Raynaud s Disease. What is Raynaud s Disease? Raynaud s disease is also sometimes known as Raynaud s phenomenon or Raynaud s syndrome.

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1 Raynaud s Disease Introduction Raynaud s disease is a rare disorder of the blood vessels. It usually affects the fingers and toes. This disorder causes the blood vessels to narrow which turns the affected areas white and blue. Blood vessels widen after a Raynaud s attack is over. The skin turns red and throbs or tingles. In severe cases, sores or tissue death may happen due to the loss of blood flow. This reference summary explains Raynaud s disease. It covers symptoms, causes, diagnosis and treatment. What is Raynaud s Disease? Raynaud s disease is also sometimes known as Raynaud s phenomenon or Raynaud s syndrome. Raynaud s disease is a rare disorder that affects the arteries. Arteries are blood vessels that carry blood from your heart to different parts of the body. The body saves heat when it is cold by slowing the supply of blood to the skin. It does this by narrowing blood vessels. With Raynaud s disease, the body s reaction to cold or stress is stronger than normal. It makes blood vessels narrow faster and tighter than normal. This is called vasospasm. Vasospasm of the arteries reduces blood flow to the affected areas. The reduced blood flow causes the symptoms of Raynaud s disease. Often Raynaud s disease does not cause long-term tissue damage or disability. The blood vessels relax and blood flow is restored before tissue is permanently damaged. 1

2 Symptoms The signs and symptoms of Raynaud s disease are triggered by cold temperatures or emotional stress. When symptoms appear, it is called an attack. Attacks usually affect the fingers and toes. Rarely, the attacks affect the nose, ears, nipples, or lips. During an attack, blood vessels become very narrow. As a result, little to no blood can flow to affected areas. This may cause these areas to: Turn pale or white and then blue Feel numb, cold or painful Turn red, throb, tingle, burn, or numb as blood flow returns Attacks can last less than a minute or as long as several hours. Attacks can happen daily or weekly. Attacks often begin in one finger or toe and move on to other fingers or toes. Sometimes only one or two fingers or toes are affected. Different areas may be affected at different times. Severe Raynaud s can cause skin sores or gangrene. Gangrene is the death or decay of body tissue. The tissue dies when it does not receive blood for a long period of time. Severe Raynaud s is rare. Causes Many things can cause Raynaud s disease. For example, it is linked to diseases and medical conditions that directly damage the arteries or the nerves that control the arteries in the hands and feet. Scleroderma and lupus are two examples of the many conditions that can cause Raynaud s disease. Scleroderma means hard skin. It is a group of diseases that causes abnormal growth of connective tissue, the proteins that support the skin and organs. About 90% of people with scleroderma have Raynaud s. Lupus is an autoimmune disease where the body attacks healthy cells and tissues by mistake. This can damage the joints, skin, blood vessels and organs. About 1 out of every 3 people who has lupus also has Raynaud s. 2

3 Repetitive actions can also cause Raynaud s disease by damaging the arteries or the nerves that control the arteries in the hands and feet. Examples of repetitive actions include typing or playing the piano. Using vibrating tools, such as jackhammers or drills, can increase the risk of developing Raynaud s. Injuries to the hands or feet from accidents, frostbite, surgery or other causes can lead to Raynaud s disease. Exposure to certain workplace chemicals can also cause Raynaud s. An example is vinyl chloride, which is used in the plastics industry. The nicotine in cigarettes can also raise the risk of developing Raynaud s. Certain medications can cause Raynaud s disease, such as: Beta blockers Birth control pills Certain cancer medicines, such as cisplatin and vinblastine Migraine headache medicines that contain ergotamine Some over-the-counter cold and allergy medicines and diet aids Doctors cannot always tell the exact cause of Raynaud s syndrome. Diagnosis Your healthcare provider will diagnose Raynaud s disease based on your medical history, a physical exam, and test results. A cold stimulation test may be used to trigger Raynaud s symptoms. For this test, your hands are briefly put into ice water. A small device measures how quickly your fingers return to normal temperature. It may take more than 20 minutes if you have Raynaud s syndrome. A nailfold capillaroscopy can be done to look for abnormal arteries in the fingers. A drop of oil is placed at the base of your fingernail for this test. Your fingernail is then examined under a microscope to see the arteries. Other tests and procedures, such as blood tests, may be done to look for conditions that are linked to Raynaud s. 3

4 Treatment There is no cure for Raynaud s disease. However, treatments can reduce the number and severity of attacks. Treatments include lifestyle changes, medicines and, rarely, surgery. Most people with Raynaud s can manage the condition with lifestyle changes. Lifestyle changes can help you avoid things that may trigger a Raynaud s attack, such as cold and stress. To protect yourself from cold temperatures: Cover up during cold weather. Layer your clothing for extra warmth and wear mittens rather than gloves to protect your fingers. Put hand and foot warmers in your mittens, boots, socks or pockets. These warmers are available at most sporting goods stores. Set the air conditioning to a warmer temperature or dress warmly in an air-conditioned space. Warm up your car before driving in cold weather. Wear gloves or mittens when taking food out of the refrigerator or freezer if your hands are very sensitive. You can also avoid other triggers by: Avoiding things that make you upset or stressed Managing stress Limiting the use of vibrating hand tools, such as power tools Wearing proper protective gear when working with chemicals Limiting repetitive hand actions, such as typing or playing the piano If a medication is triggering your attacks, use the alternative medication or dosage recommended by your healthcare provider. Make sure you talk to your healthcare provider about your best options. Other lifestyle changes that can also help you avoid attacks include: Avoid tight wristbands and rings Be physically active to increase blood flow and keep you warm If you smoke, quit Limit your use of caffeine and alcohol 4

5 You can also take steps to help stop attacks when they happen by: Moving to a warmer spot Warming your hands or feet using warm water Moving your arms in circles or shaking your arms and feet Getting out of stressful situations and trying to relax If lifestyle changes do not control Raynaud s, you may need medicines or surgery. Oral medications and prescription creams may be used to improve blood flow to the fingers and toes. Severe Raynaud s may be treated with surgery or shots to block the nerves that control the arteries in the hands or feet. This can help prevent attacks. Rarely, people who have severe Raynaud s may develop skin sores or gangrene. Gangrene is the death of tissue in part of the body. If this happens, antibiotics or surgery to cut out damaged tissue may be needed. In very serious cases, the affected toe or finger may be amputated or removed. See your healthcare provider right away if you have Raynaud s and develop sores on your fingers, toes or other parts of your body. Early treatment can help prevent permanent damage to these areas. Be sure to take care of your hands and feet. Protect them from cuts, bruises and other injuries. Use lotion to prevent your skin from drying and cracking. Summary Raynaud s disease is a rare disorder of the blood vessels. It usually affects the fingers and toes. People with this disorder have attacks that cause the blood vessels to narrow. This causes the affected areas to turn white and blue. When a Raynaud s attack is over, the blood vessels widen. The skin turns red and throbs or tingles. In severe cases, loss of blood flow can cause sores or tissue death. The signs and symptoms of Raynaud s disease are triggered by cold temperature or emotional stress. Raynaud s attacks usually affect the fingers and toes. Rarely, the attacks affect the nose, ears, nipples, or lips. 5

6 There is no cure for Raynaud s disease. However, treatments can reduce the number and severity of Raynaud s attacks. Treatments include lifestyle changes, medicines and, rarely, surgery. See your healthcare provider right away if you have Raynaud s and develop sores on your fingers, toes or other parts of your body. Early treatment can help prevent permanent damage to these areas. 6