Thursday February 2, 2017
A common question our private doctors are asked, especially in winter, is 'why do my fingers go so white in the cold?' This may just be a normal reaction to the cold environment (a sign you need to invest in a good pair of gloves!), or this may actually be a symptom of Raynaud's!
Raynaud’s syndrome is a common condition which is thought to affect as many as 1 in 9 women, and 1 in 12 men, but these figures can vary between regions, depending on the temperature of the climate.
It occurs when the blood vessels beneath the skin 'overreact' to cold temperatures and the arteries (vessels that carry blood) spasm, which affects the blood supply to certain parts of the body, usually the fingers and toes.
This condition can be frustrating and uncomfortable to live with, but it is not seriously detrimental to your long term health. In this article, we tell you everything you need to know about this phenomenon, and what you can do about it!
Types of Raynaud’s:
There are two types of this syndrome:
- Primary: when the condition develops by itself (this is the most common type), and usually develops in your 20’s or 30’s
- Secondary: this is when it develops in association with another health condition.
Usually, if Raynaud’s appears along with another health condition, the condition will be auto-immune in nature (when the body’s immune system starts attacking healthy tissue), such as lupus or rheumatoid arthritis, and it can appear at any age.
Secondary Raynaud's may cause a more severe restriction of blood supply so it carries a higher risk of causing complications such as:
- Gangrene (tissue death) in especially serious cases
As with many conditions, Raynaud’s has certain triggers, and cold temperatures or stress are two of the most common. We've listed some of the many triggers of Raynaud's:
- Cold temperatures
- usually weather related, but sometimes related to putting your hands in cold water or in the freezer
- Stress or anxiety
- Autoimmune Conditions
- e.g Rheumatoid Arthritis or Sjogrens Syndrome
- Disruptions in how the nervous system 'talks' to blood vessels
- There is some evidence to suggest that Raynaud’s is an inherited condition that runs in families
- Such as Hepatitis, can cause Raynaud’s in some people
- Certain cancers
- e.g leukemia or multiple myeloma
- Effects of certain common medications
- Such as for migraines, high blood pressure or heart disease
- Physical injury to the affected area
When the blood vessels go into spasm, they become temporarily narrower and block the smooth flow of blood, causing the area affected to change colour. The skin will first turn white, and then become blue and finally red, when the blood flow is re-established.
This colour change (from white to blue to red) is the main symptom of Raynaud's, and is often accompanied by the feeling of coolness or numbness in the affected part, when it turns white or blue.
A tingling or throbbing sensation is often then reported in the affected regions, as blood flow returns and the skin becomes red. You may also experience pain, pins and needles or complete numbness in the affected place.
These symptoms can last from minutes to hours, and the condition of Raynaud’s itself may last for a long time (many years), or disappear suddenly and completely.
- Skin ulcers on the affected part (a result of the poor blood supply)
- Dry gangrene (tissue damage and death) – this happens only in the most severe cases
- Scleroderma (overproduction of a substance called collagen), which can affect not only the skin, but also the organs inside the body
People with Raynaud's are at risk of developing ulcers on affected areas of skin, due to poor blood perfusion during Raynaud's episodes
How is Raynaud's Syndrome Diagnosed?
If you think you may have Raynaud’s syndrome, a great first step is to find a GP who can help to get you diagnosed.
Your GP may be able to diagnose Raynaud’s syndrome by studying your symptoms carefully, and may place your hands in cold water to confirm their suspicions. They may also have a close look at the tiny blood vessels at the junction where your nail meets your fingers. These tiny blood vessels are called capillaries.
However, more specific testing may be required to establish if you have primary or secondary Raynaud’s syndrome, and this is important to know, as auto-immune conditions associated with secondary Raynaud’s may also be treatable.
Depending on what your GP thinks about your specific conditions, he or she may order some blood tests to investigate further. These might include:
1) Lifestyle Changes
There are things you can do yourself to help treat the symptoms of both primary and secondary Raynaud’s syndrome. Try some of these tips:
- Keep warm!
- Stop smoking
- Take regular exercise
- Minimise stress
There are several medications you can try. One of them is called Nifedipine, and this type of medicine causes blood vessels to widen, which can help to prevent them from spasming.
There is less evidence to show that other medications are effective, but it appears that they have helped some people with the condition, so they may be worth a try. These include:
- ACE (Angiotensin Converting Enzyme) inhibitors
- Commonly used in the treatment of high blood pressure
- Also used in the treatment of depression
- Also known as Viagra
- YYsed in the treatment of erectile dysfunction
If you are diagnosed with secondary Raynaud’s syndrome, you will likely receive treatment for the auto-immune condition that co-occurs with your condition.
This is a treatment that is considered as a last resort, when your symptoms are so severe that there is a risk to the part of the body affected by the condition. The recommended surgery is called sympathectomy, and it involves cutting the nerves causing the affected blood vessels to spasm.
This surgery may only be a short-term solution, and further treatment or another surgery may be required after a few years.
For more information about Raynaud's syndrome, why not book an appointment at London Doctors Clinic? Pop into any of our central London private clinics to discuss your symptoms further. And, as always, if you need any other GP services, our fully qualified doctors are here for you.