Raynaud’s syndrome is caused by an exaggerated narrowing (vasospasm) of small blood vessels in the fingers and toes in response to cold or stress, which reduces blood flow and changes skin color. It can occur on its own (primary) or as a sign of another condition (secondary). Key causes and contributors
- Primary Raynaud’s (Raynaud’s disease)
- Thought to be idiopathic with possible genetic predisposition.
- Triggers are typically cold exposure or emotional stress.
- Smoking and hormonal factors may increase attack frequency or severity.
- Secondary Raynaud’s phenomenon
- Associated with underlying autoimmune or connective-tissue diseases such as scleroderma, systemic lupus erythematosus, rheumatoid arthritis, or Sjögren syndrome.
- Other contributing factors include:
- Occupational or mechanical: hand-arm vibration from vibrating tools, repetitive hand use, prior hand injuries.
- Medical treatments or exposures: certain migraine medications, some chemotherapy and blood pressure drugs (notably beta-blockers), vasoconstrictive substances.
- Vascular or arterial disease: atherosclerosis or other vascular conditions, particularly in older adults.
- Infections or other systemic conditions: some infections and, less commonly, malignancies.
Common triggers and modifiers
- Cold temperatures (hands in cold water, exposure to cold air) are the most frequent triggers.
- Emotional stress can also provoke attacks.
- Tobacco use worsens attacks due to nicotine’s vasoconstrictive effects.
- Hormonal factors (e.g., pregnancy or certain medications) may influence attack frequency.
What this means for you
- If attacks are limited to fingers and toes and occur mainly with cold or stress in otherwise healthy individuals, this is often primary Raynaud’s.
- If attacks are persistent, severe, or accompanied by ulcers, skin thinning, color changes, or occur in the context of an autoimmune disease, secondary causes should be investigated.
Next steps and considerations
- Discuss with a healthcare provider if you have:
- Frequent, painful, or persistent episodes.
- Digital ulcers, color changes that don’t resolve, or symptoms affecting multiple body parts.
- Symptoms suggestive of an underlying condition (joint pain, rash, fatigue, or weakness).
- Evaluation may include a detailed history, physical exam, and tests to screen for autoimmune diseases or vascular issues.
- Management commonly focuses on avoiding triggers, protecting extremities from cold, and in some cases pharmacologic therapy or treatable underlying conditions.
If you’d like, provide any details about your symptoms (which fingers/toes, what color changes you see, how long attacks last, any associated pain or ulcers, and any underlying health conditions or medications), and the information can be tailored to you.