Raynaud's syndrome

Also known as Raynaud's phenomenon

Raynaud's (pronounced 'ray-nose') is an extreme response to cold, usually affecting the hands and feet.

Key points

  1. Raynaud's (pronounced 'ray-nose') is an exaggerated response to cold, usually affecting the hands and feet.
  2. It happens when the small blood vessels in those areas narrow, allowing only a small amount of blood to get through.
  3. This extreme reaction may affect up to 10% of the population and is more common in women.

Symptoms

When the affected fingers and toes are exposed to cold or sudden temperature change, they go a very distinctive white or blue colour and become numb. When they are warmed again, they go bright red and the numbness wears off to be replaced by painful throbbing.

The colour change is due to spasm and narrowing in the small blood vessels in the skin of the hands and feet. These spasms may also occur in other areas such as the nose, earlobes and occasionally the tongue.

How is temperature normally regulated?

Our body temperature is controlled by the amount of heat retained or lost through the skin. This is regulated by the amount of the blood flowing through the small blood vessels of the skin. When we are hot, the blood vessels open wider, allowing more blood to flow through the skin. Heat is lost through the skin and we may look flushed.

When we are cold, these same blood vessels allow less blood to flow through them, so less heat reaches the skin surface. This system works very well and is controlled by special nerves and the mechanism is automatically controlled by the brain.

Causes

The cause of Raynaud's is unknown but it can sometimes run in families. There is no cure, but practical measures can be taken to prevent attacks. The use of chainsaws, jack-hammers or similar vibrating equipment may bring on a Raynaud's attack. In some people, medicines such as beta-blockers and migraine drugs can bring on Raynaud's.

In a small number of people, Raynaud's may be the first indication that an underlying condition, such as an autoimmune disorder, may be present. An example is the connective tissue disease called scleroderma. A simple blood test can be done that looks for special markers or antibodies in your blood that show whether or not you may have this condition. If the test is positive, your doctor will carry out further tests.

Is raynaud's a serious condition?

Most attacks are not serious and are no cause for alarm. Once the blood supply is restored, usually by warming, the fingers may be bright red for a while, and throb, but will then return to normal.

In those with more serious reactions or underlying disease, small ulcers may develop at the tips of the fingers, or chilblains or cracked skin may appear around the nails. See your doctor if you get these additional symptoms, as further investigation may be required.

Treatment

Milder cases of Raynaud's can be managed with lifestyle measures, such as using gloves to keep your hands warmer and thicker socks. If symptoms are severe or interfere greatly with your quality of life, see your doctor to discuss other treatment options. 

Self care

When you have an attack, try to stay calm. Gently re-warm your fingers or toes as soon as you can. Placing your hands under your armpits often helps. Go inside if you are outdoors, as this is usually warmer. Try wiggling your fingers or toes; move or walk around to try and improve your circulation. If you can, run warm (not hot) water over the affected part of your body until normal colour returns.

Aim for constant temperature

  • Try to keep your body temperature constant by wearing several layers of clothes. Mittens are warmer than gloves because the fingers keep each other warm. Tight gloves can cut off blood circulation in the fingers.
  • Try to avoid sharp changes in temperature: a change in temperature is more likely to bring on an attack than just being in the cold. Do not sit in draughts and be aware of air conditioning as this can make rooms very cool.
  • Always wear a hat: you lose a lot of heat through the top of your head.
  • Try to avoid sweating too much or make sure you use clothes that wick sweat away from the body, because sweat cools the body.

Exercise and reduce stress

  • Exercise is excellent for keeping warm (and for general health), but is not effective if you are experiencing an attack.
  • Learn how to handle stress because it can trigger an attack.
  • Don't smoke: smoking causes constriction of blood vessels.

Skin care

  • Use skin cream to keep your skin supple and soft.
  • Keep the affected skin dry: as water on the skin evaporates, it cools the skin which makes the circulatory changes worse.
  • Keep your fingernails and hands clean at all times.

Household tips

  • Protect your hands with suitable gloves when gardening or doing jobs around the house.
  • Do not get things from the freezer without using insulated gloves or mittens.
  • Do not handle cold items such as milk bottles straight from the fridge as this can bring on a spasm in the fingers - if you are going on a trip and it's likely to be cold, take a hot water bottle or 'Heat Wheat' mitts which can be warmed in the microwave.
  • Do not carry heavy shopping bags with handles because this can restrict the blood flow to the fingers: use shoulder bags where possible.  
  • Avoid extended periods of cold water exposure e.g. do not peel vegetables under a running tap, avoid hosing the garden if the hose nozzle leaks, avoid hanging wet clothes on a clothes line.
  • Start running your bath or shower water ahead of time so that you do not touch cold water. Be careful not to get chilled getting in and out of the tub or shower.
  • If possible, have someone start your car and turn on the heater a few minutes before you leave the house.

Learn more

Raynaud's disease Southern Cross Healthcare Group
Raynaud Phenomenon DermNet NZ

Credits: Editorial team. Last reviewed: 17 Jan 2015