If your fingers or toes frequently become pale or ghostly white and lose sensation in the cold, you might initially attribute it to poor circulation, as I did when I first experienced this issue with my hands years ago. Typically occurring towards the end of a lengthy hike on a chilly spring or autumn day without gloves, my pinkie, third, and middle fingers would become white, with a bluish tint appearing on the fingernails. However, I later learned that I have Raynaud's phenomenon, which involves an extreme reaction of blood vessels constricting beyond normal levels.
Raynaud's Phenomenon: More Than Just Cold Hands
When exposed to cold, your body naturally attempts to maintain its core temperature by constricting blood vessels near the skin's surface, redirecting blood flow inward. However, for individuals with Raynaud's phenomenon, this response is heightened.
Wintry weather is indeed the primary trigger for Raynaud's phenomenon. However, it can manifest at any time throughout the year. For instance, transitioning from a heated pool to cooler air, entering air-conditioned spaces, or reaching into the freezer section of a supermarket can also induce episodes. Even subtle shifts in air temperature have the potential to trigger symptoms.
What happens when an episode occurs?
During an episode, the small arteries supplying the fingers and toes contract spasmodically, hampering the flow of oxygen-rich blood to the skin. Some of these vessels even temporarily collapse, and the skin becomes pale and cool, sometimes blanching to a stark white color.
In addition to the hands, Raynaud's can also affect the feet. Less often, the nose, lips, and ears.
Is Raynaud's phenomenon a circulation problem?
Technically, Raynaud's phenomenon is a circulation problem, but it's very different than what doctors typically mean by poor circulation. Limited or poor circulation usually affects older people whose arteries are narrowed with fatty plaque (known as atherosclerosis). This condition is often caused by high cholesterol, high blood pressure, and smoking.
In contrast, Raynaud's usually affects younger people (mostly women) without those issues. And the circulation glitch is generally temporary and completely reversible.
How can you prevent episodes?
As I can attest, the best treatment for this condition is to prevent episodes in the first place, mainly by avoiding sudden or unprotected exposure to cold temperatures. I've always bundled up in the winter before heading outside, but now I bring extra layers and gloves even when the temperature might dip even slightly, or the weather may turn rainy or windy. Preheating the car in winter before getting in, and wearing gloves in chilly grocery store aisles, can also help.
Generally, it's best to avoid behavior and medicines that cause blood vessels to constrict. This includes not smoking and not taking certain medications, such as cold and allergy formulas that contain pseudoephedrine and migraine drugs that contain ergotamine. Emotional stress may also provoke an episode of Raynaud's, so consider tools and techniques that can help you ease stress, such as mindfulness techniques.
If necessary, your doctor may prescribe a medication that relaxes the blood vessels, usually a calcium-channel blocker such as nifedipine (Adalat, Procardia). If that's not effective, drugs to treat erectile dysfunction such as sildenafil (Viagra) may help somewhat. Other treatment options include losartan (Cozaar), fluoxetine (Prozac), and topical nitroglycerin. You may only need to use these medications during the cold season, when Raynaud's tends to be worse.
What steps may help during an episode?
Once an episode starts, it's important to warm up the affected extremities as quickly as possible. For me, placing my hands under warm running water does the trick.
When that's not possible, you can put them under your armpits or next to another warm part of your body. When the blood vessels finally relax and blood flow resumes, the skin becomes warm and flushed — and very red. The fingers or toes may throb or tingle.
Is Raynaud's phenomenon linked to other health problems?
Some people with Raynaud's phenomenon have other health problems, usually connective tissue disorders such as lupus or scleroderma. Your doctor can determine this by reviewing your symptoms, performing a physical exam, and taking a few blood tests. But most of the time, there is no underlying medical problem.
Sources
https://www.health.harvard.edu/mind-and-mood/beyond-momentary-calm
https://www.health.harvard.edu/a_to_z/scleroderma-a-to-z Assessed and Endorsed by the MedReport Medical Review Board