Condition hub
Living with raynaud's phenomenon
What is happening, and which kind you have.
What an attack is
The small arteries feeding your fingers and toes clamp down, and the nose and ears are sometimes involved too. Cold sets off most attacks and stress sets off the rest. Blood flow drops sharply while it lasts, then returns when the vessels open again.
Primary Raynaud's
Primary means the attacks are the whole of it, with no other illness causing them. It tends to start younger, affect both hands about equally, and leave the fingers undamaged. Most people who have it never develop anything further, though some do, and that can take years to show.
Secondary Raynaud's
Secondary means another illness is driving the attacks, most often systemic sclerosis, lupus, or a related connective tissue disease. Sorting out which of the two you have is the first thing a rheumatologist does, and it decides the treatment and how often you are seen.
The four things that raise the question
Attacks starting after the age of forty, one hand affected much more than the other, sores or ulcers at the fingertips, and an odd antibody test. Any of those pushes a doctor toward looking for a cause. The first visit is usually an examination and blood tests to determine the cause.
The four-step plan, applied to Raynaud's.
Get the right diagnosis
The question is primary or secondary, and the reason determines the treatment. Examining the tiny vessels at the base of the fingernail, alongside an antibody test, usually answers it.
Raynaud's and labs →Clean up your food
Eating enough is usually the toughest part for people, because cold sensitivity is worse when there is very little body fat to insulate you. Warm drinks and warm meals help through the day.
Raynaud's and diet →Detox your daily life
Warmth is the foundation, and whole-body warmth beats warm hands alone. Stopping smoking is the single most useful change for smokers, because nicotine clamps blood vessels down.
Raynaud's and environment →Build a stronger body
Regular aerobic work improves your circulation generally, and moving your hands keeps the fingers from stiffening through a long attack. Attacks still come, and what changes is how well you handle them.
Raynaud's and exercise →
Pro tip
Examining the small vessels at the base of your fingernail takes a few minutes in clinic and is the single most useful test for telling primary from secondary Raynaud's. Abnormal vessels there are worth a full connective tissue disease workup even when your antibody test comes back negative.
Relaxing and biofeedback
Supplements and gloves
What helps day to day
Keeping your whole body warm counts for more than warming your fingers alone, because the clamping down answers to your core temperature as well as to local cold. So hats, layers, and warm boots do more than gloves by themselves, though wear the gloves too. Warm up before you go out.
Avoiding sudden temperature swings helps, and so does planning around them, since the freezer aisle at the supermarket sets off attacks in a lot of people. Smoking clamps blood vessels down, so stopping is the single most useful change for smokers. Some drugs can make attacks worse, including certain beta blockers and decongestants, and those are worth reviewing with whoever prescribed them.
A sore or an ulcer at a fingertip needs a doctor. Skin that keeps breaking down points to blood flow worse than attacks alone would cause, and it can be hard to heal once it sets in. Treating it early is far easier than treating it late.
Common misconceptions.
Myth. Cold hands are just cold hands.
Reality. Cold sensitivity is universal. True Raynaud's has well-demarcated color changes (white, blue, red) and is reproducible with cold exposure. Distinguishing Raynaud's from generic cold intolerance counts because Raynaud's can signal underlying connective tissue disease.
In plain words. Everyone gets cold fingers. Raynaud's is different, because the fingers change color in clear stages, first white, then blue, and then red. Cold brings it on every time. It can be a sign of another disease, so the difference is worth knowing.
When to see a rheumatologist.
See a rheumatologist if you have:
- Well-demarcated color changes in fingers or toes (white, blue, red) with cold or stress
- Raynaud's symptoms plus a positive ANA
- Raynaud's plus joint pain, dry eyes/mouth, swollen hands, or skin tightening
- Digital ulcers or pitted scars at the fingertips
- New-onset Raynaud's after the age of forty, which makes a secondary cause more likely
- Severely asymmetric Raynaud's (suggests a vascular or compressive cause)
- Raynaud's plus family history of connective tissue disease
Any new Raynaud's without an obvious cause is worth that nailfold examination and an antibody test. Catching systemic sclerosis as it develops changes more than almost any other diagnosis in rheumatology, because the screening that protects your lungs and your heart starts at diagnosis.
References.
- Daniels J; Pauling J; Eccleston C. Behaviour change interventions for the management of Raynaud’s phenomenon: a systematic literature review. BMJ Open. 2018;8:e024528. 10.1136/bmjopen-2018-024528Systematic literature review of RCTs with narrative synthesis
- Muir A; Robb R; McLaren M et al. The use of Ginkgo biloba in Raynaud’s disease: a double-blind placebo-controlled trial. Vascular Medicine. 2002;7:265-267. 10.1191/1358863x02vm455oaDouble-blind
- Liem S; Hoekstra E; Bonte-Mineur F et al. The effect of silver fibre gloves on Raynaud’s phenomenon in patients with systemic sclerosis: a double-blind randomized crossover trial. Rheumatology. 2022;62:SI74-SI81. 10.1093/rheumatology/keac243Multicentre
- Karavidas MK; Tsai PS; Yucha C et al. Thermal biofeedback for primary Raynaud's phenomenon: a review of the literature. Applied psychophysiology and biofeedback. 2006;31:203-16. 10.1007/s10484-006-9018-2Narrative/systematic review of 10 studies: 7 RCTs
This page gathers the published research on this subject into one place. The studies behind it were published between 1989 and 2026, and every figure links to the paper it came from. Those studies were peer reviewed. This summary of them was not. Dr. Sarah Luebker is reviewing these pages one at a time and has not reached this one yet, so it carries no medical review date and nothing here is her opinion or her advice to you. Each page gets updated as she reaches it. It is here in the meantime because the science is worth having in one organized place that is easy to find and easy to read. Talk to your own clinician before acting on any of it.