Medicines for Raynaud's

What it is

Raynaud's is a condition in which the small blood vessels in the extremities — most often the fingers and toes, and sometimes the ears or nose — over-react to cold or emotional stress and briefly narrow, reducing blood flow. During an attack the affected parts classically turn white, then blue, and finally red as the blood returns, often with numbness, tingling or pain. In most people it is primary Raynaud's, which is common, tends to start in younger life and is not linked to any other illness; it is usually mild and more of a nuisance than a danger. Less often it is secondary Raynaud's, where the spasms are connected to another condition — particularly autoimmune diseases that affect the connective tissue — and this form can be more severe and may come with other features such as skin changes or sores. Telling the two apart matters, because secondary Raynaud's needs further assessment.

How it is treated

For most people the focus is on simple, practical measures rather than medicines, because primary Raynaud's is usually mild. The key is to keep the whole body and the hands and feet warm, anticipate and avoid triggers such as sudden cold, and stop smoking, since smoking narrows blood vessels and makes attacks worse. Some medicines and other factors can provoke attacks and may be reviewed. When attacks are frequent, painful or interfere with daily life, a medicine that relaxes and widens the blood vessels — most often a calcium-channel blocker such as nifedipine — can reduce how often and how badly they happen. Where the condition is more severe, or where it is secondary to another illness, care is shared with a specialist and aimed at both the Raynaud's and the underlying cause, with close attention to the health of the skin and the prevention of damage to the fingertips and toes.