Raynaud’s Phenomenon: Types, Symptoms, Causes, Treatment, Prognosis, Epidemiology, Complications, Risk Factors
Raynaud’s phenomenon can be defined as a health condition in which the blood vessels in an individual’s body get narrowed on experiencing changes in levels of cold and stress. The condition is commonly localized to fingers and toes. Under the effect of stress or cold, the narrowing of blood vessels obstructs the blood supply to the skin surface leading to skin discoloration. At first, the skin turns white and then it slowly turns blue. As soon as the stress factors get removed, the blood supply returns to normal and the skin gets the red color with tingly and vibrating sensation.
What is Raynaud’s Phenomenon?
Raynaud’s phenomenon is a medical condition in which the skin color changes owing to variation in temperature and events contributing to mental stress. The sensitivity to cold and stress results in contraction of blood vessels and limiting the blood supply to the skin tissues. This results in white color of the skin, followed by blue color. The blue color appears due to absence of oxygen in the surface tissues and this occurs because the oxygenated blood is unable to reach these tissues. When optimal conditions return, another phenomena takes place which is known as flushing. In case of flushing, the blood vessels expand and re-furnish the blood supply which makes the skin red in color.
Types of Raynaud’s Phenomenon
Raynaud’s phenomenon is of two types depending on the origin of the condition which are Primary Raynaud’s phenomena and Secondary Raynaud’s phenomena.
- Primary Raynaud’s Phenomenon: In case of Primary Raynaud’s phenomenon, the condition arises by itself and the cause behind is unknown.
- Secondary Raynaud’s Phenomenon: The Secondary Raynaud’s phenomenon is caused due to presence of prior medical conditions, medications or injuries.
Raynaud’s phenomena develops commonly in colder climate regions and is known to affect individuals in their late twenties up to the age of late forties with women being more vulnerable to the condition.
Symptoms of Raynaud’s Phenomenon
The signs and symptoms of the Raynaud’s phenomena are dependent on three key factors which are interval, intensity and rate of recurrence of the phenomena. The common symptoms that appear are:
- Numbness, stinging sensation and pricking feeling post the flushing phenomena.
- Skin discoloration from white to blue to red depending on the blood supply to the skin tissues.
- Fingers and toes become cold and chilled.
Epidemiology of Raynaud’s Phenomenon
According to the recent studies, the cases for Raynaud’s phenomenon in United States are common with its prevalence in women. These account for over ten percent cases in females and around eight to ten percent cases in males with an annual growth of around two percent cases. The secondary condition is found to be prevalent in the country owing to the presence of underlying medical ailments in the individuals. On the other hand, the primary Raynaud’s phenomena account for about twenty percent of cases in women and around fourteen percent cases in men.
Prognosis of Raynaud’s Phenomenon
The outlook for the individuals suffering from primary Raynaud’s phenomena is very good with minimal rate of morbidity and no cases of mortality. However, under rare circumstances, the person may suffer from necrosis of the skin tissue due to absence of supply of blood. The ailing population is usually above forty years of age with an increased risk of a cardiovascular condition. On the other hand, in case of secondary Raynaud’s phenomena, the morbidity and mortality is related to the underlying health condition.
The outlook for the fingers and toes, for both types of Raynaud’s phenomena depends on the duration, severity and frequency of the condition.
Causes of Raynaud’s Phenomenon
The causative factors for Raynaud’s phenomenon are specific to the type of Raynaud’s phenomenon ailing an individual.
- Causes of Primary Raynaud’s Phenomenon: The common factors that contribute to the condition are:
- Changes in temperature
- Emotional and physical stress
- Consumption of vasoconstrictors like nicotine by following bad practices like drugs and smoking.
- Exposure to chemicals like vinyl chloride.
- Jobs that involve handling of heavy vibration tools like jackhammers.
- Causes of secondary Raynaud’s Phenomenon: The causes behind secondary Raynaud’s phenomenon are namely underlying diseases or medications.
- Underlying Diseases: There are mainly few types of ailments that can cause secondary Raynaud’s phenomenon. These are collagen vascular diseases, arterial diseases, neurological disorders, blood disorders and pervious incidence of trauma or accident.
- Vasoconstrictor Medications: The medications for migraine, beta blockers, birth control pills and common cold medications are known to cause secondary Raynaud’s phenomena.
Risk Factors of Raynaud’s Phenomenon
The prime risk factors that can pose a threat of Raynaud’s phenomenon are:
- Gender: Women are more vulnerable to the condition than men.
- Age: This condition is commonly caused between the ages of fifteen to forty years of age.
- Climate: The disorder is known to occur more in individuals belonging to cooler climates.
- Family History: Raynaud's phenomenon has an increased risk of occurrence, if the medical condition runs within the family.
Complications of Raynaud’s Phenomenon
Though the occurrence of complications is rare in case of Raynaud's phenomenon but under rare circumstances certain complications can occur. These are:
- Permanent loss or reduction in the blood supply to the fingers or toes.
- Deformation of fingers or toes.
- Development of skin ulcers and gangrenes.
- Loss of fingers or toes, with a need for amputation.
Diagnosis of Raynaud’s Phenomenon
The diagnosis of the condition depends on:
- Physical Examination to Diagnose Raynaud’s Phenomenon: It is the first step toward the diagnosis of Raynaud’s phenomenon condition. The physician checks for the appearance of symptoms specific to Raynaud’s condition.
- Nail Fold Capillaroscopy for Detecting Raynaud’s Phenomenon: When the condition has been identified, it is important to identify the type of Raynaud’s phenomenon ailing an individual. Thus, this test is conducted to check for enlarged or deformed blood vessels near the nail by using a microscope. If such kinds of blood vessels are present then it is diagnosed as secondary Raynaud’s phenomena.
- Blood test to identify Raynaud’s phenomenon: Blood tests are done when there is a doubt for existence of other conditions like autoimmune disorder or connective tissue disease. These include:
- Antinuclear Antibodies Test: This test checks for the presences of autoimmune or connective tissue disorders by checking for the presence of antibodies within the immune system.
- Erythrocyte Sedimentation Rate test: This test checks for autoimmune condition based on the sedimentation rate of the red blood cells.
Treatment of Raynaud’s Phenomenon
Treatments for Raynaud’s phenomenon aim at reducing the recurrence and severity of attacks with no or minimal tissue damage as well as treating the underlying disease.
The general treatments opted are:
- Medications to Treat Raynaud’s Phenomenon: To treat Raynaud's phenomena, medications like calcium channel blockers, vasodilators and alpha blockers are prescribed to prevent the constriction of blood vessels.
- Surgical Procedures for Treating Raynaud’s Phenomenon: The surgical measures are opted when the prescribed medicine fail to give the desired results. The common procedures followed are:
- Chemical Injections: It involves injecting local anesthetics or Botox into sympathetic nerves to ensure their blockage and simultaneous prevention of the condition.
- Sympathectomy: The nerves that control the dilation and constriction of blood vessels in the skin are stripped off to reduce the occurrence and intensity of attacks.
- Conservative Treatments for handling Raynaud’s Phenomenon: These measures involve administration of therapeutic techniques like biofeedback, acupuncture and consumption of fish oil to improve blood circulation which consequently prevent the Raynaud’s condition.
Prevention of Raynaud’s Phenomenon
The preventive approach usually involves escaping the cold temperatures which further helps in coping with Raynaud's attacks to a great extent:
- Keeping body warm with warm clothes and chemical hand warmers to ensure cold temperature does not reach hands and feet.
- Warming up the car prior to driving in the cold weather.
- For individuals with severe Raynaud's condition, relocation to a warmer climate helps a lot.
Lifestyle and Coping Strategies for Raynaud’s Phenomenon
There are a variety of measures that can be followed to reduce the Raynaud's attacks and help in feeling better. These measures are:
- Active as well as passive smoking should not be done as it causes drop in the skin temperature, this further constricts the blood vessels, leading to an attack.
- Regular exercising helps in increasing the circulation and reduces the Raynaud's attacks.
- Avoiding stress situations and taking up stress management therapy or yoga for stress release.
- Escaping zones with rapid temperature fluctuations.
Raynaud's phenomenon is known to affect the fingers and toes with a feeling of numbness and cold whenever there is a change in temperatures or stress. This, thus, obstructs the supply blood to skin due to narrowed blood vessels and limited blood circulation. The condition is known to affect women more compared to men with prevalence in colder climates. The condition can either occur by itself or as a consequence of underlying disease. The treatment of Raynaud's disease depends on the type and severity of the condition. In most cases, the Raynaud's disease does not cause any disablement but surely affects the routine life. However, a timely advice and treatment must be taken to avoid complications from arising.