Raynaud Phenomenon

What is Raynaud phenomenon?

From: MedlinePlus, National Library of Medicine

Raynaud phenomenon is a condition that affects your blood vessels (the tubes that your blood flows through). It causes your blood vessels to narrow, which decreases blood flow. This is called a Raynaud episode or "attack." The attacks usually affect your fingers and toes, causing them to become cold and numb. They may also change color, usually to white or blue. These attacks happen in response to cold temperatures or stress.

Raynaud phenomenon may also be called Raynaud disease or Raynaud syndrome.

What are the types of Raynaud phenomenon?

From: MedlinePlus, National Library of Medicine

There are two types of Raynaud phenomenon:

• Primary Raynaud phenomenon is the more common type. Its cause is unknown.
• Secondary Raynaud phenomenon is usually caused by another disease or problem, such as lupus or scleroderma. Other causes may be exposure to cold or certain chemicals. This type can be more serious than the primary type.

What causes Raynaud phenomenon?

From: MedlinePlus, National Library of Medicine

Researchers don't know exactly why some people develop Raynaud phenomenon. But they do understand how the attacks happen. When you are exposed to cold, your body tries to slow the loss of heat and maintain its temperature. To do this, the blood vessels in the top layer of your skin constrict (narrow). This moves blood from those vessels near the surface to vessels deeper in the body. But when you have Raynaud phenomenon, the blood vessels in your hands and feet react to cold or stress by narrowing quickly. They also stay narrowed for a long time.

Who is more likely to develop Raynaud phenomenon?

From: MedlinePlus, National Library of Medicine

Anyone can develop Raynaud phenomenon, but some people are more likely to develop it:

• Primary Raynaud phenomenon has been linked to: Your sex. Women get it more often than men. Your age. It usually develops in people younger than age 30. It often starts in the teenage years. A family history of Raynaud phenomenon. You are more likely to develop Raynaud phenomenon if you have a family member who has it.
• Secondary Raynaud phenomenon has been linked to: Certain diseases. These include lupus, scleroderma, rheumatoid arthritis (RA), carpal tunnel syndrome, and connective tissue disorders. Certain medicines. Medicines that treat high blood pressure, migraines, and attention deficit hyperactivity disorder (ADHD) may cause similar symptoms to Raynaud phenomenon or make your symptoms worse. Work-related exposures, such as repeated use of vibrating machinery (such as a jackhammer), or exposure to cold or certain chemicals.

What are the symptoms of Raynaud phenomenon?

From: MedlinePlus, National Library of Medicine

Raynaud attacks most often happen when you get cold, for example when you grab something cold from the freezer or go into an air-conditioned building on a warm day. Attacks usually affect your fingers and toes. But sometimes they can affect other parts of your body, such as your ears, nose, lips, or nipples.

An attack causes the skin to become cold and numb. Your skin may also turn white or blue due to a lack of oxygen. As the blood flow returns, your skin may tingle, throb, or turn red. An attack may last a few minutes or a few hours. If you have darker skin, you may not be able to easily see the skin color changes.

For many people, especially those with the primary type, the symptoms are mild. People with the secondary type often have more severe symptoms. They may develop skin ulcers (open sores caused by poor blood flow) or skin infections.

How is Raynaud phenomenon diagnosed?

From: MedlinePlus, National Library of Medicine

There is no specific test to diagnose Raynaud phenomenon. To find out if you have it, your health care provider:

• Will take your medical history and ask about your symptoms.
• Will do a physical exam.
• May order blood and other lab tests to check for other conditions which could be causing your symptoms and/or to help decide which type of Raynaud phenomenon you have.

What are the treatments for Raynaud phenomenon?

From: MedlinePlus, National Library of Medicine

Most people with Raynaud phenomenon can keep their symptoms under control by avoiding getting cold. But if this is not enough, medicines and, in some cases, surgical procedures can help.

Secondary Raynaud phenomenon is more likely to be serious and to need more treatments. It's also important to treat the condition or problem that is causing your Raynaud phenomenon.

You may need to see a specialist such as a rheumatologist, a doctor who treats diseases of the joints, muscles, and bones.

Can Raynaud phenomenon be prevented?

From: MedlinePlus, National Library of Medicine

Raynaud phenomenon cannot be prevented, but you can help prevent attacks and manage your symptoms by:

• Placing your hands or feet in a warm place when you have an attack. This could mean putting them under warm (not hot) water or under a heating pad.
• Keeping your body, especially your hands and feet, warm in cold weather.
• Avoiding triggers, such as certain medicines and stress.
• Quitting smoking (or not starting smoking).
• Managing stress.

Genetic causes described in the linked summary

From: MedlinePlus Genetics

The signs and symptoms of Raynaud phenomenon are related to excessive narrowing (constriction) of small blood vessels in response to cold or stress. Variations in genes involved in this process may contribute to an individual's risk of developing Raynaud phenomenon, but the connection between these gene variations and the abnormal blood vessel response that occurs in this disorder is unknown.

Normally, blood vessels constrict and widen (dilate) in response to temperature changes and stress, a process called the vasomotor response. The nervous system and muscle cells in the walls of blood vessels control this response. When exposed to cold temperatures, blood vessels near the surface constrict to help keep warm blood in the body's core, near the vital organs. Blood vessels also constrict during stress as part of the body's "fight-or-flight" response, conserving the oxygen and heat carried by the blood for the body's basic functions. When the body is too warm, the surface vessels dilate to allow more blood to flow near the skin where it is cooler. Raynaud phenomenon is characterized by exaggeration of these normal vasomotor responses.

There are many causes of secondary Raynaud phenomenon. These include autoimmune disease; partial or complete loss of function of the thyroid gland (hypothyroidism); cancers of the blood, bone marrow, or immune system; disease processes that cause obstruction of blood vessels; exposure to certain medicines or chemicals; cigarette smoking; injury or trauma; prolonged repetitive motions such as typing; or long-term use of vibrating tools.

Inheritance described in the linked summary

From: MedlinePlus Genetics

Raynaud phenomenon sometimes runs in families, but the inheritance pattern is unknown. Studies suggest that about 30 percent of people with a first-degree relative (parent, sibling or child) who has primary Raynaud phenomenon also have the condition.

Which doctor should you see?

The suggested department for discussing Raynaud Phenomenon is Vascular Medicine, with a vascular specialist / vascular surgeon as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

Additional services that may be relevant, depending on the findings, include: Clinical Genetics.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which part of the circulation needs assessment?
• What changes in pain, swelling, colour or limb function require prompt reassessment?
• Would observation, a medical approach or a procedure be considered in this case?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.