Raynaud's phenomenon

Also called Raynaud's disease, Raynaud's syndrome

Small blood vessels overreacting to cold, so fingers turn white then blue then red. Common, and occasionally a warning.

What it is

Raynaud's affects up to 10 million people in the UK. Small blood vessels in the fingers and toes constrict sharply in response to cold or stress, cutting off blood supply.

Primary Raynaud's is the common form, usually starting in the teens or twenties, and it is a nuisance rather than a danger.

Secondary Raynaud's is caused by another condition, most often an autoimmune one such as lupus, scleroderma or rheumatoid arthritis. It usually starts later, is more severe, and can cause ulcers and tissue damage.

Raynaud's starting after 30, or affecting only one hand, or causing ulcers, should always be investigated.

Signs you might notice

Fingers or toes turning white, then often blue, then red as blood returns.

Numbness, then pain and tingling on rewarming, which is the painful part.

Triggered by cold, including taking something out of a freezer or holding a cold drink.

Triggered by stress as well as by temperature.

In secondary Raynaud's: ulcers on the fingertips, thickened skin, and other autoimmune symptoms.

How it can affect day-to-day life

Everyday activities become genuinely difficult: shopping in a chilled aisle, washing up, cold offices, winter commuting.

The pain on rewarming is what people find hardest, and it is not well understood by others because the visible attack has ended.

For people with a learning disability or dementia who cannot report it, cold hands with colour change should be recognised as painful rather than incidental.

Supporting someone well

Keep the whole body warm, not just the hands. Core temperature drives the response, so a warm coat matters as much as gloves.

Use gloves before going into the cold rather than after the attack starts, and keep a pair by the fridge.

Stop smoking, which constricts vessels further.

Rewarm gently: warm water, not hot, and never direct heat on numb skin.

Ask about medication such as nifedipine for frequent or severe attacks.

Get any fingertip ulcer seen urgently, and ask for autoimmune blood tests if the pattern suggests secondary Raynaud's.

Where to get help

A GP can assess and treat, and refer to rheumatology if secondary Raynaud's is suspected.

Scleroderma and Raynaud's UK run a helpline on 0800 311 2756.

An ulcer or a digit that stays discoloured needs urgent assessment.