Doctors don't completely understand the cause of Raynaud's attacks, but blood vessels in the hands and feet appear to overreact to cold temperatures or stress:

  • Cold temperatures. When your body is exposed to cold temperatures, your extremities lose heat. Your body slows down blood supply to your fingers and toes to preserve your body's core temperature. Your body specifically reduces blood flow by narrowing the small arteries under the skin of your extremities. In people with Raynaud's, this normal response is exaggerated.
  • Stress. Stress causes a similar reaction to cold in the body, and likewise the body's response may be exaggerated in people with Raynaud's.

Blood vessels in spasm

With Raynaud's, arteries to your fingers and toes go into vasospasm. Vasospasm narrows your vessels dramatically and temporarily limits blood supply. Over time, these same small arteries may thicken slightly, further limiting blood flow. The result is that affected skin turns a pale and dusky color due to the lack of blood flow to the area. Once the spasms go away and blood returns to the area, the tissue may turn red before returning to the normal color.

Cold temperatures are most likely to trigger an attack. Exposure to cold can be as simple as putting your hands under a faucet of running cold water, taking something out of the freezer or exposure to cold air. For some people, exposure to cold temperatures isn't necessary. Emotional stress alone can cause an episode of Raynaud's.

Raynaud's may be partly an inherited disorder.

Primary vs. secondary Raynaud's

Raynaud's occurs in two main types:

  • Primary Raynaud's. This is Raynaud's without an underlying disease or associated medical problem that could provoke vasospasm. Also called Raynaud's disease, it's the most common form of the disorder.
  • Secondary Raynaud's. Also called Raynaud's phenomenon, this form is caused by an underlying problem. Although secondary Raynaud's is less common than the primary form, it tends to be a more serious disorder. Signs and symptoms of secondary Raynaud's usually first appear at later ages — around 40 — than they do for people with the primary form of Raynaud's.

Causes of secondary Raynaud's include:

  • Scleroderma. Raynaud's phenomenon occurs in the majority of people who have scleroderma — a rare disease that leads to hardening and scarring of the skin.
  • Lupus. Raynaud's is also a common problem for people with lupus erythematosus — an autoimmune disease that can affect many parts of your body, including your skin, joints, organs and blood vessels.
  • Rheumatoid arthritis. Raynaud's may be an initial sign of rheumatoid arthritis — an inflammatory condition causing pain and stiffness in the joints, often including the hands and feet.
  • Sjogren's syndrome. Raynaud's phenomenon can also occur in people who have Sjogren's syndrome — an autoimmune disorder that may accompany scleroderma, lupus or rheumatoid arthritis.
  • Diseases of the arteries. Raynaud's phenomenon can be associated with various diseases that affect arteries, such as atherosclerosis, which is the gradual buildup of plaques in blood vessels that feed the heart (coronary arteries), or Buerger's disease, a disorder in which the blood vessels of the hands and feet become inflamed. Primary pulmonary hypertension, a type of high blood pressure that affects the arteries of the lungs, can be linked to Raynaud's.
  • Carpal tunnel syndrome. The carpal tunnel is a narrow passageway in your wrist that protects a major nerve to your hand. Carpal tunnel syndrome is a condition in which pressure is put on this nerve, producing numbness and pain in the affected hand. The affected hand may become more susceptible to cold temperatures and episodes of Raynaud's.
  • Injury due to overuse. Raynaud's can also be caused by repetitive injuries that damage nerves serving blood vessels in the hands and feet. Some people who type or play the piano vigorously or for long periods of time may be susceptible to Raynaud's. Workers who operate vibrating tools can develop a type of Raynaud's phenomenon called vibration white finger.
  • Smoking. Smoking constricts blood vessels and is a potential cause of Raynaud's.
  • Injuries. Prior injuries to the hands or feet, such as wrist fracture, surgery or frostbite, can lead to Raynaud's phenomenon.
  • Certain medications. Some drugs — including beta blockers, which are used to treat high blood pressure; migraine medications that contain ergotamine; medications containing estrogen; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter (OTC) cold medications — have been linked to Raynaud's.
  • Chemical exposure. People exposed to vinyl chloride, such as those who work in the plastics industry, may develop an illness similar to scleroderma. Raynaud's can be a part of that illness.
  • Other causes. Raynaud's has also been linked to thyroid gland disorders.
Oct. 20, 2011

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