Raynaud's Phenomenon

Laryn Sapetti

Description

Raynaud's phenomenon is a circulatory disorder that causes discoloration or numbness in fingers or toes after changes in temperature or stress. Raynaud's disease occurs because smaller arteries that supply the skin with blood narrow abnormally. This causes a lack of oxygen in affected areas which brings numbness and discoloration. Raynaud's phenomenon is more common in women and people who live in colder climates.
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Symptoms

Symptoms of Raynaud's phenomenon depend on the frequency, duration, and severity of the blood vessel spasms. Symptoms include

  • cold digits
  • color change in skin in response to cold temperatures or emotional events
  • numb, prickly, or stinging feeling when digits are warmed


When a person is experiencing Raynaud's phenomenon, the affected area of their skin usually turns white, then blue. As warming occurs the affected area usually turn red, throb, or swell. The order may change and not everyone experiences every color change.

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Causes

Raynaud's attacks appear to be triggered by an overreaction to cold temperatures or stress, however the cause is not completely understood by doctors. There are two types of the condition: Primary Raynaud's and Secondary Raynaud's.

  • Primary Raynaud's is not associated with a medical condition that causes the spasm.
  • Secondary Raynaud's are usually caused by another problem, such as smoking, diseases of the connective tissue or arteries, or injury. Diseases that can cause Raynaud's include collagen vascular diseases such as rheumatoid arthritis or arterial diseases such as atherosclerosis.

Treatments

Patients with Raynaud's phenomenon have a few options for treatment. Protection of digits (warm gloves and socks) is recommended for mild symptoms of Raynaud's. However, in more severe cases, certain medications may be prescribed such as:
  • Calcium Channel Blockers: work to relax small blood vessels in your hands and feet
  • Examples: nifedipine, amlodipine, felodipine
  • Alpha Blockers: work against norepinephrine, a hormone that constricts blood vessels
  • Examples: prazosin, doxazosin
  • Vasodilators: medications that are usually used to solve other problems such as high blood pressure, erectile dysfunction, and depression cans sometimes relieve the symptoms of Raynaud's
  • Examples: Cozaar, Viagra, Prozac, Sarafem


In the most severe cases of Raynaud's phenomenon, treatments other than medication may be used.

  • Nerve surgery may help reduce the frequency and duration of attacks. Small incisions are made in the affected hands or feet, which cuts sympathetic nerves that control the opening and narrowing of blood vessels. Cutting these nerves may stop the exaggerating narrowing of blood vessels.
  • Chemical injections may be used to block the sympathetic nerves in the affected hands and feet. Anesthetics or Botox are commonly injected.

Prevention

There are several ways to prevent Raynaud's phenomenon attacks.

  • Wear warm clothes
  • Warm your car in the winter
  • Protect your digits with gloves and socks
  • Exercise regularly
  • Avoid smoking
  • Identify stressors in your life and avoid them


Certain medications have also been known to cause Raynaud's phenomenon such as:

  • Ergot derivatives, used for migrane headaches
  • Beta blockers
  • Amphetamines
  • Birth control pills
  • Certain over-the-counter medications for the common cold such as Sudafed