Raynaud's Phenomenon
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editors: Dennis Lee, MD, and Melissa Conrad Stöppler, MD
What is Raynaud's phenomenon?
Raynaud's phenomenon (RP) is a condition resulting in a particular series of discolorations of the fingers and/or the toes after exposure to changes in temperature (cold or hot) or emotional events.
Skin discoloration occurs because an abnormal spasm of the blood vessels causes
a diminished blood supply to the local tissues. Initially, the digit(s) involved turn white
because of the diminished blood supply. The digit(s) then turn blue because of
prolonged lack of oxygen. Finally, the blood vessels reopen, causing a
local "flushing" phenomenon, which turns the digit(s) red. This three-phase color sequence
(white to blue to red), most often upon exposure to cold temperature, is characteristic of RP.
Raynaud's phenomenon most frequently affects women,
especially in the second, third, or fourth decades of life. People can have
Raynaud's phenomenon alone or as a part of other rheumatic diseases. When it
occurs alone, it is referred to as "Raynaud's disease" or primary Raynaud's
phenomenon. When it accompanies other diseases, it is called secondary Raynaud's
phenomenon.
What causes Raynaud's phenomenon?
The causes of primary and secondary RP are unknown. Both abnormal nerve control of the blood-vessel diameter and nerve sensitivity to cold exposure have been suspected as
being contributing factors. The characteristic color changes of the digits are in part related
to initial blood-vessel narrowing due to spasm of the tiny muscles in the wall of the vessels, followed by sudden opening (dilation), as described above. The
small arteries of the digits can have microscopic thickness of their inner lining, which
also leads to abnormal narrowing of the blood vessels.
What conditions have been associated with Raynaud's phenomenon?
Raynaud's phenomenon has been seen with a number of conditions,
including rheumatic diseases (scleroderma, rheumatoid arthritis, systemic lupus erythematosus),
hormone imbalance (hypothyroidism and carcinoid), trauma
(frostbite, vibrating tools), medications
(propranolol [Inderal], estrogens without additional progesterone,
nicotine, bleomycin [Bleoxane] used in cancer treatment, and ergotamine used for
headaches), and even
rarely with cancers.
Next: What are the symptoms and signs of Raynaud's phenomenon? »
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