Raynaud's phenomenon is a common condition in which the blood vessels in the extremities overreact to cold or stress. As the days get colder, how can Raynaud's sufferers manage their condition?
Winter is coming, and that means wrapping up warm. By the time Bonfire Night comes around, many of us have already invested in a woolly hat and scarf and brought our winter coat out of retirement.
However, some people have a harder time with the cold than others. If you've ever wondered why your hands change colour in response to cold temperatures - accompanied by tingling, pain or numbness - you could be one of the 10 million Brits who are affected by Raynaud's phenomenon.
Raynaud's phenomenon (also called Raynaud's disease, Raynaud syndrome or simply Raynaud's) is a condition in which the blood vessels in the extremities overreact to cold temperatures. While anyone can be affected, it's more common in women than men, and typically begins between the ages of 15 and 30 years.
"With Raynaud's, your blood vessels go into a temporary spasm, blocking the flow of blood," explains Dr Adam Abbs, a GP at Medicspot. "You can usually identify Raynaud's by a change of colour in your fingers, and less commonly, your toes. For some people, this may also affect the ears, nose, lips or nipples."
In the first stage of a Raynaud’s attack, the skin turns white or yellow in response to the limited blood supply. After a while, the blood vessels reopen and the fingers turn purplish blue.
"The blood that returns has the oxygen removed from it immediately, so you see the colour of deoxygenated blood, which is blue," explains Abbs. "After a minute or two, normal, oxygenated blood can fill the fingers again, so the colour returns to normal. These changes in oxygenation can cause pain or pins and needles."
Managing the symptoms
Not all Raynaud's sufferers cycle through this spectrum of colour changes, and attacks can vary greatly in severity. However, the symptoms are certainly uncomfortable, and can increase your aversion to cold weather.
In some cases, the symptoms are triggered less by the cold per se and more by a sudden drop in temperature - as someone with Raynaud's myself, I have complicated feelings about the supermarket freezer aisle. Or you might notice that stress and anxiety tend to exacerbate your symptoms.
"Stress often makes Raynaud's worse, so you should try to keep your stress levels to a minimum. You may want to consider taking up yoga or other exercises to help you relax. This will also help with your circulation," says Abbs. "Other risk factors for Raynaud's include smoking, exercises requiring gripping - such as cycling - and using vibrating tools."
Dr Fatima Sulaiman, head of research and services at Scleroderma and Raynaud's UK (SRUK), adds that while there is currently no cure for Raynaud's, the condition can be managed with practical interventions and does not usually affect someone's quality of life.
"Practical tips include making sure that you wear thick gloves and many thin layers in cold weather," she says. "Additionally, taking up stress relief practice such as mindfulness has been shown to help manage the stressful conditions that can make the symptoms worse. If you are a smoker, SRUK also highly recommend that you seek help in quitting smoking through your GP or the NHS website."
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SRUK offers a guide, 'Handy hints on keeping warm', which offers some more tips on how to manage symptoms. This could be particularly useful for breastfeeding mothers, who may experience difficulties (think painful, bloodless nipples) if their Raynaud's is undiagnosed.
When to see the GP
While in most cases, Raynaud's is little more than an annoyance, for some people it can spell something more serious. Around 300,000 people in the UK are affected by secondary Raynaud's, which can be related to an underlying condition or induced by certain medications.
"There are two different types of Raynaud's: primary and secondary," says Abbs. "Primary Raynaud's is usually mild and manageable; it is not associated with any other conditions. Secondary Raynaud’s is usually caused by autoimmune conditions like scleroderma or lupus. If you are worried about your symptoms, have noticed a change in your symptoms, or have Raynaud's with any other symptoms, you should book an appointment with your GP."
Sulaiman adds that people with secondary Raynaud's will experience more severe bouts of symptoms, and you should discuss possible treatments with your GP.
"They may also develop finger/toe ulcers or open wounds on their fingertips, and are more likely to have Raynaud's symptoms throughout the year, rather than just during the cold weather," she says. "There are prescription treatments that are available for people with severe or secondary Raynaud's, such as nifedipine."
In most cases, though, managing your Raynaud's is simply a matter of staying cosy, heating up your home, and investing in some thick socks. The winter months may never be your favourite time of year, but simply being mindful of your triggers can be enough to keep symptoms at bay.