Raynaud’s Disease (Raynaud’s Phenomenon)
Raynaud’s disease is a widespread constriction of small arteries of unknown cause, but aggravated by cold conditions. This condition almost invariably affects women. The hands go white then blue, swell and become very painful and there is constriction of blood vessels in the feet, face, chest, abdomen and sometimes internal organs. Patients have intense feelings of cold in these areas. Poor blood supply to the fingers and toes may lead to ulceration and eventually gangrene. It usually starts in the teenage years or early twenties, may remain lifelong, and affects one in every five women, but often eases after the menopause.
Attacks are usually triggered by cold conditions, such as entering an air-conditioned building or a cold climate. Other triggers may be hormonal changes, stress and anxiety, exercise and some foods. Raynaud’s disease is the most common cause, but in most cases no specific cause can be found, although it may be associated with rheumatoid arthritis, CREST syndrome and scleroderma. Patients should keep their hands warm, and alcohol in low doses may be useful. A wide range of tablets (eg. alpha-blockers) and ointments can be used to dilate the tiny arteries in the fingers. As a last resort, operations to cut the nerves that cause the artery spasm can be performed. A wide range of medications may be used regularly to dilate the constricted arteries.