What is Raynaud’s Syndrome?

An Article Written By Bonnie McNab
Podiatrist – New Step Podiatry

White, blue and red skin, oh my! Cold or cool skin, colour changes and altered sensation…it could be Raynaud’s! This blog article explains Raynaud’s types, symptoms, diagnosis and management. 

What is Raynaud’s?

Raynaud’s syndrome refers to spasms that occur in the small blood vessels of your hands and feet which are linked to skin colour changes. The spasms temporarily restrict blood flow to the vessels of the extremities (fingers and toes) in response to cold or emotional stimuli.
A flare-up of Raynaud’s is often referred to as a ‘Raynaud’s attack’ and, by no means the only cause, attacks can often be triggered by sudden changes in temperature.
It’s not just the freezing Canberra Winter that can trigger symptoms – Raynaud’s attacks can be set off by a number of other things including:
– Stress
– Anxiety
– Underlying health conditions and
– Some pharmaceutical medications

There are two types of Raynaud’s syndrome: primary and secondary. Primary Raynaud’s typically occurs without cause while secondary Raynaud’s occurs as a result of an underlying health issue.

Primary Raynaud’s

– Often occurs without cause
– Typically affects females who are less than 30 years of age
– Familial history of condition
Primary Raynaud’s is more likely to be benign and episodic when compared to secondary Raynaud’s. Additionally, there is increasing evidence that primary Raynaud’s may remit over time.

Secondary Raynaud’s

– Often the result of an underlying health issue such as a chronic illness, autoimmune disease or thyroid condition
– Can also be caused by different pharmaceutical medications
Patients with secondary Raynaud’s often describe more frequent and painful attacks which are often asymmetric and can lead to digital ulceration. Ulceration in secondary Raynaud’s often resolves but may result in scarring or pitting of the skin. In very severe cases, this may progress to necrosis, gangrene, or auto-amputation.

Did you know? Secondary Raynaud’s (also referred to as Raynaud’s Phenomenon) is usually caused by connective tissue disease – people with this type of Raynaud’s are likely to experience attacks which are more severe than those with primary Raynaud’s.

What are the symptoms?

During a Raynaud’s attack, people often notice that the skin on either their hands or feet turns white or pale in colour. They may also notice a loss of feeling in the fingers and/or toes. During this stage of the attack, some People may also notice a bluish colour change in the affected region. These changes in colour are due to the restriction of blood flow to the area. Once the blood vessels re-dilate, and circulation returns, the area may turn pink or red in colour. It is during this stage of the attack that people may experience burning or a pins and needles sensation as the feeling returns to the area.

Did you know? A Raynaud’s attack can last anywhere from minutes to hours!

(Illustration by Emily Roberts, Verywell)

Raynaud’s or Chilblains? What’s the difference?

Raynaud’s and Chilblains can occur in the same person and both can be triggered by exposure to cold weather, however, they differ slightly in causation and presentation.
In Raynaud’s, skin and sensation changes are caused by a spasm of the blood vessels, often in response to changes in temperature or during periods of emotional distress, which causes a temporary restriction of blood flow to the area. Raynaud’s can visually be defined by the characteristic colour changes of white, blue and red.
In chilblains, sudden changes in temperature can cause the blood vessels to dilate and contract faster than they are used to, leading to damage in the vessels and surrounding areas. Some factors which can increase your risk of developing chilblains include:
– living in cold, damp climates
– being female
– poor or reduced circulation
– cigarette smoking
– low BMI
– poor diet
– anaemia
– family history of the condition

Typical presentation of Raynaud’s Typical presentation of Chilblains

Did you know? Cigarette smokers are at a higher risk for developing chilblains. Why? Smoking causes a restriction of the blood vessels and has been linked to delayed tissue and wound healing.

If you would like to know more about chilblains, have a read of ‘How to Care for your Chilly Chilblains’ by Yen-Chii Wong – you can find the link here

How is Raynaud’s diagnosed and treated?

Raynaud’s is often diagnosed based on symptoms by either your GP, Rheumatologist or Podiatrist.
Despite the concerning appearance of the skin during an attack, many people experience mild symptoms that can be managed through simple lifestyle changes such as:
– keeping whole body warm (including core, head, hands and feet)
– managing stress and anxiety levels
– keeping active
– having regular medication reviews with your GP, especially if you are taking multiple prescription medications or have recently started a new medication
– a medication called Nifedipine is sometimes prescribed for severe cases

Can I reduce my risk of developing Raynaud’s?

Yes! Preventative measures such as keeping your whole body warm, managing stress and anxiety levels, and managing underlying health conditions are all great ways to reduce your risk of developing a Raynaud’s attack. Unsurprisingly, the same preventative approach can be applied to reduce your risk of developing chilblains.

If it’s not Raynaud’s or Chilblains, what could it be?

If your hands and feet are feeling cold, if you’re noticing altered sensation or skin changes, it’s important to follow-up with your Podiatrist and GP. Poor circulation and altered nerve function can be signs of underlying conditions such as diabetes or nerve damage.

Book an Appointment at Our Canberra Clinic for a foot assessment

Our podiatrists are here to ensure those in Canberra have access to quality services that can help individuals get the treatment they deserve. Easily book an appointment at our clinic online or give us a call on 02 6198 4818.

References

– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139949/
– https://www.bmj.com/content/344/bmj.e289.abstract
– https://www.mymed.com/diseases-conditions/raynauds-phenomenon-syndrome-disease/what-are-the-signs-you-may-have-raynauds
– https://www.bodyandsoul.com.au/health/health-news/i-thought-i-was-just-cold-now-i-face-amputation/news-story/cd7db1748d979018bf7f26b13dee5d13
– https://www.livehealthily.com/health-library/conditions/raynauds-phenomenon
– https://www.verywellhealth.com/raynauds-syndrome-3233150