Credit: Harvard Medical Publishing, Harvard Medical School, Patient Education
When you reach into the dairy case at the grocery store, do your fingers blanch, then get cold and tingly? You may have Raynaud’s syndrome (pronounced ray-NOSE or ray-NODES), which affects one in 20 adults over the age of 18 in the United States, and women more often than men. Identified by Dr. Maurice Raynaud in 1862, the syndrome impacts blood flow to fingers and toes, lips, noses and earlobes.
Normally when our fingers get cold, the arterioles — small blood vessels that bring oxygen to the skin — constrict to conserve heat. In Raynaud’s syndrome, the blood vessels tighten excessively, causing the skin to turn white and then blue from lack of oxygen. Normally, when there are no underlying complications, the arterioles expand again within 15 minutes, and the skin will redden before returning to normal color.
Raynaud’s syndrome is split into two types: primary and secondary. The first, also called Raynaud’s disease, is the most common and has no known cause. The symptoms (numbness and skin color changes) are mild, manageable and not life-threatening.
Secondary Raynaud’s syndrome, also called Raynaud’s phenomenon, is associated with underlying causes: an autoimmune disease (such as lupus), medication side effects (beta blockers like atenolol, which affect blood flow to hands and feet) or long-term use of vibrating tools (such as chainsaws or jackhammers). The symptoms can be intense, lingering and more frequent. Skin ulcerations are common and if left untreated can escalate seriously and result in gangrene.
Triggers for both types of Raynaud’s syndrome include exposure to the cold — winter weather, air conditioning, or just getting food out of your refrigerator or freezer. Holding an iced beverage can also lead to an attack, as can the sweat cooling on your skin after a workout. Stress and anxiety aggravate just about all health problems, including Raynaud’s.
To stop an episode, go to a warm place immediately. Gently rub the skin that’s tingly and cold. If your fingers are affected, move your arms in circles to increase circulation, then put your hands in your armpits to warm up. Warm compresses or a heating pad on a light setting can help. Deep breaths or other stress managers also make a difference.
Lifestyle changes can significantly diminish the frequency and severity of your Raynaud’s episodes. Keep your body warm with layered clothing during cold months, wear gloves outside and in the grocery store, grab a sweater if the AC is blasting in your office, avoid going barefoot, cut back on caffeine and stop using nicotine (which both constrict blood flow). In general, help stimulate healthy blood flow with exercise and good hydration and by minimizing stress to the degree possible.
Secondary Raynaud’s syndrome often requires additional treatment, including oral medication (calcium channel-blockers, which keep blood vessels dilated). Botox injections, which increase blood flow to the skin, or a sympathectomy, a procedure that cuts the nerves that control peripheral blood vessels, may also be necessary.
If you are a sufferer or have a loved one affected by the syndrome, The Raynaud’s Association is a non-profit organization dedicated to information sharing and support.
Mary Jenkins recently retired after nearly 40 years as a family practice physician in New York state.