Raynaud’s disease is a condition that causes some areas of your body to feel numb and cool in response to cold temperatures or stress. This is caused by narrowing of the small arteries that supply blood to your skin, limiting blood circulation. When exposed to cold temperature the blood supply is markedly reduced and the skin turns pale or white and becomes cold and numb. When the oxygen supply is depleted, the skin color turns blue, and is known as cyanosis. These events are episodic and when the episode subsides or the area is warmed, the skin turns red and the blood flow returns.
Although this is a classic sign of Raynaud’s, these symptoms can also be a sign of other diseases. For example, cold or numb fingers are present in 90% of individuals with scleroderma and 85% of those with mixed connective-tissue disease. Similarly, some studies have found that 46-81% of affected patients have secondary Raynaud’s, which means these classic Raynaud’s symptoms are associated with another disease.
What treatments are available to those with Raynaud’s Disease?
In general there are several things you can do to treat, or at least make the symptoms of Raynaud’s better. General measures include avoiding things that make your hands colder, and using gloves if you need them. As nicotine worsens episodes, quitting smoking can be helpful as well.
Pharmacologic therapy includes calcium channel blockers as they cause vasodilation, increasing circulation in the hands. Clinical trials have shown some benefits from angiotensin receptor blockers as well as serotonin uptake inhibitors. Unfortunately, patients with autoimmune disorders and associated Raynaud phenomenon do not usually respond well to therapy.
Are there medications to avoid when you have Raynaud’s?
If you have this disease, you should avoid certain over-the-counter cold drugs. Examples include drugs that contain pseudoephedrine like Sudafed. You should also avoid the following:
- Beta blockers. This class of drugs, used to treat high blood pressure and heart disease, includes metoprolol, nadolol and propranolol.
- Birth control pills. If you use birth control pills, you may wish to switch to another method of contraception because these drugs affect your circulation and may make you more prone to attacks. Talk to your doctor before stopping the pill.
Trials are currently testing rho kinase inhibitors as a method of vasodilation. Nitroglycerin also shows potential in reducing the severity of Raynaud’s phenomenon. Preliminary reports suggest that botulinum toxin A improves symptoms, reduces the frequency of attacks, and improves the healing of digital ulcers. Furthermore oral phosphodiesterase type 5 inhibitors may be effective in patients with severe and disabling Raynaud’s phenomenon, although further studies are needed.