Raynauds phenomenon

"Raynaud's phenomenon - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Heart and blood vessels Conditions Raynauds phenomenon Raynauds phenomenon About Raynauds phenomenon Causes of Raynauds phenomenon Diagnosing Raynauds phenomenon Treating Raynauds phenomenon Complications of Raynauds phenomenon About Raynauds phenomenon Raynauds phenomenon is a common condition that affects the blood supply to certain parts of the body  usually the fingers and toes. Its often referred to as Raynauds syndrome, Raynaudsdisease or just Raynauds. Why does it happen? Raynauds is usually triggered by cold temperatures, anxiety or stress. The condition occurs because your blood vessels go into a temporary spasm, which blocks the flow of blood. This causes the affected area to change colour to white, then blue and then red, as the bloodflow returns.You may also experience numbness, pain, and pins and needles. Symptoms of Raynauds can lastfrom a few minutes to several hours. IIts nota serious threat to your health, but can be painful and difficult to live with. If can affect your ability to move your fingers and hands.People with Raynauds often go for long periods without any symptoms, and sometimes the condition goes away altogether. Other parts of the body that can be affected by Raynauds include the ears, nose, nipples and lips. Treating Raynauds In many cases, it may be possible to control the symptoms of Raynauds yourself by avoiding the cold, wearing gloves and using relaxation techniques when feeling stressed. Stopping smoking can also improve symptoms, as smoking can affect your circulation. If youre unable to control your symptoms yourself, then a medication called nifedipine may be recommended. Read more about treating Raynauds . Types of Raynauds There are two types of Raynauds: primary  when the condition develops by itself (this is the most common type) secondary  when its caused byanother health condition Most cases of secondary Raynauds are associated with conditions that cause the immune system to attack healthy tissue (autoimmune conditions), such as sclerodermaand lupus . The causes of primary Raynaudsare unclear. However1 in 10 people with primary Raynauds goes on to develop a condition associated with secondary Raynauds, such as lupus. Your GP can help to determine whether you have primary or secondary Raynaudsby examining your symptoms and carrying out blood tests . Read more about what causes Raynauds and diagnosing Raynauds . Possible complications Secondary Raynauds can severely restrict theblood supply, so it carries a higher risk of complications, such as ulcers, scarring and eventissue death (gangrene) in the most serious cases. However, severe complications are rare. Read more about the complications of Raynauds . Who gets Raynauds? Raynauds phenomenon is a common condition. It affects up to 20% of the adult population worldwide. There may be as many as 10 million people with the condition in the UK. Primary Raynauds usually begins in your 20s or 30s. Secondary Raynauds can develop at any age, depending on the cause. Raynauds is slightly more common in women than men. Causes of Raynauds phenomenon Raynauds phenomenon is the result of over-sensitive blood vessels in the bodys extremities. In many cases, no cause is identified, although its sometimes linked to other health conditions. When your body is exposed to cold temperatures, the extremities, such as your fingers and toes, lose heat. This is because the small blood vessels under the skin spasm, slowing down the blood supply that is helping to preserve your bodys core temperature. In people with Raynauds, the sensitive blood vessels overreact to cold temperatures and become narrower than usual, significantly restricting the blood flow. Symptoms can be triggered by mildly cool weather, getting something out of the freezer, or running your hands under a cold tap. Strong emotions such as stress or anxiety may also trigger symptoms. Primary Raynauds The most common form of Raynauds is primary Raynauds phenomenon. This means the condition occurs by itself, without being associated with another health condition. It seems thatprimary Raynauds is caused by disruptions in how the nervous system controls blood vessels. Exactly what causes these disruptions is unclear. Theres some evidence that primary Raynauds may be an inherited condition, as cases have been known to run in families. Secondary Raynauds In some cases, an underlyinghealth condition couldbe causing the blood vessels to overreact. This is called secondary Raynauds. Autoimmune conditions The majority of cases of secondary Raynauds are associated with autoimmune conditions, which cause the immune system to attack healthy tissue. Autoimmune conditions known to be associated with secondary Raynauds include: scleroderma  a condition that causes hardening and thickening of the skin rheumatoid arthritis  which causes joint pain and swelling Sjogrens syndrome  where the immune system attacks the bodys sweat and tear glands lupus  which causes tiredness, joint pain and skin rashes Around1 in 10 people with primary Raynauds go on to develop an autoimmune condition. Infections Blood-born viral infections, hepatitis B and hepatitis C , can occasionally trigger Raynauds in some people. Cancer Some types of cancer can cause secondary Raynauds. These areusually cancers that develop inside the blood, bone marrow or immune system, such as: acute lymphoblastic leukaemia  a cancer of the white blood cells that mainly affects children lymphoma  a cancer that develops inside one or more of the glands that are part of the immune system multiple myeloma  a cancer that develops inside bone marrow Medicines Secondary Raynauds can also be a side effect of taking certain medicines, including: some types of anti- migraine medication  such as sumatriptan and ergotamine beta-blockers  which are used to treat high blood pressure and heart disease some chemotherapy medicines decongestants the contraceptive pill medicines used in hormone replacement therapy some types of medicines usedto treathigh blood pressure Illegal drugs, such as cocaine and amphetamines, can also cause secondary Raynauds. Injury and overuse Raynauds sometimes results from a physical injury. It can also affect musicians, people who type a lot, or other people who use their fingers and hands more than usual. Skin and tissue damage caused byfrostbite can also lead to Raynauds. Smoking Smoking cigarettes also increases your risk of developing Raynauds. Readabout the support available to help you quit smoking . Vibration white finger Vibration white finger is a term used when secondary Raynauds has been caused by vibration. This typically happens to people who regularly use certain types of vibrating tools, such as: sanders, grinders and disc cutters hammer drills chainsaws, hedge trimmers and power mowers Any vibrating tool that causes tingling or numbness in your fingers could lead to vibration white finger. Your employer has a responsibility to protect you from vibration white finger. If the job cant be done without vibrating tools: ask to use suitable low-vibration tools make sure youre using the right tool for the job check tools are properly maintained keepcutting tools sharp reduce the amount of time you use the tool in one go by doing other jobs in between keep warm at work wear anti-vibration gloves store toolsindoors, so they dont have cold handles when next used encourage your blood circulation by keeping warm, stopping smoking and massaging and exercising your fingers during your breaks If youre diagnosed with the condition, tell your employer as soon as possible. If you stop using vibrating tools at an early stage, you may recover fully. By law, your employer must contact the Health and Safety Executive about your condition. You may be entitled to an Industrial Injuries Disablement Benefit, which is a payment given to people who have become ill or injured as a result of their work. See the GOV.UK website for more information about the Industrial Injuries Disablement Benefit . Diagnosing Raynauds phenomenon Raynauds phenomenon can usually be diagnosed after an examination of your symptoms and some blood tests. Your GP may place your hands in cold water or cool air to see if you show symptoms of Raynauds. Further testing is usually recommended to find out whether you have primary or secondary Raynauds. Secondary Raynauds may require more treatment and, in some cases, referral to a specialist. Secondary Raynauds may be suspected if: your symptoms only started when you were over 30 years of age  most cases of primary Raynauds begin between the ages of 20 to 30 youre experiencing severe pain during an attack of Raynauds only one side of your body is affected Your GP may also check the tiny blood vessels, known as capillaries, found where your nail meets the finger. These capillaries are oftenlarger in people with secondary Raynauds, and look like red pen marks. Blood tests Your GP may also refer you for blood tests to check for other health conditionsthat could be causing your symptoms. These tests may include: a full blood count to check forinfection or, much less commonly, a cancer of the blood, such as leukaemia an antinuclear antibodies (ANA) test tocheck for anoveractive immune system, which is common in people with autoimmune conditions such as sclerodermaand lupus erythrocyte sedimentation rate to check for an autoimmune disorder Scleroderma & Raynauds UK (SRUK) If youve been diagnosed with Raynauds, Scleroderma & Raynauds UK (SRUK) may be helpful. It is the UKs leading charity for people affected by the condition. Treating Raynauds phenomenon You can usually treat Raynauds phenomenon yourself, although medication is sometimes necessary. If youve been diagnosed with secondary Raynauds, you may be referred to a specialist in the treatment of the underlying condition. If your secondary Raynauds may be a side effect of a medication, you may be asked to stop taking it, to see if your symptoms improve. Self-help The following advice is recommended forboth primary and secondary Raynauds. Keep your whole body warm, especially your hands and feet. Wear gloves and warm footwear in cold weather. If you smoke, stop. Quitting smoking will improve your circulation, which should help to improve symptoms. Exercise regularly, as this helps to improve your circulation and reduce stress levels (see below). For most people, 150 minutes of vigorous exercise a week is recommended. Read more about exercise . Try to minimise your stress levels. Regular exercise, eating a healthy diet , and relaxation techniques , such as deep breathing or activities such as yoga , can help. You may find it useful to avoid stimulants such as coffee, tea and cola. If you find it difficult to control feelings of stress, you may require additional treatment, such as counselling. Read more about therapies for stress . Medication Nifedipine If your symptoms fail to improve, you may be prescribed nifedipine. This is the only medicine licensed to treat Raynauds phenomenon in the UK. It doesnt cure Raynauds, but can help to relieve the symptoms. Nifedipine is a calcium channel blocker  a type of medication that encourages the blood vessels to widen. Depending on the pattern of your symptoms and how well you respond to treatment, you may be asked to take your medication every day. Alternatively, you may only need to take it as prevention; for example, duringa sudden snap of cold weather. Side effects are common and include: oedema  swelling of certain parts of the body, such as your hands and feet, due to a build-up of fluid headaches heart palpitations dizziness constipation Dont drink grapefruit juice when taking nifedipine, as this could make side effects worse. The side effects should improve as your body gets used to the medicine, but tell your GP if you find them particularly troublesome. There are alternative calcium channel blockers that may suit you better. Other medications Other medications have been used to treat Raynauds, but their use is controversial, as there is limited evidence to show theyre effective in most people. However, some people have claimed to benefit from treatment. These medications include: fluoxetine  which was widely used in the treatment of depression sildenafil  which is used to treat erectile dysfunction (inability to get or maintain an erection) These medicines are not licensed for the treatment of Raynauds in the UK, but you may be prescribed them if its thought the potential benefit outweighs the possible risks. Surgery Surgery for Raynauds is rare. Its usually only recommended if your symptoms are so severe that theres a risk the affected body part, such as your fingers, could lose their blood supply and begin to die. Read more about the complications of Raynauds phenomenon. A type of surgery called sympathectomy is sometimes used. It involves cutting the nerves causing the affected blood vessels to spasm. The results of a sympathectomy are often only temporary and further treatment and possibly more surgery may be required after a few years. Complications of Raynauds phenomenon People with Raynauds phenomenon have an increased risk of developing other problems, such as scleroderma. Scleroderma Around1 in 16 women and1 in 50 men with Raynauds develop a condition called scleroderma, usually between the ages of 25 and 55. Scleroderma is when the body produces excessively high levels of collagen. Scleroderma is a Greek word meaning hard skin, but it can affect other areas of the body, such as the kidneys, heart and lungs. Symptoms of scleroderma include: puffy and itchy skin tight and uncomfortable joints small calcium spots and red spots under the skin trouble swallowing, known as dysphagia diarrhoea , bloating or constipation Theres no cure for scleroderma, but there are ways of overcoming problems it may cause. For example, medicines can reverse or slow down the processes that cause damage around the body. For more information, visit Scleroderma & Raynauds UK (SRUK) , a UK charity dedicated to improving the lives of people affected by Scleroderma and Raynauds. Ulcers and gangrene In severe cases of Raynauds, the blood supply to an affected body part can become severely diminished. Without a constant supply of blood, the tissue in the body part will begin to die. This problem is rare and normally only occurs in secondary Raynauds. The initial sign is an open sore, known as an ulcer, which develops on the surface of the body part. If you suspect a skin ulcer, contact your GP for advice. Left untreated, the tissue can die, which is known as gangrene (specifically, dry gangrene). The symptoms of dry gangrene normally begin with a red line on the skin that marks the edges of the affected tissue. The tissue becomes cold and numb, and can be painful as the tissue dies. However, many people, particularly the elderly, experience no sensations. The affected area changes colour from red, to brown, to black. The dead tissue will then shrivel up, separate from the healthy tissue and fall off. These complications normally require admission to hospital, where youll be given medication designed to thin your blood, which should help to restore blood flow. If you fail to respond to treatment, you may need surgery to unblock or repair damaged blood vessels. Source: Chest Heart & Stroke Scotland - Opens in new browser window Last updated: 05 May 2023 How can we improve this page? 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