Raynaud’s syndrome is a rare autoimmune disorder that affects blood vessels in the fingers and feet. It causes vasospasms, a brief constriction of those blood vessels, when you feel cold or when you are under high levels of stress.
There are two types of Raynaud’s: primary Raynaud’s and secondary Raynaud’s. Primary Raynaud’s happens on its own without any trigger, usually discovered between the ages of 15 and 25. It is typically milder than secondary Raynaud’s and the individual may not require treatment. It is more common among women and people residing in colder climates.
Secondary Raynaud’s is more complex, as it is triggered by another underlying health issue, often between the ages of 35 and 40. In this form, the original, underlying disease reduces blood flow to the feet and Raynaud’s develops. Secondary Raynaud’s is more prevalent in people with connective tissue disorders, such as lupus, scleroderma and Sjogren’s syndrome.
Raynaud’s Risk Factors
In Secondary Raynaud’s, the underlying disorders mentioned above don’t always cause Raynaud’s, but several risk factors have been found to increase risk. They include hypertension, diabetes, high cholesterol, smoking, and the use of certain medications (beta blockers, cold and allergy drugs, birth control, cancer treatment). Other factors include working around certain chemicals, or using tools that vibrate such as a jackhammer.
Symptoms of a Raynaud’s Attack
When you are feeling cold, your body preserves heat by reducing the supply of blood to the skin. This is done by constricting the blood vessels. When you have Raynaud’s, your body’s reaction to cold is not normal. The blood vessels constrict faster and more tightly than normal. When this occurs in the feet, for example, your toes may undergo a color change, turning pale or white, then possibly a shade of blue or red.
The white color appears as a response to spasms of the arterioles and the collapse of arteries supplying blood to the feet. The blue color change is as a result of lack of oxygen-rich blood. The red color indicates the dilation of the arterioles.
You also feel cold and numb as a result of lack of blood flow. When the attack ends, your toes can start to throb and tingle. The blood supply to the skin remains low until the skin is warmed. It may take approximately 15 minutes to recover from the attack.
Treatment of Raynaud’s
Raynaud’s treatment helps to lower the occurrence or frequency of attacks, and prevent tissue damage or gangrene decay. Raynaud’s is treated according to its severity. Primary Raynaud’s is mild, so it can be treated without medications.
- Covering up properly when it is cold
- Placing chemical warmers, such as heating pouches, into shoes and boots
- Controlling stress
- Using warm (not hot) water to warm up your feet
- Keeping your feet dry
- Exercising on a regular basis
- Avoid smoking, as it causes the temperature of the skin to drop
Secondary Raynaud’s can be more severe and may need to be treated with medication. In some cases, shots or surgery may be necessary.
- Blood pressure medicines such as calcium channel blockers. It works by relaxing and opening up small blood vessels in your feet. Examples of channel blockers include felodipine, nifedipine, and amlodipine.
- Drugs that helps the blood vessels to relax, such nitroglycerin cream.
- Alpha blockers – these are drugs that counteract the functions of norepinephrine, a hormone that narrows blood vessels. Examples include prazosin and doxazosin.
In severe cases of secondary Raynaud’s, doctors may recommend a surgical procedure known as digital sympathectomy with adventitial stripping. This procedure can help protect the affected tissue, reducing symptoms and providing an overall improvement. However, patients suffering from secondary Raynaud’s may see a higher incidence of recurrence due to the chronic, underlying condition that caused it in the first place.
If you have been diagnosed with Raynaud’s you know that any cold environment can bring on an attack. It is up to you to manage the symptoms effectively. Be proactive about limiting your risk factors, and pay close attention to any numbness, change in color, or tingling in the feet. If you are concerned about the onset of Raynaud’s or changes in your foot health, please call Houston Foot and Ankle Care at (713) 541-3199 for an appointment. Dr. Gabriel Maislos is a board certified podiatrist in Houston who treats many patients dealing with complex conditions like Raynaud’s phenomenon, diabetic foot care and more.