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Named for the French medical student who first described it in 1862, Raynaud’s phenomenon is a rare condition in which blood vessels react in an exaggerated way (called a vasospasm) to cold or emotional stress. You may also see the terms “Raynaud’s disease” and “Raynaud’s syndrome,” but they’re misleading. Raynaud’s isn’t a disease: It’s a variant of the body’s natural way of keeping its temperature under control.
When we’re hot, we get flushed as small blood vessels under the skin widen (dilate) to bring blood close to the surface and let its warmth escape. But when we’re cold, those blood vessels narrow (constrict) to preserve warmth inside for our brain, heart and other vital organs.
In Raynaud’s, blood vessels going to certain parts of the body—often the fingers—overreact to cold or even a brief drop in temperature, like walking into an air-conditioned room. The vessels clamp down in what’s called a vasospastic attack, blocking the blood flow and causing the skin in the affected area to:
Not everyone with Raynaud’s has all three color changes, or in the same order. Which body parts are affected and how long the attacks last also varies from person to person. But all patients do fall into one of two categories of Raynaud’s.
Who is at risk?
According to the Arthritis Foundation, 4 to 15 percent of the people in the United States have Raynaud’s phenomenon. In that group, more than 80 percent have primary Raynaud’s (largely benign), while the rest have secondary Raynaud’s (sometimes serious). And just as the severity of the two types of Raynaud’s is different, so are their risk factors.
Risk factors for Primary Raynaud’s
Risk factors for Secondary Raynaud’s
When to see a doctor
If your child seems extremely sensitive to cold or emotional stress and you think he may have Raynaud’s phenomenon, it’s generally okay to decide to wait until his next regular check-up. Raynaud’s isn’t a disease, and for the vast majority of kids, the diagnosis just means they’ll have to take extra care to stay warm.
But you should make an appointment to bring your child in sooner if his symptoms are accompanied by warning signs of a more serious illness. These include:
Most children with Raynaud’s phenomenon have no complications. While they may not outgrow their condition, it likely won’t get any worse and they’ll live a normal life.
For the rare few with secondary Raynaud’s, there is a risk of tissue damage if their condition is severe and their attacks tend to last a long time. Blood flow to the affected area may become permanently diminished, causing ulcers or gangrene—ailments that can be very difficult to treat.
As a parent, you may worry whether there was anything you should’ve done to head off your child’s condition. Yet primary Raynaud’s phenomenon—which, by far, is the type most children have—can’t be prevented. Nor can secondary Raynaud’s, if it is caused by an underlying disease.
But by helping your child avoid cold, reduce stress and make some simple lifestyle changes, you can help him cut down on the frequency and severity of his Raynaud’s attacks. For tips on how to do this, see our Treatment and Care section.
For children with primary Raynaud’s, we don’t yet know what causes their blood vessels to react in such a vigorous way to cold and emotional stress.
However, there are concrete causes for secondary Raynaud’s, and in children it’s most often an underlying autoimmune disease. Here at Children’s Hospital Boston, the illnesses we tend to see with secondary Raynaud’s are:
Diseases like arteriosclerosis and hypertension can also damage the blood vessels and cause secondary Raynaud’s, though almost always in adults. Other potential causes of secondary Raynaud’s include:
Raynaud’s phenomenon isn’t something you can spot by simply looking at your child. Symptoms occur only when the blood vessels are actually in vasospasm—clamping down—in response to cold or emotional stress. Here are the telltales of a Raynaud’s attack:
It usually takes about 15 to 20 minutes for these symptoms to resolve themselves after whatever triggered the attack is gone (for example, after you’ve moved your child to a warmer area or helped him calm down).
In secondary Raynaud’s, the attacks can last longer and may have more severe symptoms, such as pain in the affected area; lingering weakness or numbness; and skin ulcers or dead tissue (gangrene).
You and your family are key players in your child’s medical care. It’s important that you share your observations and ideas with your child’s health care provider and that you understand your provider’s recommendations.
If your child has Raynaud’s phenomenon and you’ve set up an appointment, you probably already have some ideas and questions on your mind. But at the appointment, it can be easy to forget the questions you wanted to ask. It’s often helpful to jot them down ahead of time so that you can leave the appointment feeling that you have the information you need.
If your child is old enough, you may want to suggest that he write down what he wants to ask his health care provider, too.
Here are some questions you may want to ask:
Cyanosis: A bluish color of the skin caused by insufficient oxygen in the blood; one of three color changes associated with Raynaud’s phenomenon.
Digit: A finger or toe. The small blood vessels that feed the fingers and toes are called digital arteries.
Extremities: The limbs of the body, most commonly referring to the hands and feet.
Ischemia: A lack of blood flow in a body part.
Necrosis: The death of body tissue. Gangrene is a kind of necrosis.
Pallor: A whitening of the skin caused by lack of blood flow; one of three color changes associated with Raynaud’s.
Rubor: A reddish color of the skin caused by increased blood flow; one of three color changes associated with Raynaud’s.
Triphasic: Having three parts. If the skin changes to blue, white and then red during a Raynaud’s attack, it’s called a triphasic reaction. If only two colors occur, it’s called a biphasic reaction.
Vasoconstriction: A narrowing of blood vessels caused by the tightening of muscles in their walls.
Vasodilation: A widening of blood vessels caused by the relaxation of muscles in their walls.
Vasospasm: Sudden, temporary vasoconstriction—literally, a spasm in the blood vessels.
Q: Is Raynaud’s phenomenon dangerous?
A: By and large, Raynaud’s is more a nuisance than a cause for concern. But there is a risk of long-term tissue damage and other complications with secondary Raynaud’s, the rare form caused by an underlying disease.
Q: Will my child outgrow Raynaud’s?
A: This condition tends not to go away, but it also tends not to get any worse. Most people with primary Raynaud’s can manage their symptoms with minor lifestyle changes, and don’t need medication.
Q: Are Raynaud’s attacks painful?
A: Only rarely, in truly severe cases. By contrast, children with primary Raynaud’s may feel cold, stiffness and a “pins and needles” sensation in their hands or feet—but some may not even sense they’re having an attack at all, and notice it only by sight.
Q: How is Raynaud’s different from frostbite?
A: Exposure to extreme cold causes frostbite, in which there is actual tissue damage. A Raynaud’s attack can occur in fairly mild temperatures (say, around 60 degrees) and doesn’t injure the affected fingers or toes, except in severe cases.
Q: Why does emotional stress trigger an attack?
A: It’s tied into our natural “fight or flight” response. The body reacts to stress the way it would a physical threat, pulling blood away from the skin’s surface and concentrating it in the muscles, brain, heart, lungs—the things you’d really need to fight or flee!
Q: Are there any alternative therapies?
A: Certain people find help in alternative therapies such as biofeedback, fish oil, dietary supplements and acupuncture. However, most patients need no therapy or choose to use well-tolerated medications. You can discuss these options with your doctor.
Why are my friendships changing? How can I convince my parents that being a vegetarian is heathy and right for me? What types of birth control are available to me, and how do I use them? Young men and young women may have some concerns specific to their gender, and some that they share. At Children’s, the Center for Young Women’s Health and Center for Young Men’s Heath offer the latest general and gender-specific information about issues including fitness and nutrition, sexuality and health, health and development and emotional health.
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