Raynaud’s Disease

Raynaud’s disease is a condition which affects blood flow. It usually affects the hands and feet, causing them to be cold and change colors—turning white, purple, and red. These color changes are due to sudden contractions of blood vessels, which severely reduce blood flow to the extremities. White color changes occur when there is no circulation in the digit, then purple and red color changes follow as the blood flow returns. In Raynaud’s, blood flow will return, but if blood flow is impaired for a prolonged period, there can be tissue damage.

Causes and Risk Factors

Although it is uncertain why people develop Raynaud’s, there are some risk factors associated with the disease, including:

• Pre-existing connective tissue or autoimmune disease
• Cigarette smoking
• Repetitive force to the hands, such as from using vibrating (power) tools or typing
• Injury or trauma
• Chemical exposure
• Side effects from certain medications

Symptoms

The following are the most common symptoms of Raynaud's, but each patient may experience symptoms differently:

• The fingers or toes turn white and then blue – usually after being exposed to cold air or objects, or experiencing stress – and subsequently turn red after re-warming.
• In severe cases, sores develop on the tips of the fingers or toes.
• In rare cases, fingers or toes can become infected or gangrenous, which can lead to amputation if not treated.

Diagnosis

Our team will look to diagnose Raynaud’s by way of the following:

• Complete medical history
• Physical exam
• Evaluation of symptoms
• Blood tests
• Cold challenge test

With Secondary Raynaud’s phenomenon, it’s also important to identify – and treat – the underlying autoimmune or other disorder that may be causing Raynaud’s phenomenon.

Treatment

Following a thorough evaluation, the physician team will develop a treatment plan based on the type and extent of the disease, the patient’s overall health, and the patient’s preferences.

Although there is no cure for Raynaud’s, it normally can be well managed with appropriate treatment, such as:

Lifestyle Changes

• Limiting exposure to the cold by dressing warmly – gloves, socks, scarf, hat, and layering
• Quitting smoking to improve circulation and overall health
• Avoiding use of vibrating tools

Medical Therapies

• Prescribing alpha blockers, which suppress the sympathetic nervous system response that leads to vasoconstriction (blood vessel narrowing)
• Prescribing other medications that also improve blood flow to the fingers and toes by dilating (expanding) blood vessels, such as calcium channel blockers or phosphodiesterase inhibitors
• Avoiding use of beta blockers, usually used to treat high blood pressure, which slows the heart rate and reduces blood flow to the extremities
• For patients who don’t respond well to the above medications, there may be investigational drug options – drugs that are allowed to be used in clinical trials

Multi-Disciplinary Care

The Raynaud’s Disease Clinic at Brigham and Women’s Hospital is one of only a few clinics in New England exclusively dedicated to the evaluation and treatment of patients with Raynaud’s disease (Raynaud’s phenomenon). A multidisciplinary team of vascular medicine, rheumatology, pulmonary vascular, plastic surgery, and other medical specialists collaborate to provide the most appropriate and effective care for patients with Raynaud’s.

Contact Us

To learn more about our rheumatology services or to make an appointment with a Brigham and Women’s Hospital rheumatologist, contact one of our trained coordinators at 1-800-294-9999 to get connected with the best doctor for your needs.