What Is Raynaud's Disease?
Raynaud's phenomenon causes blood vessels in the fingers and toes (and sometimes ears, nose or lips) to narrow excessively in response to cold temperatures or stress, temporarily cutting off blood supply and causing a characteristic three-phase colour change.
The Three Phases
| Phase | Colour | What's Happening |
|---|---|---|
| 1st | White (pallor) | Blood vessel spasm stops blood flow |
| 2nd | Blue/purple (cyanosis) | Oxygen is depleted from remaining blood |
| 3rd | Red (erythema) | Blood flow returns — reactive hyperaemia with pain and tingling |
Primary vs Secondary Raynaud's
| Feature | Primary Raynaud's | Secondary Raynaud's |
|---|---|---|
| Cause | No underlying disease | Associated with autoimmune disease, drugs, occupation |
| Age of onset | Young women, teens–30s | Older onset, any sex |
| Severity | Mild, no tissue damage | More severe, can cause ulcers |
| Common associations | None | Lupus, scleroderma, Sjögren's, RA, vibration white finger |
Blood Tests to Differentiate
| Test | Purpose |
|---|---|
| ANA | Positive in many autoimmune secondary causes |
| Anti-SCL-70 (anti-topoisomerase I) | Scleroderma — diffuse type |
| Anti-centromere antibody | Limited scleroderma (CREST) |
| Anti-Ro/SSA, Anti-La/SSB | Sjögren's syndrome |
| Rheumatoid factor + Anti-CCP | Rheumatoid arthritis |
| ESR & CRP | Raised in secondary types |
| Full Blood Count | Anaemia in connective tissue disease |
| Nailfold capillaroscopy | Not blood test — microscopy shows abnormal capillaries in secondary Raynaud's |
FAQs
Can Raynaud's cause permanent damage?
Primary Raynaud's: very rarely. Secondary Raynaud's: yes — severe episodes can cause digital ulcers and tissue death (necrosis).
How is Raynaud's treated?
Lifestyle: warm clothing, gloves, avoid cold and smoking. Medications: calcium channel blockers (nifedipine). Severe cases: prostacyclin infusions.
Is Raynaud's common?
Primary Raynaud's affects around 3–5% of the population — mostly young women. Secondary is less common.
Medical Disclaimer: New-onset Raynaud's in older adults or those with other symptoms needs investigation for an underlying autoimmune cause.