Raynaud's is more than just having cold hands and feet. It's also not the same as frostbite. Signs of Raynaud's depend on how often, how long and how severe the blood vessel spasms are. Signs and symptoms include:
- At first during an attack, affected areas of skin usually turn white. They often then turn blue and feel cold and numb. The ability to perceive sensory information is dulled, and the affected skin may look slightly swollen. As circulation improves, the affected areas may turn red, throb, tingle or swell. The order of the color changes is not the same for all people, and not everyone experiences all three colors.
- Numbness, prickles or stinging pain upon warming or relief of stress
- Occasionally, an attack affects just one or two fingers or toes. Attacks don't always affect the same digits. Although it most commonly affects your fingers and toes, the condition also can affect other areas of your body, such as your nose, cheeks, ears and even tongue. An attack may last less than a minute to several hours, and over time, attacks may grow more severe.
People who have Raynaud's with another disease also may have symptoms related to their underlying condition.
Causes and Risk Factors
It is not known what causes the blood vessels in the hands and feet to overreact to cold or stress. Women get this disorder more than men, and studies are being done to see if it is an inherited condition.
To help maintain its core temperature, the body naturally cuts down the flow of blood to the hands and feet when temperatures are cold or there is a threat by narrowing the small arteries under the skin of the hands and feet. In people with Raynaud's, this response is exaggerated.
With Raynaud's, arteries to the fingers and toes go into what's called vasospasm, which makes the vessels narrow temporarily to limit the blood supply. In time these same small arteries also may thicken slightly, further limiting blood flow. The affected skin turns pale-dusky-colored from lack of blood. Once the spasms end, blood flows back, but the tissues may turn red before returning to a normal color.
Simple tasks, such as putting hands under running cold water, taking something out of a freezer or exposure to cold air can provoke an attack. Emotional stress can also cause an episode of Raynaud's. Other conditions and activities that put you at increased risk for Raynaud's phenomenon are:
- Scleroderma. Raynaud's phenomenon occurs in about 90% of people who have scleroderma, a rare disease that leads to hardening and scarring of the skin. Scleroderma results in Raynaud's because the disease reduces blood flow to hands and feet, and it causes tiny blood vessels to thicken and constrict too easily.
- Lupus. Between 30 and 40% of Americans with lupus (a disease that can affect many parts of the body, including the skin, joints, organs and blood vessels) develop Raynaud's.
- Rheumatoid arthritis. Raynaud's often is the first sign of rheumatoid arthritis, an inflammatory condition causing pain and stiffness in the body's joints, often including the hands and feet.
- Sjögren's syndrome. Raynaud's phenomenon can also occur in people who have this rare disorder that often comes with scleroderma, lupus or rheumatoid arthritis. The hallmark of Sjögren's syndrome, a connective tissue disease, is chronic dryness of the eyes and mouth.
- Diseases of the arteries. Raynaud's phenomenon can occur with diseases that affect arteries, such as Buerger's disease in which the blood vessels of the hands and feet become inflamed.
- Carpal tunnel syndrome. The carpal tunnel is a narrow passage in your wrist that protects a major nerve to your hand. Carpal tunnel syndrome is a condition in which pressure is put on this nerve, producing numbness and pain in the affected hand. The affected hand may become more susceptible to cold temperatures and episodes of Raynaud's.
- Repetitive trauma. Raynaud's also can be caused by repetitive trauma that damages nerves serving blood vessels in the hands and feet. Some people who type or play the piano for long periods of time or vigorously may be susceptible to Raynaud's. Workers who use vibrating tools can develop a type of Raynaud's phenomenon called vibration-induced white finger.
- Smoking. Smoking constricts blood vessels and can cause Raynaud's.
- Injuries. Injuries to the hands or feet from surgery or frostbite, for example, can lead to Raynaud's phenomenon.
- Certain drugs. Some drugs, such as beta blockers (used to treat high blood pressure), ones for migraines that have ergotamine, estrogen replacement therapy, certain chemotherapy agents and drugs that cause blood vessels to narrow (such as some over-the-counter cold medications), have been linked to Raynaud's.
- Chemical exposure. Some plastics industry workers who are exposed to vinyl chloride develop an illness like scleroderma. Raynaud's can be a part of that.
- Other causes. Raynaud's has also been linked to an overactive thyroid gland (hyperthyroidism), a condition in which blood pressure rises in the blood vessels of the lungs (pulmonary hypertension) and, rarely, to certain cancers.