Raynaud’s Disease

What is Raynaud's Disease?
Raynaud’s disease is a disorder of the circulation where people get blue/white and then red peripheries.

This is due to spasm of the small arteries (known as arterioles) in the peripheries which causes a reduction of blood supply to the peripheries such as the fingers and toes, and also at times ears and nose. This results in first purplish discolouration and then whitening of the affected digits, returning to bright red once the circulation has been restored. It can affect one digit, or it can affect several. It can last anywhere from minutes to weeks, depending on how severe the disease is.

There is usually a clear line of demarcation between the affected tissue and tissue which still has normal circulation.

This means that normal skin will look normal, and then suddenly the affected skin will be white or purple.

What is the difference between Raynaud's Disease and Acrocyanosis?

Raynaud’s disease is often confused with a condition called ‘Acrocyanosis’ and there is a difference between the two that is important:

Acrocyanosis results in a more general purplish discolouration of the whole hand or foot or fingers with no white fingers or toes. and There is no clear ‘cut off’ line between normal tissue and affected tissue in Acrocyanosis.

Raynaud’s disease can be associated with autoimmune diseases and sometimes even cancer, whereas Acrocyanosis is not associated with these conditions

What is the difference between Primary and Secondary Raynaud's Disease?

Primary Raynaud’s disease is the most common form of the disease coming on in young adulthood. It is not usually associated with any other illness and disease, and tends to be quite mild.

Secondary Raynaud’s disease usually comes on after the age of 40, and is usually associated with other conditions such as:

Autoimmune disease such as Lupus or Scleroderma
Overuse injury
Some cancers
Some medications such as beta blockers
Thyroid disorders
Vascular disorders
Who gets Raynaud's Disease?
Raynaud’s disease tends to occur more frequently in women than men.

It can have an onset in childhood or early adulthood, when it is known as ‘Primary’ and in this case it is usually not thought to be associated with other diseases. If it comes on later in life after the age of 40, it is then that clinicians may be on the look out to make sure that there are no other diseases present, and to be aware to be on the look out in case something develops later in life.

The things that are associated with that later onset of Raynaud’s disease are autoimmune connective tissue disorders such as Scleroderma or Lupus, as well as Thyroid disease.
What causes Raynaud's Disease?
Things that make the arterioles go into spasm can bring on an episode of Raynaud’s.

What sort of things can bring on an episode of Raynaud’s disease?

Cold weather
Stress, anxiousness

We don’t know why this happens in some people but not others.

How is Raynaud's disease diagnosed?
Raynaud’s disease is a clinical diagnosis, made on the understanding of the pattern of the change in discolouration in the affected limb/or limbs when the circulation changes.

A good history is key here, and, having photos to show the doctor of what happens to the circulation can really help as often when people see the doctor the circulation may be ok!!

If Raynaud’s disease has started after the age of 40 your doctor will investigate you for the possibility of autoimmune diseases or thyroid problems.

How is Raynaud's disease treated?
Treatment depends on how severe it is. Most people have mild disease that doesn’t need any particular treatment, apart from staying as warm as possible.

If there is severe disease where simply measures of staying warm and avoiding obvious triggers of attacks is not working then medications can be considered. The first step with Raynaud’s if you have it is to stay warm. It’s doing sensible things like wearing socks, shoes, gloves and hats in cold weather, as well as underlying singlets to keep the core body temperature warm. If stress and anxiousness are triggers it’s important to find ways to deal with them also.

What medications are used if needed?

If simple measures of staying warm do not work, then medications can be trialled. The medications that are used are ones which improve the blood supply by relaxing the peripheral blood vessels that are in spasm.

NB – just because there are medications doesn’t mean you stop keeping warm!!

The most common types of medications are known as ‘calcium channel blockers’.

The medications we usually use are:


Prostaglandin infusions can be considered if the disease is so severe that it is affecting the health and condition of your fingers or toes. If nothing is working and the health of the tissues of your hands and or feet is in danger and seriously affected then chemical injections to sympathetic nerve ganglion may be tried, or surgical transection of the sympathetic nerve ganglia, and in extreme situations amputation.

Please note that most cases of Raynaud’s disease are very mild and don’t even require medications to treat it.
What happens long term with Raynaud's disease?
Most people have very mild Raynaud’s disease, known as Primary Raynaud’s, that begins as a young adult.

Most people have minor inconvenience of cold hands that are a bit painful when they get cold, but keeping warm helps minimize the impact.

Secondary Raynaud’s disease is more likely to be more difficult to manage and more likely to need medications.

It is rare to have serious problems from Raynaud’s disease.

These problems come when there is long term extremely poor circulation on a day to day basis. In these situations there can be ulceration and death of the tips of the fingers and toes. This usually occurs in association with a severe systemic disease such as Scleroderma and is not usually seen with benign Primary Raynaud’s disease. Amputation is a last resort when nothing else is working and there is such severely compromised circulation that the tissues are dying in the affected digits, and is very, very rare to be needed.

Can I do anything other than take drugs to help my Raynaud's disease?

Most people have very mild disease that responds to people looking after themselves. Self-care (aka looking after ourselves), is a foundational part of our health care.

What are the important self-care things with respect to Raynaud’s disease?

The key in all of this is to listen to and learn from your body. There are no rules to ‘follow’ but if you listen to your body and become aware you will learn the things that trigger you and how to avoid those triggers. Some examples for you to consider are as follows:

1. Consider removing the things from your life/or learning to deal with things that can trigger your Raynaud’s disease such as:

Smoking (it makes blood vessels constrict, taking less blood to areas)

Caffeine (it causes the blood vessels to narrow)

Getting cold! Stay warm from head to toe, inside and outside can be helpful. This can include hats, gloves, warm socks, singlets under tops to stay warm etc.


Anxiousness or anxiety

Touching things that are cold, even in the freezer or refrigerator. Gloves can help here.

Going bare feet, even indoors.

2. Consider doing things to improve your circulation:

Regular exercise is important to build good vascular tone. Exercise that is too intense is counter productive.

3. When you get an episode it’s important to get warm.

Getting warm with clothes from head to toe is a good start

You can put affected areas in warm, but NOT HOT water until the circulation improves. Make sure the water temperature is OK as when your hands are affected, feeling can be affected and its important you don’t accidentally burn yourself. Getting someone else to test the temperature of the water is a good idea.

The more you listen to your body, the more you will learn new ways to take care of yourself.

What about supplements. Can they help with Raynaud's disease?
As with medications, there is no guarantee that any supplements are going to be able to control your Raynaud’s disease.

There are some different suggestions such as fish oil that may assist and some people report some relief with Magnesium based supplements. My recommendation is to seek advice from someone who is an expert in natural supplements.

Severe Raynaud’s disease needs medications to best support the body.

I would not recommend trialling supplements instead of medications if your Raynaud’s disease is severe.

With supplements for mild disease it is a matter of trying for a few months and see if it makes a difference for you. If you don’t notice any change after a few months, then it’s probably not working for you.

I suggest informing and liaising with your treating doctor about any supplements that you may be trying.

What are the take home points about Raynaud's disease?
Most Raynaud’s disease is mild and more of an inconvenience.
  • Raynaud’s disease which starts in teenage and young adult years is most likely to be quite mild and not associated with complications.
  • Raynaud’s disease associated with other connective tissue diseases can be associated with more complications.
  • It’s important to stay warm and avoid your triggers if you have Raynaud’s disease.
  • Medications are important if your Raynaud’s disease is severe.