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| Raynaud's Phenomenon |
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| What is Raynaud's Phenomenon? |
 Raynaud's
Phenomenon is a disorder of the small blood vessels that supply the skin.
During an attack of Raynaud's, these arteries contract briefly, limiting
blood flow. This is called a vasospasm. Deprived of oxygen from the blood,
the skin first turns white and then blue. Once the arteries relax and blood
flows again, the skin turns red. Extremities - hands and feet - are most
commonly affected, but Raynaud's can attack other areas such as the nose
and ears. |
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| What are the symptoms? |
| Symptoms include changes in skin color
(white to blue to red) and skin temperature (the affected area feels cooler).
Usually there is no pain, but it is common for the affected area to feel
numb or prickly, as if it has fallen asleep. |
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| What causes Raynaud's? |
Doctors believe that the body's blood
vessels overreact to cold. When the body is exposed to cold, the hands and
feet lose heat rapidly. To conserve heat, the body reduces the amount of
blood flowing to these areas by narrowing the small arteries that supply
them with blood. In people affected by this condition, the small blood vessels
over respond to cold. For example, reaching into a refrigerator may trigger
an attack.
Cold temperatures are more likely to provoke an attack when the individual
is physically or emotionally stressed. For some people, exposure to cold
is not necessary; stress alone causes vessels to narrow. |
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| Who is affected? |
| Women between the ages of 15 and 50
are most often affected, but anyone can have the problem. |
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| How is this condition diagnosed? |
| An attack is usually temporary, so
the doctor relies on the patient's description to diagnose the problem.
The doctor will also determine whether the patient has Raynaud's alone (called
Primary Raynaud's phenomenon) or if another disease or some aspect of the
patient's lifestyle is causing the symptoms. If the problem is caused by
another disease or risk factor, the patient is said to have Secondary Raynaud's
phenomenon. |
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| How is primary Raynaud's different
from secondary Raynaud's? |
| Primary Raynaud's usually affects
both hands and both feet, and the cause is not known for certain. Secondary
Raynaud's usually affects either both hands or both feet. Causes of secondary
Raynaud's can be identified. Smoking is one cause. Some drugs may also cause
this form of Raynaud's phenomenon. These include: |
- Some heart and blood medications.
- Migraine headache medications.
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| Other medical conditions that may
cause secondary Raynaud's phenomenon include: |
- Scleroderma--a thickening and hardening of the skin and other
body tissues.
- Systemic lupus erythematosus--a chronic inflammation of the
skin and organ systems.
- Rheumatoid arthritis--a chronic inflammation and swelling of
tissue in the joints.
- Blood flow reduction--problems that slow or stop blood flow
in a vessel. These include inflammation and hardening of the arteries
(arteriosclerosis).
- Nerve problems--problems that affect the nerves supplying the
muscles.
- Pulmonary hypertension--a condition in which the blood pressure
rises in the blood vessels of the lungs.
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| Injuries may also cause Raynaud's
phenomenon. They can result from frostbite, surgery, or other causes. For
example, regular use of machinery such as chain saws and vibrating drills
can hurt blood vessels. Other activities that may aggravate the phenomenon
are regular typing and piano playing. |
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| What are the treatments for Raynaud's? |
| Patients with primary Raynaud's are
taught how to prevent attacks (see below). In patients with secondary Raynaud's,
doctors first treat the underlying cause. Vasodilators - drugs that help
relax artery walls to improve blood flow - may be prescribed for patients
with secondary Raynaud's or primary Raynaud's that resists other forms of
therapy. |
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| Are there ways to prevent attacks? |
Yes. People suffering from Raynaud's
should protect themselves from cold and keep all parts of their body warm--not
just their extremities. When they go outdoors in winter, they should wear
scarves, warm socks and boots. People with Raynaud's should also take care
to cover the area between the sleeves and the gloves. While indoors they
should wear socks and comfortable shoes.
Patients with Raynaud's should guard against cuts, bruises, and other injuries
to the affected areas. Activities such as sewing may have to be limited.
Patients who smoke should quit. Doctors may also adjust medications if the
drugs appear to be responsible for the symptoms.
After several sessions of training, patients can often prevent or stop attacks
using biofeedback, a technique in which patients are taught to "think"
their fingers or toes warm.
It is important for persons who suspect they have Raynaud's to talk with
their family doctors and take advice on the best ways to manage and treat
the problem. |
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| What is the prognosis? |
| Between 40 to 60 percent of patients
with primary Raynaud's respond to management techniques. A rare but serious
complication of Primary Raynaud's is dry gangrene, or death of some tissue.
This may occur if the arteries stay contracted and prevent blood supply
to that area. In most people with Secondary Raynaud's, the problem does
not get worse. |
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| This page was last modified on August 30, 2001 |
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