Raynaud’s phenomenon is an exaggerated narrowing of small blood vessels in the fingers and toes, triggered by cold temperatures or emotional stress. Blood flow drops suddenly, causing colour changes and numbness that resolve once the area warms up.

• Primary Raynaud’s occurs on its own, is usually mild, and is not caused by any other disease — it is common, especially in young women, and often runs in families.
• Secondary Raynaud’s occurs alongside an underlying autoimmune or connective tissue disease — most often scleroderma, but also lupus, Sjögren’s syndrome or rheumatoid arthritis — and tends to be more severe.
• Because secondary Raynaud’s can be the very first sign of a systemic autoimmune disease, sometimes appearing years before other symptoms, it is best evaluated by a rheumatologist rather than assumed to be harmless.
• The classic colour sequence is white (blood flow stops) → blue (oxygen is used up) → red (blood flow returns) — though not everyone experiences all three colours every time.

• Fingers or toes turning white, then blue, then red on exposure to cold or emotional stress
• Numbness, tingling or a cold sensation in the affected fingers or toes during an episode
• Throbbing or aching pain as blood flow returns and colour normalises
• In more severe or secondary Raynaud’s: painful sores or ulcers at the fingertips
• Associated symptoms that suggest an underlying disease: skin thickening, joint pain, dry eyes/mouth, or unexplained fatigue

• In primary Raynaud’s, small blood vessels in the fingers and toes are simply more reactive to cold or stress than normal — the exact cause is not fully understood, though it often runs in families.
• In secondary Raynaud’s, an underlying autoimmune or connective tissue disease damages or inflames small blood vessels, making them narrow excessively — scleroderma is the condition most strongly linked to severe Raynaud’s.
• Certain medications, smoking, and repetitive vibration exposure (such as with power tools) can also trigger or worsen Raynaud’s.
• Cold weather and sudden temperature changes, as well as emotional stress, are the most common everyday triggers.

• A detailed history of the colour-change pattern, triggers, and any other symptoms suggesting an underlying autoimmune disease.
• Nailfold capillaroscopy — a simple, painless examination of the tiny blood vessels at the base of the fingernails under magnification — helps distinguish primary from secondary Raynaud’s.
• Blood tests, particularly ANA (antinuclear antibody) and disease-specific autoantibodies, to screen for an underlying connective tissue disease.
• A careful examination for early signs of scleroderma, lupus or Sjögren’s syndrome, since these often first appear as Raynaud’s.

Protective lifestyle measures

Keeping the whole body warm (not just the hands), avoiding sudden cold exposure, dressing in layers, and stopping smoking are the foundation of treatment for most patients with mild, primary Raynaud’s.

Medication for frequent or severe episodes

For patients with frequent, painful or ulcer-prone episodes — especially secondary Raynaud’s — vasodilator medications (such as calcium channel blockers) are commonly used to widen blood vessels and reduce attack frequency and severity.

Treating the underlying disease

If Raynaud’s is secondary to an autoimmune condition like scleroderma or lupus, treating that underlying disease is central to managing the Raynaud’s itself and preventing complications like finger ulcers.

Consultations with the OARC rheumatology team run Monday to Saturday, 9:00 AM–2:00 PM and 4:30–9:00 PM. Call +91 93386 53086 or book online.

• Primary Raynaud’s is generally mild and manageable with simple lifestyle measures, and does not shorten life or damage tissue.
• Secondary Raynaud’s needs ongoing rheumatology monitoring, since it points to an underlying disease that may need its own specific treatment.
• With the right combination of lifestyle measures, medication where needed, and treatment of any underlying condition, most patients manage their symptoms well and avoid complications like finger ulcers.