What is Raynaud’s phenomenon?
In Raynaud's phenomenon the small arteries of the fingers and toes constrict excessively in response to cold or emotional stress. Blood flow drops, the digit blanches, then becomes blue as oxygen is extracted, then flushes red and throbs as circulation returns.
Primary Raynaud's typically begins in the teens or twenties, affects both hands symmetrically, does not cause tissue damage and needs only protective measures. Secondary Raynaud's begins later, is often asymmetrical, more severe, and can cause fingertip ulcers — and it is associated with connective tissue disease, most commonly systemic sclerosis or lupus. Nailfold capillaroscopy and antibody testing separate the two.
Symptoms to watch for
- Fingers or toes turning white, then blue, then red with cold or stress
- Numbness or pins and needles during an attack
- Throbbing, burning pain as circulation returns
- Attacks brought on by air conditioning, cold water or refrigerated shelves
- Involvement of the nose, ears or nipples in some patients
- Painful sores, pits or ulcers at the fingertips (suggests secondary Raynaud's)
- Associated skin tightening, joint pain, dry eyes or reflux
When to seek urgent care
A finger or toe that stays white or blue for hours, becomes blackened, or develops a painful ulcer needs urgent assessment.
How it is diagnosed
Investigation is chosen to answer a specific question rather than as a blanket screen. For Raynaud’s phenomenon that usually means:
- History of triphasic colour change and its triggers, plus examination of the digits
- Nailfold capillaroscopy — the key test separating primary from secondary disease
- ANA and extended connective tissue antibody panel
- Inflammatory markers and full blood count
- Assessment for occupational vibration exposure, drugs and thoracic outlet compression
- Arterial assessment where the pattern is one-sided or pulses are abnormal
Treatment options at Siva Sakthi
Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.
- Cold protection and lifestyleLayered gloves, hand warmers, avoiding sudden temperature change, and stopping smoking — smoking directly worsens digital circulation.
- Medication reviewBeta blockers, some migraine drugs and stimulants can provoke attacks and are reviewed.
- Calcium channel blockersNifedipine or amlodipine are first-line drug treatment for frequent or severe attacks.
- Additional vasodilatorsPhosphodiesterase-5 inhibitors, topical nitrates or ARBs are added where attacks persist.
- Treatment of digital ulcersProstacyclin analogues, wound care and infection control for ischaemic fingertip ulceration.
- Treating the underlying diseaseWhere secondary Raynaud's reflects scleroderma or lupus, treating that condition is central.
Common questions
Primary Raynaud's is uncomfortable but harmless and does not damage tissue. Secondary Raynaud's can threaten the fingertips and signals underlying disease — which is why testing is worthwhile even when attacks are mild.
Capillaroscopy examines the tiny vessels at the nail base under magnification. Abnormal loops there are one of the earliest and most reliable indicators of connective tissue disease.
Attacks can usually be reduced substantially with cold protection and medication, though the tendency itself generally persists. Treating any underlying condition improves control.
Book a consultation in Guntur
Raynaud's Phenomenon is assessed and treated by Dr. Deepika Ponnuru, MD (Internal Medicine), DM (Rheumatology), at our Kothapeta clinic. Request an appointment or call +91 00000 00000.