Treatment for Raynaud's Disease
There is no cure for Raynaud's. The goals of treatment are to reduce the number, frequency, and severity of attacks; prevent tissue damage; and treat any related conditions. In most cases, treatment for primary Raynaud's involves lifestyle changes. Patients who have secondary Raynaud's are more likely to need medication and may, in severe cases, require surgery.
At the first sign of a Raynaud's attack, warming the affected area is critical. This may be achieved by moving to a warmer place, by running warm water on or massaging the affected area, or by putting the hands under the armpits (if the fingers are affected). If the attack is triggered by emotional stress, leaving the situation and trying to relax may be helpful.
Lifestyle Changes to Treat Raynaud's Disease
The following strategies may help prevent Raynaud's attacks:
- Wear extra layers (e.g., hats, mittens, jackets with tight wrist cuffs) when it’s cold outside. (Gloves under mittens provide even more warmth.)
- When out in the cold, massage your fingers and toes, shake your arms and feet, or make wide circles (windmills) with your arms to stay warm.
- Use chemical warmers or small heating pouches in mittens or boots.
- Wear mittens and socks to bed in the winter.
- Run the car heater for a few minutes before driving.
- If possible, make gradual transitions from warm to cold temperatures.
- Turn down air conditioning indoors. If that's not possible, wear extra layers.
- Use oven mitts to remove items from the freezer or refrigerator.
- Put beverages in insulated drinking glasses.
- In the workplace, avoid using vibrating tools or exposure to vinyl chloride. Be sure to wear any recommended protective gear.
- Don't smoke. Nicotine constricts blood vessels and causes skin temperature to drop.
- Avoid wearing tight shoes, jewelry, and clothing that may constrict blood vessels in the hands and feet.
- Manage stress effectively. Ask for help if you need it.
- Exercise regularly.
- Try to avoid repeated actions with the hands (e.g., typing, playing the piano).
Medications to Treat Raynaud's Disease
Several types of medicines can be prescribed to reduce the frequency and severity of Raynaud's attacks. These drugs include the following:
- Calcium channel blockers (e.g., nifedipine, diltiazem, amlodipine; open up [dilate] blood vessels in the hands and feet and are effective in about two-thirds of Raynaud's patients)
- Alpha blockers (e.g., prazocin, doxazosin; reverse the effects of the hormone norepinephrine, which constricts blood vessels)
- Vasodilators (e.g., nitroglycerine cream; dilate blood vessels and heal skin ulcers)
- Pentoxifylline (helps red blood cells pass through constricted blood vessels)
Some medications worsen Raynaud's symptoms and should be avoided if possible. These drugs include the following:
- Certain blood pressure medications (e.g., metoprolol, nadolol, propranolol, clonidine)
- Birth control pills (can affect blood circulation)
- Certain over-the-counter cold and diet medications (e.g., phenylpropanolamine, pseudoephedrine)
- Migraine medications that include ergotamine
- Some chemotherapy drugs (used to destroy cancer cells)
- Caffeine (found in coffee, tea, cola, and chocolate)
- Narcotics (e.g., prescription pain relievers)
Other Treatments for Raynaud's Disease
In severe cases, Raynaud's may be treated using a surgical procedure called sympathectomy. In this procedure, the sympathetic nerves, which regulate the widening and narrowing of blood vessels in the hands and feet, are cut. This surgery may decrease the frequency and severity of attacks, but it does not reduce symptoms in all cases. Surgery also is not a permanent solutionsymptoms may be alleviated for a year or two, but often return.
Raynaud's also may be treated using injections that block sympathetic nerve impulses. This treatment can provide temporary relief; however, patients may require repeated injections over long periods of time.
Rarely, when blood flow has been completely blocked in the affected areas and gangrene (tissue death, necrosis) has developed, amputation (surgical removal of damaged tissue) is necessary.