Raynaud's Phenomenon

Prevention

Although there is no way to prevent a person from developing the condition, the number of episodes of vasospasm can be reduced or even eliminated by avoiding situations that can trigger events. Tips for avoiding vasospasm:

• Avoid unnecessary exposure to the cold.

• At home, turn up the thermostat a few degrees.

• In very cold weather, wear a hat and mittens (which protect better than gloves) to conserve as much warmth as possible.

• Bundle up before you head out into the cold, rather than after you are in the cold, to make sure your arms and legs are not shocked by the temperature change.

• Leave coat, mittens and hat on in the freezer or refrigerator sections of the grocery store.

• At home, use pot holders, mittens or a towel to remove items from the refrigerator.

• Use a cup holder when drinking a cold beverage.

• Stop smoking.

Treatment

Most people with primary Raynaud's phenomenon do not need professional care. Their symptoms can be managed by avoiding triggering events as much as possible. An episode of vasospasm often can be stopped by warming the affected areas by going indoors or soaking fingers or toes in a bowl of warm water. Biofeedback, which trains the body to warm the extremities, can help some patients to control their symptoms. This mind-body method uses a machine to help the patient learn how to gain voluntary control over body processes that are typically involuntary, such as blood flow. Ask your health care professional to recommend a specialist near you if you would like to try biofeedback training.

For more severe cases (which are more common with secondary causes of Raynaud’s), medication may be prescribed. Calcium channel blockers, including nifedipine (Procardia, Adalat) and diltiazem (Cardizem, Dilacor), can decrease the severity and number of vasospasm episodes. Other medications that dilate (widen) blood vessels, and are usually prescribed for high blood pressure, also can be effective. These medications include nitroglycerin cream or ointment, hydralazine (Apresoline), prazosin (Minipress), or losartan (Cozaar). In extreme and rare cases, the sympathetic nerves that control blood vessels may be cut in a surgical procedure called a sympathectomy or intravenous medications (called prostaglandins) may be needed to open up the blood supply to the fingers or toes and prevent death of the affected tissues.

People with secondary Raynaud's may also need to be treated for their main disease.