What is Raynaud’s syndrome?
Also called Raynaud’s phenomenon or Raynaud’s disease, Raynaud’s syndrome is a disorder of blood vessels, which causes the small arteries in fingers or toes to suddenly spasm when exposed to cold. This leads to narrowing of the vessel and a sudden decrease in blood flow to the digit. As a result, the finger or toe will turn suddenly white or blue. As the blood returns, the skin may turn red and throb or tingle. Raynaud’s is usually not dangerous, but it can be painful and frustrating. In rare, severe cases, reduced blood flow may lead to ulcers or tissue damage.
Primary care providers can often manage mild Raynaud’s. Rheumatologists treat cases linked to autoimmune disorders. Penn Medicine specialists are national leaders in diagnosing and treating the autoimmune and connective tissue diseases most often linked with Raynaud’s.
Types of Raynaud’s disease
There are two types of Raynaud’s. Understanding the difference is key to getting the right care.
This is the most common type. The cause is unknown, and it’s not linked to another condition. It’s more common in people assigned female at birth and is usually less severe than the secondary form. While it may affect daily life, it doesn’t lead to permanent damage to your blood vessels.
This type happens because of another condition, like an autoimmune disease, injury, or certain drugs. It’s often diagnosed in people in their late 30s. Secondary Raynaud’s can be more serious. Left untreated, it may cause ulcers or, in rare cases, tissue death (gangrene). The underlying condition may also need specialized care.
Raynaud’s syndrome symptoms
If your fingers turn white or blue when holding a cold drink, experiencing strong emotions, or reaching into the freezer, you might have Raynaud’s syndrome. This condition makes parts of the body overreact to cold or stress. During an attack, the skin may change color and feel cold, numb, or tingly. As the area warms up, you might feel stinging or throbbing pain. Symptoms usually last around 15 minutes but can be shorter or longer.
Raynaud’s most often affects the fingers and toes, but it can also involve the ears, nose, or lips.
What causes Raynaud’s syndrome?
Primary Raynaud’s has no known cause, but cold temperatures and emotional stress are common triggers. While Raynaud’s is a circulatory issue, it’s different from general poor circulation in the hands or feet. In some people, even a small drop in temperature can trigger blood vessel spasms and an exaggerated narrowing of the vessels.
In secondary Raynaud’s, several factors may contribute to symptoms.
Secondary Raynaud’s is often linked to diseases that affect blood flow to the body’s tissues. The most common are autoimmune or connective tissue diseases, including:
Some medications can trigger symptoms, including:
- Cold and allergy medicines with phenylephrine or pseudoephedrine
- Diet pills containing pseudoephedrine
- Beta blockers used to treat high blood pressure
- Migraine medications with ergotamine
- Stimulants like methylphenidate (used for attention deficit hyperactivity disorder, or ADHD)
- Hormonal birth control pills
- Some chemotherapy drugs
Certain physical and environmental factors may also play a role:
- Use of vibrating tools or machinery (sometimes called vibration white finger)
- Repetitive hand movements like typing or playing piano
- Exposure to chemicals like vinyl chloride
- Hand or foot injuries, like frostbite or a broken wrist
- Smoking, which narrows blood vessels and reduces circulation
Diagnosing Raynaud’s syndrome
Your provider will start by asking about your symptoms, when they began, how often they happen, and what seems to trigger them. There’s no single medical test for Raynaud’s, but your provider may do blood or urinalysis tests to rule out other conditions as part of the workup. For example, you might also have a nailfold capillaroscopy test where a small drop of oil is placed at the base of your fingernail, then viewed under a microscope to check the tiny blood vessels. If the vessels look unusual, it could mean you have another disease linked to Raynaud’s.
Treating Raynaud’s syndrome
Your treatment plan depends on how severe your symptoms are and whether you have primary or secondary Raynaud’s. Mild symptoms are often managed with lifestyle changes like keeping your hands and feet warm and avoiding cold or stress. If these changes aren’t enough, your provider may recommend medications like calcium channel blockers to improve blood flow.
If you develop an infection, your provider may prescribe antibiotics. Botox injections can sometimes help relieve pain and sensitivity to cold. In rare cases, surgery may be needed to remove damaged tissue or to interrupt the nerves that are contributing to the problem.
Lifestyle changes to help manage Raynaud’s
You may be able to manage symptoms with simple changes:
- It is important to wear warm gloves, thick socks, and use hand or foot warmers when temperatures are below 60 degrees Fahrenheit. Raynaud’s may also be triggered by low core temperature, so wear clothing that keeps your core warm.
- Avoid common triggers, like stress or certain medications.
- At the first sign of an episode, warm your hands by soaking them in warm water.
- Limit repetitive hand movements, like typing or playing the piano.
- Stay active with regular physical activity.
- Raise the air conditioning temperature or wear warm clothing when in cool indoor spaces.
Specialists in Raynaud’s and related rheumatological conditions
Penn Medicine is one of the world’s leading academic medical centers. Our specialists provide diagnosis, treatment, and ongoing care for Raynaud’s syndrome, as well as for autoimmune connective tissue diseases that can cause secondary Raynaud’s. We take a team approach to care, bringing together experts in rheumatology, dermatology, vascular medicine, and other specialties to understand your condition and find the right treatment plan for you.