Raynaud's is a condition that causes some areas
of your body - such as your fingers, toes, tip of
your nose and your ears - to feel numb and cool in
response to cold temperatures or stress. It's a
disorder of the blood vessels that supply blood to
your skin. During a Raynaud's attack, these arteries
narrow, limiting blood circulation to affected
You can have Raynaud's without any underlying
disease associated with it, in which case it's
called Raynaud's disease or primary Raynaud's. Or it
can be part of another disease, in which case
doctors may refer to it as Raynaud's phenomenon or
Women are more likely than men are to
have the disorder. It's more common in people who
live in colder climates.
The aims of treatment are to reduce the number and severity of attacks
and to prevent tissue damage. Doctors also want to treat any underlying
disease or condition.
Depending on the cause of your symptoms, medications may prove effective
at treating Raynaud's. To widen (dilate) blood vessels and promote
circulation, your doctor may prescribe:
These drugs relax and open up small blood vessels in your hands and
feet. They decrease the frequency and severity of attacks in about
two-thirds of people with Raynaud's. These drugs can also help heal
skin ulcers on your fingers or toes. Examples include nifedipine (Adalat,
Procardia), diltiazem (Cardizem, Dilacor), amlodipine (Norvasc),
verapamil (Calan, Isoptin) and nicardipine (Cardene).
Some people find relief with drugs called alpha blockers, which
counteract the actions of norepinephrine, a hormone that constricts
blood vessels. Examples include prazosin (Minipress) and doxazosin (Cardura).
Some doctors prescribe a vasodilator — a drug that relaxes blood
vessels — such as nitroglycerin cream. You apply the cream to your
fingers to help heal skin ulcers.
Some people with persistent symptoms may benefit by adding a
medication called pentoxifylline (Trental), which improves
circulation by making red blood cells more flexible as they pass
through narrowed blood vessels.
You and your doctor may find that one drug works better for you than
another. Often people with primary Raynaud's respond better to
medications than do those with the secondary form.
Some drugs used to treat Raynaud's have side effects that may require
you to stop taking the medication. A drug may also become less effective
over time. Work with your doctor to find what works best for you.
Some medications actually can aggravate Raynaud's by leading to
increased blood vessel spasm. Your doctor may recommend that you avoid
over-the-counter (OTC) cold and diet drugs.
Examples include drugs that contain pseudoephedrine (Actifed,
Chlor-Trimeton, Sudafed) or phenylpropanolamine (PPA), a drug that
has been widely used as a nasal decongestant and for weight control
in some OTC medications.
This class of drug, used to treat high blood pressure and heart
disease, may worsen Raynaud's. Examples include metoprolol (Lopressor,
Toprol), nadolol (Corgard) and propranolol (Betachron, Inderal).
If you use birth control pills, switch to another method of
contraception because these drugs affect your circulation and may
make you more prone to attacks.
If you have questions about how best to manage Raynaud's, contact your
doctor. Your primary care doctor may refer you to a physician who
specializes in treating Raynaud's.
Sometimes in cases of severe Raynaud's, approaches other than
medications may be a treatment option:
Nerves called sympathetic nerves in your hands and feet control the
opening and narrowing of blood vessels in your skin. Sometimes it's
necessary in cases of severe Raynaud's to cut these nerves to
interrupt their exaggerated response as seen in Raynaud's. Through
small incisions in the affected hands or feet, a doctor strips away
these tiny nerves around the blood vessels. The surgery, called
sympathectomy, may reduce the frequency and duration of attacks, but
it's not always successful.
Doctors can inject chemicals to block sympathetic nerves in affected
hands or feet. You may need to have the procedure repeated if
symptoms return or persist.
Sometimes, doctors need to amputate a finger or toe affected by
Raynaud's in which the blood supply has been completely blocked and
the tissue has developed gangrene. But this is rare.