What is Raynaud’s?
Raynaud’s is a rare condition that causes some parts of your child’s body — usually their fingers and toes — to change colors and feel painful or numb in cold temperatures or under stress. Raynaud’s causes blood vessels to narrow and limits blood circulation to the affected areas.
There are two types of Raynaud’s — primary and secondary.
Primary Raynaud’s, which is more common and less severe, is also known as Raynaud’s disease. The cause of this type of Raynaud’s is unknown.
Secondary Raynaud’s, also known as Raynaud’s phenomenon, is less common and produces more severe symptoms. It can be seen as part of an underlying systemic autoimmune disease.
Signs and symptoms
During a Raynaud’s attack, little or no blood flows to the affected fingers or toes. This causes the skin to turn white, then blue, for a short time. As blood flow returns, the affected areas turn red and may throb, tingle or feel numb.
In some severe cases, the loss of blood flow can cause sores, called ulcers, or necrosis (tissue death).
There is no known cause for primary Raynaud’s.
It is thought that secondary Raynaud’s is caused by an underlying disease, or a condition that affects the arteries or nerves in the hands and feet. It may also be triggered by injuries to the fingers or toes or by blood pressure medication that narrows the arteries.
Testing and diagnosis
Testing for Raynaud’s frequently results in a diagnosis.
To make a diagnosis, your child’s doctor will conduct a complete physical history and examination, and may order the following blood tests:
- Antinuclear antibodies test (ANA) detects nuclear antibodies in your child’s blood. Nuclear antibodies attack the body’s own tissue and are frequently found in people who suffer from autoimmune conditions.
- Erythrocyte sedimentation rate test (ESR or sed rate) measures how quickly your child’s red blood cells fall to the bottom of a test tube of blood that hasn’t clotted. If the cells fall quickly (the sed rate) there is inflammation in the body.
Your child’s physician may also do a test called the nailfold capillaroscopy. Here, the child’s fingers are examined under a microscope to determine if there are problems in the capillaries, the tiny blood vessels. If the capillaries are enlarged or badly formed, the child may have an autoimmune, such as lupus or scleroderma.
Treatment for Raynaud’s should reduce the number and harshness of attacks, and prevent tissue damage and loss of tissue in the fingers and toes.
For patients with primary Raynaud’s, non-drug preventative measures are often recommended. This may include dressing in layers, and wearing gloves and thick socks.
Prescription medications, which work to keep blood vessels open, are given to patients with secondary Raynaud’s. They are used to head off severe attacks that cause ulcers or tissue damage.
Medications often prescribed include:
- Calcium-channel blockers, a class of drugs commonly used to treat high blood pressure. These drugs work by relaxing the smooth muscle and dilating the small blood vessels.
Patients with either form of Raynaud’s should soak their hands and feet in warm water when they feel an attack is beginning. They should also keep their hands and feet warm in cold weather. Some patients find that wearing mittens and socks to bed during the winter is helpful.
Raynaud’s is a lifelong condition. By making lifestyle changes such as keeping your child’s fingers and toes warm and protected in cold weather, and sometimes using medications, Raynaud’s can be successfully managed.
Children with Raynaud’s should receive long-term monitoring. Talk to your child’s physician about how frequently your child should be examined, and if you notice any changes to your child’s condition.
Reviewed by Jay Mehta, MD, MS