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December 2008
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Cold Fingers and Toes?
It Might Be Raynaudís

Cartoon of woman bundled up in heavy clothing

When the temperature drops this winter, itís normal to feel it most in your fingers, toes, ears and nose. But if your fingers and toes regularly turn bluish or white when the temperature dips even slightly, or if they often feel numb or painful or turn red and tingle when youíre stressed or cold, it may be a sign you have something called Raynaudís disease.

Raynaudís (pronounced Ray-NOSE) disease is a disorder that affects blood vessels. Estimates vary, but most studies suggest that it affects about 3-5% of the population, especially women. It can arise at any age, although it typically appears during teenage years or later.

In people with Raynaudís disease, blood vessels have an extreme response to cold temperatures and stress. The bodyís normal response to prolonged cold temperatures is to tighten blood vessels and reduce blood flow to the fingers, toes and other extremities. This helps to slow heat loss and keep warm blood flowing to your brain and other vital organs. Likewise, stressful situations normally trigger the release of hormones that can also cause blood vessels to narrow in your extremities.

But in people with Raynaudís, the response to cold and stress is far more rapid and severe. Just taking something out of the freezer or sitting in an air-conditioned room can trigger an attack, which may last for less than a minute or as long as a few hours.

During a Raynaudís attack, the blood vessels quickly narrow and reduce the flow of blood, causing the skin to temporarily turn white, then bluish. When blood flow later returns, the skin turns red. Your fingers and toes may throb or feel numb and tingly. With severe Raynaudís, which is uncommon, prolonged or repeated episodes can cause skin sores or tissue death (gangrene).

Most cases of Raynaudís have no known causeóa condition called primary Raynaudís disease. Primary Raynaudís is typically more of a bother than a serious illness. It can often be managed with minor lifestyle changes, like wearing warm socks around the house or wearing gloves when removing things from the freezer.

When Raynaudís disease can be linked to an underlying medical condition, itís called secondary Raynaudís or Raynaudís phenomenon. Secondary Raynaudís is a more complex and typically more serious condition. It is most often caused by connective tissue disease, like scleroderma or lupus. Some of these diseases reduce blood flow to the fingers and toes. Secondary Raynaudís can also be caused by some medications that reduce blood flow, including certain blood pressure and migraine headache drugs. Treating the underlying condition or changing medications, if possible, is often the best way to reduce Raynaudís symptoms.

Physicians usually recommend non-drug treatments for patients with primary Raynaudís, because theyíre not at risk for tissue damage. Secondary Raynaudís may require prescription medications that help to improve blood flow and heal skin sores on fingers and toes. Be sure to talk with your doctor if you think you may have Raynaudís disease.


Wise Choices iconWise Choices
Avoid Raynaudís Attacks

You can take some simple steps to prevent or reduce the severity of Raynaudís attacks:

  • Keep warm. Wear a hat, gloves, scarf and coat when it’s cold. Soak your hands in warm water at the first sign of an attack.
  • Don’t smoke. The nicotine in cigarettes causes the skin temperature to drop, which may lead to an attack.
  • Avoid certain medications that cause blood vessels to narrow. These can include beta-blockers, some over-the-counter allergy or cold remedies and some migraine headache medications.
  • Control stress. Steer clear of stressful situations. Relaxation techniques may help.
  • Exercise regularly. Many doctors encourage patients who have Raynaud’s disease to exercise regularly, but talk with your doctor before beginning an exercise program.

Links iconWeb Sites

Raynaud's Phenomenon 

What Is Raynaud's Disease? 

Raynaud's Disease 
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