NAME: Larissa Sachs
TITLE: Medical doctor
COMPANY: PinnacleHealth Medical and Surgical Associates
YEARS IN FIELD: 4, including fellowship
Q: What is Raynaud’s phenomenon?
A: Raynaud’s phenomenon is a condition in which some of the blood vessels (primarily those in the fingers and toes) constrict in response to cold or emotional stress. The vessel constriction decreases blood flow to the tissue, which causes fingers or toes to change color from normal pink to white or blue or gray. When constriction resolves and blood flow normalizes, it causes fingers or toes to turn very pink or red.
Q: Who is usually affected by it? Is it common?
A: Anybody can be affected by this condition but it is more common in young women and in family members of patients with Raynaud’s. Approximately 3 to 5 percent of the population is affected by this condition but it is more prevalent in places with cold climate.
Q: What causes the condition?
A: The human body responds to cold temperatures through narrowing small arteries of the skin so the heat from the body won’t dissipate. The same happens with stress. In patients with Raynaud’s, this system is overactive which causes severe narrowing of the blood vessels which in turn decreases blood flow to the tissues that presents as a dusky or blue color of the fingers or toes.
Raynaud’s can be primary when no underlying disease is found or secondary which is associated with autoimmune disease, underlying disease of the arteries or another pathological process.
Q: Are there any treatments for Raynaud’s?
A: Simple steps can help a patient to prevent or diminish a Raynaud’s attack:
- Avoid or decrease cold exposure by means of keeping body core temperature warm (dressing in layers, using thermal underwear, etc.) and using warm mittens and socks.
- Try to reduce stress if possible.
- Do your best to quit smoking.
- Avoid medications that can cause vasospasm (certain diet pills, some migraine medications containing ergotamine, herbs and over-the-counter medications containing ephedra or pseudoephedrine and some blood pressure medicine).
Q: How can people with Raynaud’s cope during winter weather?
A: If self-care and preventive steps are not helpful enough, medications are used. Calcium-channel blockers (e.g., nifedepine, amlodipine) can help to decrease frequency and severity of attacks and prevent tissue damage to the skin of the toes and fingers.
Doctors can also prescribe medications called vasodilators that can relax blood vessel and improve Raynaud’s symptoms. Most of these medications are approved to treat other conditions but they are found very helpful in patients with Raynaud’s. These drugs include anti-depressants such as fluoxetine; medications that can be used for erectile dysfunction (Viagra) or drugs that can treat angina (nitroglycerin ointment).
There are other medications that can be used with success for patients with Raynaud’s. Doctors and patients work together to find which medication is most helpful for each particular patient.
Interview conducted via email by Patriot-News staff.