Treatment of Raynaud's

Unfortunately, there is no permanent cure for Raynaud's, and sufferers usually manage their symptoms with a combination of self-care and preventive treatment. However, medication may also be prescribed to treat more severe forms of the condition.

1. Prevention

Attacks may be prevented in a number of ways:

Keeping Warm Outdoors

Before going outside in cold weather, sufferers should always make sure that they are warmly dressed, with a hat, scarf, warm coat (preferably with snug cuffs), socks, warm boots, and mittens or gloves. These should be put on indoors, so that there is no chance of becoming cold. Portable heat packs, and battery heated gloves and socks are also available, and may be extremely useful for those with severe symptoms.

Keeping Warm Indoors

Socks should always be worn indoors, and some people may also find it helpful to wear gloves during winter. Gloves, mittens or oven gloves should be worn when taking food out of the fridge or freezer. Many people find it helpful to use insulated drinking glasses.

2. Self Care

A number of steps can decrease the frequency of Raynaud's attacks:

Stop Smoking

The nicotine in tobacco causes the blood vessels to constrict, making the skin temperature drop, and may trigger an attack. Even secondary smoke can aggravate Raynaud's.

Cut Down Caffeine

Caffeine found in drinks such as tea, coffee and cola can exacerbate symptoms in some people.

Start Exercising

Regular exercise can help to increase circulation, which is particularly useful for primary Raynaud's sufferers.

3. Medication

Some medicines designed to widen (dilate) blood vessels and promote circulation may be used to help treat Raynaud's. These may include:

Alpha Blockers

This type of drug counteracts the actions of norepinephrine, a hormone that constricts blood vessels.

Calcium Channel Blockers

This group of drugs (including nifedipine and amlodipine) is found to decrease the frequency and severity of attacks in about two-thirds of people. They relax and open up small blood vessels, and can also heal skin ulcers on fingers or toes. Some people find that they only need to use the medication during the winter, or during cold weather spells.

Vasodilators

A vasodilator is a drug that relaxes blood vessels. Often available as an ointment (such as nitroglycerin cream), it may be applied to help heal skin ulcers.

However, there are also a number of drugs that may aggravate the condition, and patitents may be advised by their doctor to avoid taking drugs that contain pseudoephedrine (a decongestant), beta-blockers and the contraceptive pill.

4. Other Treatments

In severe cases of Raynaud's, self-help and medication may not work, and other treatments may be necessary.

Surgery

There are a number of nerves that control the opening and narrowing of blood vessels in the skin. In severe cases, these sympathetic nerves may be cut or stripped in a procedure called sympathectomy to prevent their exaggerated response. Although this treatment may produce immediate relief and reduce the frequency and duration of attacks, it is not always successful and will only last a year or so.

Injections

In severe cases, doctors may want to carry out an intravenous infusion therapy, where a drug is slowly injected into bloodstream through a vein over 3-5 days (also called a drip). A vasodilator drug known as iloprost is used for this procedure, which opens up the blood vessels and helps to prevent clotting.