DON’T IGNORE IT. It could be something else. If you suffer from these or know someone who does, they might have Raynaud’s phenomenon. It affects 10 million people here in the UK, including babies and children and in some cases can be a concern that needs to be addressed by a doctor.
For some people it is no more than a nuisance and can be very mild but it can also be much more severe, interfering with one’s daily life. Upon exposure to the cold or even a slight change in temperature unfortunately a Raynaud’s attack may occur and the fingers and/or toes can change colour due to the restriction of blood flow.
There are three colour changes, white when the blood is prevented from reaching the small blood vessels, bluish when there is deoxygenated blood and finally bright red when the circulation is restored. Not everyone has all ‘three colour’ changes but usually the white phase, which comes first, is the most significant. In certain cases Raynaud’s can be hereditary affecting more than one generation in a family.
Secondary Raynaud’s is when a person shows signs of Raynaud’s but there is an underlying cause to these symptoms. In some cases this could be a form of arthritis (rheumatoid, inflammatory), it could indicate heart/ vascular problems or initial signs of other auto immune, connective tissue diseases, (connective tissue is everything between the skin and the bone), such as Lupus or Scleroderma. Scleroderma is extremely rare; its name comes from two Greek words “sclero” meaning hard and “derma” meaning skin. Scleroderma is described as a rare condition affecting an estimated 1 per 10,000 of the population. Stress can also play a part in this condition. If you suffer with Raynaud’s or know someone who does, please do not ignore it.
Some of the above diseases have silent phases, so you have few symptoms or know no pain until the disease is in its later stages. A few simple tests may be able to diagnose a condition earlier so go to your local GP and discuss any concerns you have.
For people who have been diagnosed with primary Raynaud’s they can probably be treated by your doctor.
Those people, who have been diagnosed with secondary Raynaud’s due to with an underlying condition, may need to be referred to a specialist in the treatment of that condition.
- Smoking can make symptoms worse. The chemicals in tobacco can cause the small blood vessels to narrow. So stopping smoking may ease or even cure the problem.
- Some drugs (medicines) that are used to treat other conditions sometimes trigger symptoms, or make them worse. The drug may cause the blood vessels to narrow. Such drugs include: beta-blockers, some anti-migraine medicines, decongestants, and, very occasionally, the contraceptive pill. Don't stop a prescribed drug if you suspect it may be making symptoms worse. See your doctor to discuss possible alternatives.
- Other drugs. Caffeine (in tea, coffee, cola and in some painkillers) triggers symptoms in some people. Cutting out caffeine for a few weeks may help. Amphetamines (amphetamines) and cocaine may also be a trigger.
- Try to keep warm in cool weather or in cool environments:
- Keep the hands and feet warm. Warm gloves, socks and shoes are essential when outside in cool weather.
- Keep the whole body warm, not just the hands and feet. Although hands and feet are the most important, symptoms are less likely to occur if the entire body warm. So, wrap up warmly before going into cooler areas, such as outside on cold days. For example, wear hats and scarves in addition to warm clothes.
- It is better to put on the gloves before going into colder areas. Ideally, keep gloves, socks and headgear in an airing cupboard or near a radiator so they will be warm when put on.
- If the symptoms are severe, or symptoms that are easily triggered, then portable heat packs and battery heated gloves and socks are useful. The Raynaud's and Scleroderma Association have a list of suppliers - see below for their details. Your local pharmacist may also be able to advise.
- Try not to touch cold objects. For example, use a towel or gloves when removing food from the freezer or working with cold food.
- Regular exercise is recommended by many experts. Exercise the hands and feet frequently to improve the circulation.
- When a bout of symptoms develops, warm the affected hands or feet as soon as possible. Soaking the hands or feet in warm running water is a good way to get warm (but take care that the water does not become too hot, or lose its heat and become cool). Keeping warm is the main treatment. Symptoms are much less likely to occur, and be less severe, if you keep warm (described above).
Other treatments are needed only in some cases such as:
- Medication - Nifedipine may be advised if symptoms are severe. It works by 'opening up' (dilating) the small blood vessels. Some people take nifedipine regularly, each day, to prevent symptoms. Some people take nifedipine just during the winter, or just during cold weather spells. Nifedipine has a list of possible side-effects and cautions. Most people do not get any side-effects, or only minor side-effects. Of the side-effects that may occur, the most common are headache, flushing, nausea (feeling sick) and dizziness.
- Other medications have been used in the treatment of Raynaud’s but their use is controversial as there is limited or insufficient evidence to show that they are effective in most people. However, some people have claimed to benefit from treatment. The medications include angiotensin-converting enzyme (ACE) inhibitors fluoxetine (sold under the brand name Prozac), which was widely used in the treatment of depression)sildenafil (sold under the brand name Viagra), which is used to treat erectile dysfunction (inability to get or maintain an erection)
- Stress counselling or relaxation techniques may be helpful if you have primary Raynaud's and the symptoms are triggered by stress or emotion.
The outlook for people with primary Raynaud's is usually good. Most people have mild symptoms that do not interfere much with daily life. People with more severe symptoms often respond well to treatment with nifedipine. In some cases the condition remits (goes away) in time. In one study that followed up people with primary Raynaud's over seven years, the condition had gone away in nearly 2 in 3 cases at some point over the study period. Sometimes, someone who is thought to have primary Raynaud's develops other symptoms several months or years later and the diagnosis is changed to secondary Raynaud's. This is thought to occur in about 1 in 10 people who are initially diagnosed with primary Raynaud’s.
There are various underlying conditions that can cause secondary Raynaud's and their severity can vary. In general, symptoms are often more severe than with primary Raynaud's, and tend to respond less well to treatment. In some situations, treating an underlying condition will ease the symptoms of Raynaud's.
Further information and help:
The Raynaud's and Scleroderma Association
112 Crewe Road, Alsager, Cheshire, ST7 2JA
Tel (helpline): 0800 917 2494 Web: www.raynauds.org.uk