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Dear Dr. Sugar,
I think I have Raynaud’s syndrome, and I am wondering if there is anything I can do about it. When I bike in cold weather my fingers and toes turn very white. Sometimes my fingers go white if they come into contact with cold water when I am washing produce. When the blood returns to my hands and feet, they feel slightly swollen for a bit. I am wondering if there is anything I can do to help prevent it from happening and if I am causing any permanent damage to my skin?
— Cold Feet
Raynaud’s syndrome, also known as Raynaud’s phenomenon, is a very common condition that results in discolorations of the fingers and/or toes (most commonly) after exposure to changes in temperature or stress. The skin discoloration occurs because of abnormal spasms of the small blood vessels, which in turn decreases the blood supply to the tissues involved (fingers, toes, nose, lips, ears, and even nipples can be involved). To learn more about Raynaud’s phenomenon, keep reading!
According to the Raynaud’s Association, approximately five to 10 percent of all Americans suffer from Raynaud’s, and while both men and women can suffer from the condition, women are nine times more likely to be affected. According to the Mayo Clinic, other risk factors include your age (age of onset often begins around 15 to 30), stress, living in colder climates, and having a family history of Raynaud’s phenomenon. Smoking, medications that affect the blood vessels, and exposure to certain chemicals can also increase the risk of developing Raynaud’s phenomenon. According to Medicine Net, Raynaud’s phenomenon is also associated with a number of conditions, including rhematologic diseases (scleroderma, lupus, rheumatoid arthritis) and hormone imbalance (thyroid disorders).
The symptoms that you describe correlate with the typical symptoms that people with Raynaud’s phenomenon have. During a typical attack of Raynaud’s, affected areas of the skin turn white first. Then, the affected areas often turn blue, feel very cold and possibly numb. Then, once the area is warmed and circulation improves, the affected areas may turn red, have a pins and needles tingling sensation, and may feel swollen or throbbing. According to the Mayo Clinic, the order of the changes of color is not the same for everyone and not everyone goes through all the color changes.
According to Medicine Net, symptoms tend to be correlated with disease severity. If the extent of the color and sensory changes are severe and more sustained, which is quite rare, the poor oxygen supply to the affected areas can cause the skin to develop ulcers, which can lead to infection or gangrene. Again, this is very rare, and most people with Raynaud’s phenomenon have mild and controllable symptoms if appropriate prevention, treatment, and precautions are taken. Ultimately, if you have the symptoms of Raynaud’s phenomenon, or if you have them and they are accompanied by other symptoms like joint pain, rashes, or fatigue, you should be evaluated by a physician to determine if any special treatments or workup for other diseases are necessary.
The primary management of Raynaud’s phenomenon is self-care and prevention to reduce stress and protect the affected areas from the cold. You should dress warmly when outdoors, taking care to keep affected areas warm (hat, scarf, mittens, gloves, socks, and boots for example). Additionally, you should take care to keep yourself warm when indoors as well! Wear socks, use mittens, gloves, or oven mitts when getting items out of the refrigerator or freezer, and wear rubber gloves when doing dishes or washing produce. Other lifestyle modifications include quitting smoking, exercise, controlling stress, avoiding caffeine, and avoiding injury or infection of the affected areas. Should all these steps fail to improve or prevent your symptoms, or if symptoms are severe, there are other options for treatment including medications, injections, and surgery that can be effective. For more information on these options, talk with your treating physician.
Just so you know, I have Raynaud’s phenomenon as well! Before I lived in California, I lived in a state with fairly cold weather and my symptoms started in college. My symptoms worsened in medical school and residency, where I would spend long hours in cold operating rooms and hospital call rooms. I sometimes have a hard time controlling my symptoms at work since I can’t very well wear mittens or gloves while taking care of patients! However, moving to California has done wonders in controlling my outdoor symptoms and I always make sure to have my gloves and mittens with me even when it’s not too super cold outside!
Hopefully the information above will be able to help you better control your symptoms, and as always, I recommend talking with your physician about your problems if you continue to be concerned or have symptoms that don’t improve with conservative care.
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