smoking

Possible complications

• Scleroderma: Raynaud's may be an early sign
• Lupus: Can cause secondary Raynaud's

Diagnosis

There's no single test. Doctors usually diagnose it from a description of a typical attack in the cold.

Questions you may be asked

• What happens to your fingers or toes during an attack
• What brings attacks on
• Joint pain, rashes, or skin sores
• Smoking and medicines you take
• Family history of Raynaud's

The exam

They'll check your hands, fingers, and skin.

Tests

Blood tests may be done to look for a related disease:

• ANA test: Looks for antibodies seen in autoimmune diseases.
• Thyroid test (TSH): To check for thyroid problems.

Treatment

Most people can manage Raynaud's by staying warm and avoiding triggers.

Self-care

• Keep your whole body warm, not just your hands and feet; wear layers, a hat, and mittens
• During an attack, warm up gently: run warm (not hot) water over fingers, put hands in your armpits, or whirl your arms
• Don't smoke or vape, and avoid secondhand smoke
• Manage stress
• Avoid fast temperature changes, like going from heat to air conditioning
• Care for your skin; treat cracks or sores promptly

Medicines

Medicine is usually only needed for frequent or severe attacks.

If attacks are frequent or severe, your doctor may prescribe medicine that opens blood vessels. Secondary Raynaud's also needs treatment of the disease causing it.

How it compares

Prevention

You can lower the number of attacks:

• Dress warmly and carry layers, even indoors with air conditioning
• Don't smoke
• Manage stress
• Ask your doctor about medicines that may trigger attacks

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a rheumatologist (joint and immune system doctor).

Living with it

• Keep a simple diary of symptoms, triggers, and medicines to bring to visits.
• Bring a list of your medicines and questions to each visit.
• Stay active in ways that feel good to you.
• Get enough sleep and manage stress.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

• Children and teens: Primary Raynaud's often starts young and is usually mild.
• Workers: Using vibrating tools can cause a type called vibration white finger.
• Adults over 30: Secondary Raynaud's is more common at this age. Get checked.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Each attack is temporary, but Raynaud's is a long-term condition. Primary Raynaud's is usually more bothersome than harmful. Secondary Raynaud's can be more serious and needs follow-up.

Getting ready for your visit

A photo of your fingers during an attack can help.

What to bring

• What attacks look like and how long they last
• Other symptoms like joint pain or rashes
• Family history of autoimmune diseases
• All medicines and supplements

Questions to ask

• Is it primary or secondary Raynaud's?
• Do I need more tests?
• Do I need medicine?
• How can I prevent attacks?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Raynaud's phenomenon