Raynaud’s Phenomenon

Raynaud’s Phenomenon is a disorder of the small blood vessels in the skin causing a vasospasm (vessel becomes smaller). When the vessel is in vasospasm there is decreased oxygen supply to the skin, causing a blue appearance. As the rush of blood returns along with the oxygen it carries, the red color appears. Finally as the blood is at its normal level, the skin turns back to the whitish normal color. The skin of the hands and feet are mostly affected but also can attack other areas such as the tip of the nose and the ears.

Symptoms of Raynaud’s phenomenon in the foot is this turning of colors from blue, red, to white in one or more toes. The area may feel numb or prickling as the blood flow is decreased keeping oxygen from the nerves in the area as well. There is little pain associated with this condition.

Causes of Raynaud’s phenomenon is not clearly understood but it appears to be an overreaction to cold or to stress. Normally if the body is cold it will safe heat by reducing the blood flow to the extremities and keeps the blood going to the more vital organs like the heart, lungs, and brain. In someone with Raynaud’s phenomenon this event is triggered to occur. Raynaud’s is a common condition and is more common in women between the ages of 15 and 50.

Diagnosis of Raynaud’s is typically by history of the patients symptoms. The event is usually very temporary and does not occur during your examination. There are two types of Raynaud’s either primary or secondary. Primary Raynaud’s usually affects both the hands and feet and the cause is unknown. In secondary Raynaud’s usually both hands or both feet are affected and a cause is identifiable. Smoking is one of the major causes as this helps constrict blood vessels and triggers the event. Other drugs can trigger the event to occur such as heart and blood pressure pills, or migraine headache medications. Other associated medical conditions which have a higher tendency to produce Raynaud’s phenomenon are scleroderma, systemic lupus erythematosus, rheumatiod arthritis, pulmonary hypertension, and arteriosclerosis.

Prevention of Raynaud’s is by avoiding events that trigger it. You should try keeping your entire body warm, not just your hands and feet. Warm socks and gloves help during winter’s cold temperatures. For severe cases, doubling gloves under mittens, or wearing gloves to take things out of the freezer or refrigerator may help. You should also prevent against cuts, bruises, and other injuries due to the vasoconstriction not allowing blood flow to heal these types of injuries. If you smoke, you should quit.

Treatment may include changes in medications or use of vasodilators which increase the flow of blood in the vessels. Preventative techniques may be the best treatment and the condition may never completely resolve. In some severe cases where the vessels remain vasoconstricted or narrowed, death of the tissue may result forming dry gangrene.