Raynaud’s disease and cold weather

As we have discussed in previous articles, Raynaud’s Disease is a potentially debilitating disorder in which the small blood vessels in the fingers and toes (and possibly in the ears and tip of the nose) become constricted and inflamed by a build-up of plaque.  This constriction causes episodes that last from minutes to hours in which there is a tri-phasic change of skin color in the affected areas accompanied by pain, numbness, throbbing and tingling.

When blood does not flow freely enough to the surface of the skin, that skin will first turn white indicating that blood flow is at its lowest level. This is followed by a change in color from white to blue indicating that blood is beginning to pool in the area. And finally, the skin will turn red as the episode subsides and blood flow returns.  In severe cases of Raynaud’s, skin infections or skin ulcers can even develop which, if left untreated, may lead to gangrene.

Raynaud’s episodes can be triggered by smoking and the ingestion of nicotine, extreme emotions such as fear, anger and excitement, or most commonly by exposure to cold temperatures.  We have learned, however, that the episodes are almost always reversible, meaning when the trigger is removed, the symptoms subside and the episode ends quickly. So, while medications can be prescribed in the most extreme cases to relax the blood vessels and minimize symptoms, the optimal form of treatment is simply preventing the symptoms from occurring.

If you are diagnosed with Raynaud’s or are experiencing its symptoms, you must stop smoking immediately and you should work to manage your emotions to prevent extremes.  But the simplest and most effective strategy during these winter months is to avoid the effects of reduced temperatures:

Dress warmly.  Pay special attention to protecting your hands, feet and ears from the cold, and layer your clothing for an insulating affect.

Wear mittens instead of gloves. Mittens are superior to gloves because they allow your fingers to generate contact warmth.  Mittens designed for outdoor sports may even contain heating elements that are helpful for certain Raynaud’s patients.  Also keep a supply of hand and foot warmers (found in sporting goods stores or departments) in your home and car.

Limit outdoor activities.  You are not expected to give up the winter activities you enjoy most – snow skiing for example – but it is best to limit their duration during cold months.

Guard your hands and feet indoors.  Even when you are inside, protect your hands by wearing mittens if removing things from a freezer or ice chest, and protect your feet by wearing socks and shoes or socks and house slippers at all times.

In addition to dressing warmly and limiting your time outdoors, avoid caffeine intake and smoking immediately before you go out since both will constrict blood vessels, contribute to more frequent episodes and worsen the symptoms during each episode.  If your hands or feet do become chilled, return to a warm environment immediately and soak them in warm – not hot – water for several minutes.

Taking these measures to protect yourself from extremely cold temperatures during winter months should diminish the number of Raynaud’s episodes you experience, but also remember to avoid long periods of sitting or standing which constrict your blood vessels further.  Engaging in low-impact exercise such as walking, swimming or bicycling each day will help optimize your blood flow and promote circulation as will rotating your ankles and feet whenever possible.  Finally, Raynaud’s sufferers should limit the use of any equipment that vibrates such as electric mixers or power tools, and should take few if any decongestants or amphetamines.

Most importantly, seek medical attention immediately if one or more of your fingers or toes remains pale or blue for an extended period. And if your episodes increase in frequency or length, speak to your physician about medications that are used in the treatment of Raynaud’s in certain patients.

To learn more about how to manage the symptoms of Raynaud’s in cold weather, log on to vascularhealthclinics.org.