How to treat Raynaud's disease with medication, lifestyle changes, and cold-weather preparedness

Madeline KennedyOct 31, 2020, 00:05 IST

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If you have Raynaud's, it's especially important to bundle up in winter weather.JGI/Tom Grill/Getty Images

Raynaud's disease treatment is necessary to improve blood flow and keep your body warm.
To treat Raynaud's, you can try medication and lifestyle changes — like exercising more, quitting smoking, and reducing stress — that increases circulation and relaxes blood vessels.
It's also important for people with Raynaud's to bundle up with a hat, insulated gloves, and thick socks during the colder months since people with the condition are at a greater risk for frostbite.
This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.

Raynaud's disease is a condition that causes parts of your body, like your fingers or toes, to feel cold and numb when you are in cold temperatures or feeling stressed.

Raynaud's occurs in 3% to 5% of adults worldwide. While there is no cure for Raynaud's, there are medical treatments and lifestyle changes that can help make your symptoms more manageable.

Here's what you need to know about Raynaud's disease and what you can do to keep symptoms under control.

What is Raynaud's disease?

Raynaud's disease, or Raynaud's phenomenon (RP), is caused by problems with your blood vessels, often the small vessels in your fingers and toes. A Raynaud's attack happens when these blood vessels narrow abnormally, decreasing blood flow to your fingers and toes and causing painful symptoms.

An attack of Raynaud's symptoms usually happens in 3 stages:

The skin on your fingers or toes turns white.
Your skin then turns blue and starts to feel cold and numb.
When you become warm again or circulation returns, your skin turns red and may tingle, throb, or swell up.

There are two different kinds of Raynaud's disease: primary and secondary.

Primary Raynaud's. This is the most common form of the disease and tends to have more mild symptoms. Primary Raynaud's isn't caused by any underlying condition, and it may resolve itself without any treatment.

You are at greater risk for primary Raynaud's if:

You are female. Women between 15 and 40 make up about 75% of primary Raynaud's patients.
You live in a cold climate, since colder weather can be a trigger.
You have a family history of Raynaud's disease. Around 25% of people with Raynaud's have a family member with the condition.

Secondary Raynaud's. This is caused by an underlying medical condition that lowers blood circulation to your hands and feet. Secondary Raynaud's usually develops around age 40 and the symptoms tend to be more severe.

Secondary Raynaud's can be caused by conditions including:

Arterial diseases
Connective tissue diseases like lupus, rheumatoid arthritis, and scleroderma, a tissue disorder
Injuries to your hands or feet from accidents or surgery
A history of smoking
Certain medications that can narrow blood vessels, like those for migraines, high blood pressure, or colds

If you experience additional symptoms on top of Raynaud's, like difficulty swallowing, skin thickening, or shortness of breath, this may be a sign that there is an underlying medical issue, says Elena Schiopu, MD, a professor of rheumatology at the University of Michigan. If you have any of these signs, you should see a doctor as soon as possible.

How to treat Raynaud's disease

There is no treatment that can permanently cure Raynaud's, but there are many ways to help reduce Raynaud's attacks and keep your symptoms under control.

Use medication

If you have severe Raynaud's, you may need to take medication to keep your symptoms under control. For example, your doctor can prescribe:

Calcium channel blockers, which help by opening up the small blood vessels in your hands and feet. This can include amlodipine (Norvasc) and nifedipine (Afeditab).
Vasodilators can be used when someone does not respond to calcium channel blockers. Vasodilators work to relax your blood vessels, allowing blood to flow through your body more easily. This can include blood pressure medications like losartan (Cozaar) or erectile dysfunction medications like sildenafil (Viagra).

Try lifestyle changes

There are several important lifestyle changes you can make to help reduce Raynaud's flare-ups.

Exercising can be helpful because it increases blood circulation throughout your body. However, you may want to ask your doctor if you can exercise outside in cold weather, particularly if you have secondary Raynaud's.
Quitting smoking may help Raynaud's symptoms because smoking constricts your blood vessels and makes your skin temperature drop, which can trigger a Raynaud's attack. Secondhand smoke from another person can have the same harmful effect.
Reducing stress in your life may be an important step to treat Raynaud's, as emotional stress can cause your blood vessels to narrow. Schiopu suggests trying techniques like mindfulness-based stress reduction or biofeedback.

Make sure to bundle up

It's vital for you to stay warm if you want to prevent Raynaud's attacks. "It is important to protect the head with a hat because a lot of heat is lost through our heads," Schiopu says.

Wearing a warm hat, insulated gloves, and thick socks is helpful, but ideally, you should aim to wear warm clothes over your whole body in cold weather. Keeping your chest and abdomen bundled up with insulated layers can help stop your blood vessels from narrowing too much.

Dressing carefully for cold is vital, as people with Raynaud's are at greater risk for frostbite.

Even if you are indoors, spending time in an area with heavy air conditioning can trigger Raynaud's attacks for some people. Wearing extra layers or fingerless gloves at work may help keep symptoms at bay. Schiopu also recommends sitting far away from fans or vents and using a space heater if needed.

Consider surgery

In more rare, extreme cases, your doctor may suggest getting surgery to treat Raynaud's disease. There are two types of surgery that may help Raynaud's symptoms:

Injecting chemicals like onabotulinumtoxin type A (Botox) or a local anesthetic can also help block the nerves that cause blood vessels to narrow.
Nerve surgery is a rare treatment that involves cutting out the nerves that surround the blood vessels in your hands and feet. These nerves trigger your blood vessels to narrow, so getting rid of them may help stop the excessive narrowing.

Though surgery is possible, most doctors will try other treatments first. "There isn't widespread use of surgical interventions," Schiopu says. Overall, many patients with Raynaud's tend to adjust to lifestyle modifications over time and can live relatively comfortably.

The bottom line

Raynaud's disease can be a painful and sometimes dangerous condition, but there are many treatments available to help keep symptoms under control. If you think you may have Raynaud's, talk to your doctor about the best treatment for you.

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