The aims of treatment are to reduce the number and severity of attacks and to prevent tissue damage and loss in the fingers and toes. Most doctors are conservative in treating patients with primary and secondary Raynaud's phenomenon; that is, they recommend non-drug treatments and self-help measures first.
Doctors may prescribe medications for some patients, usually those with secondary Raynaud's phenomenon. In addition, patients are treated for any underlying disease or condition that causes secondary Raynaud's phenomenon.
Non-Drug Treatments and Self-Help Measures
Several nondrug treatments and self-help measures can decrease the severity of Raynaud's attacks and promote overall well-being.
Take Action During an Attack:
An attack should not be ignored. Its length and severity can be lessened by a few simple actions. The first and most important action is to warm the hands or feet. In cold weather, people should go indoors. Running warm water over the fingers or toes or soaking them in a bowl of warm water will warm them. Taking time to relax will further help to end the attack. If a stressful situation triggers the attack, a person can help stop the attack by getting out of the stressful situation and relaxing. People who are trained in biofeedback can use this technique along with warming the hands or feet in water to help lessen the attack.
It is important not only to keep the extremities warm but also to avoid chilling any part of the body. In cold weather, people with Raynaud's phenomenon must pay particular attention to dressing.
- Several layers of loose clothing, socks, hats, and gloves or mittens are recommended.
- A hat is important because a great deal of body heat is lost through the scalp.
- Feet should be kept dry and warm.
- Some people find it helpful to wear mittens and socks to bed during winter.
- Chemical warmers, such as small heating pouches that can be placed in pockets, mittens, boots, or shoes, can give added protection during long periods outdoors.
People with Raynaud's phenomenon should also be aware that air conditioning can trigger attacks. Turning down the air conditioning or wearing a sweater may help prevent attacks. Some people also find it helpful to use insulated drinking glasses and to put on gloves before handling frozen or refrigerated foods.
The nicotine in cigarettes causes the skin temperature to drop, which may lead to an attack.
Stress management is important. Stress and emotional upsets may trigger an attack, particularly for people who have primary Raynaud's phenomenon, learning to recognize and avoid stressful situations may help control the number of attacks. Many people have found that relaxation or biofeedback training can help decrease the number and severity of attacks. Biofeedback training teaches people to bring the temperature of their fingers under voluntary control.
Many doctors encourage patients who have Raynaud's phenomenon, particularly the primary form, to exercise regularly.
Most people find that exercise:
- promotes overall well-being
- increases energy level
- helps control weight
- promotes restful sleep
You should always talk to your doctor before starting an exercise program. People who have secondary Raynaud's phenomenon should also talk to their doctors before exercising outdoors in cold weather.
See Your Doctor:
People with Raynaud's phenomenon should see their doctors if they are worried or frightened about attacks or if they have questions about caring for themselves. They should always see their doctors if attacks occur only on one side of the body (one hand or one foot) and any time an attack results in sores or ulcers on the fingers or toes.
Treatment With Medications
People with secondary Raynaud's phenomenon are more likely than those with the primary form to be treated with medications.
Many doctors believe that the most effective and safest drugs are calcium-channel blockers, which relax smooth muscle and dilate the small blood vessels. These drugs decrease the frequency and severity of attacks in about 65% of patients who have primary and secondary Raynaud's phenomenon. These drugs also can help heal skin ulcers on the fingers or toes.
Other patients have found relief with drugs called alpha blockers that counteract the actions of norepinephrine, a hormone that constricts blood vessels. Some doctors prescribe a drug that relaxes blood vessels, such as nitroglycerine paste, which is applied to the fingers, to help heal skin ulcers. Often, patients with the secondary form will not respond as well to treatment as those with the primary form of the disorder.
Patients should keep in mind that the treatment for Raynaud's phenomenon is not always successful.
NIH Publication No. 01-4911