Raynaud’s syndrome – causes, symptoms, treatments and self-care tips

25th November, 2022 • 13 min read

Most of us know the feeling of frosty fingers and toes once winter arrives. But what if they also turn paler, whiter or purplish-blue and become numb or painful so it’s hard to do simple things like turning the key to unlock your front door? Or your weekend jog around the park leaves your feet in pain? There’s a chance you might have Raynaud’s (say it like this: ray-NODES). Here’s what you need to know about signs, triggers, self-care and treatments…

What is Raynaud’s phenomenon?

Raynaud’s is a problem with your circulation where your blood doesn’t flow properly to the outer parts of your body (AKA your extremities) when you’re exposed to cold.

Raynaud’s is pretty common – 15 to 30 million people in the US have it – and women are more likely than men to develop it. It’s estimated that it affects less than 5.8% of men and up to 7.8% of women.

Raynaud’s can be known as Raynaud’s phenomenon, Raynaud’s syndrome, or Raynaud’s disease. Although it doesn’t usually cause many major long-term problems, it can have a big impact on your life.

“Patients have told me it makes air-conditioned offices uncomfortable, it makes them want to stay inside in winter so they might miss out on their social life or they can’t walk their dog. Or it can stop them traveling on holidays to places that might be cold,” says

Dr Ann Nainan
, family doctor and Healthily expert.

It may be hard to hold a cold glass or ice cream, shop in supermarket refrigerated aisles, or prepare frozen food. And if you live in a cooler place, higher energy costs can be a real concern when it comes to keeping warm with Raynaud’s.

“The good news is that with some lifestyle tweaks and possibly medication if necessary, you can get Raynaud’s under control and live life with fewer limits,” says Dr Ann.

What are the signs and symptoms of Raynaud’s phenomenon?

In Raynaud’s, some of your blood vessels, usually the ones in your fingers and toes, get extremely narrow when you’re cold or stressed.

Everyone’s blood vessels get narrower when they feel cold – it helps your body keep to its regular temperature. But in Raynaud’s, your blood vessels have an over-sensitive reaction and that causes noticeable color changes to your skin, plus pain and discomfort.

When you’re having a Raynaud’s attack:

  • your fingers may become paler in color
  • sometimes they also become blue or red
  • the color changes often start at the tip of your fingers and spread downwards or to other digits
  • you may have discomfort, including a ‘pins and needles’ feeling and numbness, resulting in clumsiness with things like doing up buttons
  • you may also have pain, which is more likely if you have secondary Raynaud’s

Raynaud’s syndrome feet

Along with your hands, your feet and toes are the most commonly affected areas when you have Raynaud’s. Read more about self-care for Raynaud’s by keeping your feet warm.

Raynaud’s can also affect your ears, nose and nipples

Raynaud’s can also affect the blood vessels supplying the skin on your ears, nose, face, knees and more rarely, your tongue.

And did you know you can also get Raynaud’s of the nipple? It’s most common if you’re pregnant or breastfeeding but it can happen in other women, too. Women who’ve been through it when breastfeeding describe applying a heated wheat pack to their breast to help ease symptoms.

One woman explains how she coped with breastfeeding to

Summer Warmth
, a breastfeeding support website: “I tried gently rubbing my nipples with olive oil after feeding … and I decided to try doing 1 or 2 breastfeeds during the warmest part of the day.”

What does Raynaud’s feel like?

For one woman, before she got a Raynaud’s diagnosis, feeling cold became something to dread. “I hated being outside or in a cold building, as my fingers would hurt and lose color and turn white. I would just feel cold all over. I felt like I was inside a freezer,” she tells

Raynaud’s Association
, a non-profit organization supporting people with the condition.

It can also mean that trying to do some basic things, like undoing the buttons or zipper on your coat, becomes hard.

Another woman explains: “If I take tomatoes out of the fridge and hold them to cut them, it really hurts!”

What happens during a Raynaud’s attack?

There are 3 stages of a Raynaud’s attack. You won’t necessarily go through all 3, but symptoms you may experience include the following:

  1. as your blood vessels get narrower, this reduces blood flow to the skin of whichever area of your body is affected. Your skin there may feel cold to touch and it goes paler – this is because there’s almost no blood flowing to your skin when your blood vessels are severely narrowed
  2. your skin then becomes a purple-blue color, as blood flow starts to return to your skin
  3. once your blood vessels recover, they widen and your circulation goes back to normal. At this stage, your skin might blush and become very pink or red

Your symptoms can last from a few minutes to a few hours.

What triggers a Raynaud’s attack?

Raynaud’s symptoms can be triggered by:

  • cold: even mildly cold temperatures – such as being in an air-conditioned office or walking through the freezer aisle of the grocery store – can trigger an attack. So can feeling generally chilly, even if your hands and feet are warm

  • stress: cold is the main trigger but sometimes emotional stress can bring on a Raynaud’s attack. The blood vessels in your skin that react to temperature changes are mainly controlled by your sympathetic nervous system – and it’s this same system that reacts when you feel stressed or upset about something

Who is most likely to get Raynaud’s phenomenon?

There are 2 types of Raynaud’s:

Primary Raynaud’s

This is when there’s no underlying condition that causes your Raynaud’s – it’s usually known as Raynaud’s disease. About 80-90% of Raynaud’s cases are primary Raynaud’s. It may get better over time and you can usually learn to manage it with self-care.

Causes of primary Raynaud’s

Doctors don’t know what causes primary Raynaud’s, but it seems to be linked to how your nervous system controls your blood vessels. Some evidence suggests it may be hereditary, since it can run in families.

For some people, it can be the first sign of another underlying health condition. About 10% of people with primary Raynaud’s have, or go on to develop, an autoimmune condition (see below).

Secondary Raynaud’s

This is when your Raynaud’s is associated with an underlying health condition (see below). Secondary Raynaud’s accounts for 10-20% of Raynaud’s cases.

Causes of secondary Raynaud’s

There is a Raynaud’s syndrome autoimmune link.

Most cases of secondary Raynaud’s are linked with conditions where your immune system mistakenly attacks healthy tissue in your body. These are known as autoimmune conditions and can include:

  • scleroderma
    : a rare condition affecting your skin and sometimes the connective tissue that surrounds your internal organs and blood vessels. This can result in patches of thick, hard skin that may be discolored. For most people symptoms are mild. It affects more women than men

  • lupus
    : this is when your immune system attacks different parts of your body, causing a range of symptoms including fatigue, skin rash and joint pains and swelling. Lupus is around 9 times more common in women than in men

  • rheumatoid arthritis (RA)
    : a type of arthritis which causes long-term pain, swelling and stiffness in your joints. RA is between 2 and 4 times more common in women than in men

  • Sjogren’s syndrome
    : a condition where your immune system attacks your glands that secrete fluid, such as your tear and saliva glands. 9 in 10 people with Sjoren’s are women

Other causes of secondary Raynaud’s may include:

  • medications: Raynaud’s can come on as a side effect of taking some drugs such as beta blockers which are used to treat

    high blood pressure
    and
    angina

  • working with vibrating tools over a long period, such as hedge cutters and other power tools

  • conditions that can affect the blood supply to your hands such as

    carpal tunnel syndrome
    or a
    cervical rib

  • hormonal conditions such as an

    underactive thyroid
    or certain blood disorders

  • being exposed to chemicals such as vinyl chloride (used to make plastic products such as pipes)

  • smoking – this can also be a trigger for a Raynaud’s attack (see our section below, on self-care for cutting your risk of a Raynaud’s attack)

Does Raynaud’s cause fatigue?

It’s not thought that primary Raynaud’s itself causes fatigue, but living with a chronic health condition can lead to fatigue – and some of the conditions associated with secondary Raynaud’s, such as

scleroderma
and lupus, are chronic conditions.

Science-backed self care for Raynaud’s

Here are some ideas on coping with Raynaud’s that don’t involve moving to a tropical island (if only):

How to cut your risk of a Raynaud’s attack with self-care

  • layer up: when there’s a chill in the air, layers are your friend. Wear thermal underwear, a hat and mittens or gloves.This means that you’re avoiding sudden exposure to cold temperatures and you’re keeping your whole body warm

  • avoid smoking: nicotine and other chemicals in cigarettes can narrow your blood vessels, which can aggravate your Raynaud’s. Your pharmacist may be able to help you quit smoking and you can also read our article here

  • gadgets might help: you could try a beverage holder or insulating sleeve when you’re holding a cold drink. Or invest in a rechargeable hand warmer – it looks a bit like a computer mouse which you hold in your hand to warm up. And don’t forget trusty hot water bottles and heating pads – usually available from pharmacies – for staying toasty

  • dial down your stress: easier said than done, right? While you can’t totally avoid stress, there are techniques to help you manage your stress levels, such as mindfulness meditation. Read more in our

    7 science-backed stress relieving tips
    article

  • stay active: regular exercise is a stress-buster and it helps to improve your circulation. For ideas on how to get started, read our

    Get fit for free
    article

  • skip the caffeine: it may trigger Raynaud’s symptoms so swap teas and coffees for decaffeinated options

Raynaud’s disease gloves

If your fingers and hands are affected by Raynaud’s, gloves are a must-have. People with Raynaud’s have told the UK charity,

Scleroderma & Raynaud’s UK
, what helps them:

  • keep your gloves warm before putting them on – you could try placing them on a warm radiator before going out

  • some people find that wearing silver-lined cotton gloves helps ease their symptoms – it’s thought that they may move heat from your palm to your fingers but there’s no current evidence for this

Self-care to ease symptoms of a Raynaud’s attack

  • if you're having a Raynaud’s attack that involves your hands or feet, place them in a bowl of warm water (check the temperature with an unaffected part of your body)
  • if it’s just your hands, put them under your armpits or rotate your arms in a whirling windmill pattern
  • massage the area that’s affected

When to see a doctor about Raynaud’s

Make a routine appointment with your doctor if you think you have symptoms of Raynaud’s disease.

You should see a doctor urgently if:

  • your symptoms are very bad or are getting worse
  • you have a child under 12 who has Raynaud’s symptoms
  • you have symptoms of an autoimmune conditions such as: joint pain or swelling, skin rashes, a dry mouth or you have general muscle pain or weakness
  • you have any pits, dimples, ulcers or sores in your skin
  • you have signs of infection like red, warm and painful skin which could be
    cellulitis

You should go to A&E or call an ambulance if:

  • you have pain in your chest, shortness of breath
  • you have signs that the blood supply to the area is dangerously reduced such as:
    • your fingers are painful or are tender to touch
    • your skin has turned much darker, brown or black
    • your skin has stayed blue or white or the numbness has not gone away

How Raynaud’s is diagnosed

When you see your doctor, they will probably ask about symptoms you experience when you’re exposed to cold.

You may be wondering: is there a Raynaud’s syndrome test? Well, your doctor may do the following tests:

  • water test: your doctor may place your hands in cold water or cool air to see if you show symptoms of Raynaud’s

  • blood tests: to help work out whether an underlying cause is causing your symptoms

  • occasionally, you may have other specialist tests that look at your blood vessel function

Raynaud’s treatment

If the self-care tips mentioned above aren’t helping, your doctor might recommend medication. You might be prescribed:

  • nifedipine: this calcium channel blocker is the most common medication used for Raynaud’s. It works by widening your blood vessels – it can reduce how often you get Raynaud’s and how severe your symptoms are

  • losartan: a type of drug called an angiotensin II receptor blocker which may be taken by people who haven’t improved on nifedipine or have had side effects

  • fluoxetine: usually prescribed to people to help depression. You might be prescribed this if other medications aren’t working as there’s some evidence that it may help Raynaud’s symptoms

Other medications that are often prescribed by a specialist for Raynaud’s include:

  • topical nitroglycerin: an ointment which you apply to the affected areas. It’s usually used for days or weeks rather than long-term

  • sildenafil: this drug stops an enzyme called phosphodiesterase type-5 from working too quickly and is also commonly used to treat

    erectile dysfunction
    . You shouldn’t use this for your Raynaud’s unless instructed by your doctor

What are the potential complications of Raynaud’s?

If you have secondary Raynaud’s, you might get ulcers on your fingertips and you may lose tissue on your fingertips. But this is very rare. If a Raynaud’s attack doesn’t get better and if it seriously restricts your blood flow, you may be at risk of gangrene or losing a finger or toe – again, this is very rare.

Your questions answered

Can you die from Raynaud’s disease?

No, primary Raynaud’s itself can’t kill you. Secondary Raynaud’s might be a sign of a more serious condition. Complications are more likely with secondary Raynaud’s – such as ulcers and in very rare cases, infection,

gangrene
and loss of fingers or toes.

Is there a link between Raynaud’s and depression?

If a medical condition is affecting your life, it may also impact on your mental health. One recent study compared the mental health of people with primary Raynaud’s with those diagnosed with secondary Raynaud’s. Researchers found higher levels of anxiety and depression in people with secondary Raynaud’s. But more research is needed. If you’re struggling with your mental health because of Raynaud’s, always speak to your doctor.

Watch this space

Botox for Raynaud’s? That’s right, some studies have looked into whether injecting Botox into the base of the fingers can be a useful treatment for Raynaud’s. But more research is needed to better understand how Botox might help. Meanwhile, some people with Raynaud’s find that [acupuncture(/health-library/treatments/acupuncture) can improve their condition but right now, there’s not enough scientific evidence to support that.

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.