Materiały źródłowe

• #1 Raynaud’s Phenomenon: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/raynauds-phenomenon/diagnosis-treatment-and-steps-to-take

  The goals of treatment for Raynauds phenomenon are to: […] For most people with Raynauds phenomenon, avoiding getting cold prevents attacks and keeps symptoms under control. But if this is not enough, medications and, in some cases, surgical procedures can help. […] Secondary Raynauds phenomenon is more likely to be serious and to need more aggressive therapy, such as prescription medications. […] While there are no medications approved by the U.S. Food and Drug Administration for Raynauds phenomenon, medications that have been approved for other conditions are routinely used to treat it. […] If you have severe Raynauds phenomenon, your doctor may recommend a procedure called a sympathectomy to destroy the nerves that trigger blood vessel narrowing in the affected areas. […] In serious cases, repeated attacks can lead to skin sores or gangrene (death and decay of tissue).

• #1 Raynaud’s disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/raynauds-disease/diagnosis-treatment/drc-20363572

  Dressing for the cold in layers and wearing gloves or heavy socks usually can help mild symptoms of Raynaud’s. Medicines can treat more-serious symptoms. The goals of Raynaud’s treatment are to: […] Depending on the cause of symptoms, medicines might help. Medicines used to treat people with Raynaud’s disease may include: […] Surgery or shots might be needed to treat serious Raynaud’s. […] Nerves in the hands and feet control opening and narrowing of blood vessels in skin. Cutting these nerves stops those responses. […] Certain practices and supplements that help blood flow better might help manage Raynaud’s. However, alternative medicine practices need more study to know how much they can help Raynaud’s. […] Talk to your healthcare professional if you’re thinking of trying alternative treatments. Your health professional can warn you if there are possible side effects.

• #1 Raynaud’s Phenomenon: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/raynauds-phenomenon/diagnosis-treatment-and-steps-to-take

  Raynauds phenomenon is primarily treated by: […] Other specialists who may be involved in your care include: […] In most people, Raynauds phenomenon can be controlled by making lifestyle changes. […] Regular exercise and a healthy diet can help you deal with stress and improve blood flow. […] Remember to visit your health care providers regularly and to follow their recommendations.

• #1 Living with Raynaud’s? 6 tips for managing pain and flare-ups | UCLA Health

  https://www.uclahealth.org/news/article/living-with-raynauds-6-tips-managing-pain-and-flare-ups

  There is no cure for Raynauds disease. But taking specific steps and following your physicians guidance can reduce the episodes you experience. […] If you are living with Raynauds syndrome, you should: […] Exposure to cold is a surefire way to ignite an episode of Raynauds. But its not just about keeping your fingers and toes warm Raynauds attacks occur when your bodys core is cold, too. […] Learning how to manage your stress and anxiety can help limit episodes. […] Exercise offers a double benefit for people living with Raynauds. It improves blood flow and circulation. […] Quitting smoking improves circulation and lays the foundation for healthier blood vessels. […] Like nicotine, caffeine can cause blood vessels to narrow and trigger a Raynauds flare-up. […] Only 10% of people with Raynauds seek treatment. But working with your PCP can be essential to controlling flare-ups. Your physician can identify secondary Raynauds and treat the underlying condition.

• #1 Raynaud’s Phenomenon: Causes, Signs, and Treatment

  https://www.verywellhealth.com/raynauds-phenomenon-8643512

  Reducing stress and anxiety […] When you experience an attack, treat it immediately. To shorten the duration of the attack, find a way to warm the affected areas as quickly as possible. […] To warm fingers experiencing an attack, place them under warm water or under the armpits. You can also use a heating pad for your hands or feet. […] Treatments for Raynauds include avoiding triggers, treating the underlying condition, and medications. Lifestyle changes such as avoiding the cold and reducing stress can help minimize the number, frequency, and severity of attacks.

• #1 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Therapy for secondary Raynaud phenomenon must be tailored to the underlying disorder. If the disorder is associated with occupational or toxic exposure, the patient should avoid the inciting environment. […] Patients with secondary Raynaud phenomenon should also use lifestyle measures. However, these patients are more likely to require pharmacologic therapy than are patients with primary Raynaud phenomenon. […] Pharmacologic options for secondary Raynaud phenomenon include calcium channel blockers and prostacyclin analogues. Other agents may be considered; however, in a meta-analysis of interventions for secondary Raynaud phenomenon by Huisstede et al, solid evidence for therapies beyond calcium channel blockers and the prostacyclin analogue iloprost was lacking. […] Calcium channel blockers are the class of drugs most widely used for treatment of Raynaud syndromespecially the dihydropyridines (eg, nifedipine, nicardipine), which are the most potent vasodilators.

• #1 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  Calcium channel blockers remain the most widely used class of drugs in the management of RP. The dihydropyridine calcium channel blockers are most effective; nifedipine has been the most extensively studied. In a meta-analysis in primary RP, calcium channel blockers reduced frequency of attacks by 2.8 to 5 fewer attacks per week and severity by 33%. In another meta-analysis in RP secondary to systemic sclerosis, calcium channel blockers reduced RP attack frequency by 8.3 attacks over 2 weeks and severity by 35%. […] Nitroglycerin ointments, sublingual tablets, and transdermal patches have also been used in the therapy of RP, demonstrating improvements in finger temperature and perfusion, but with a high incidence of side effects including headache and dizziness. Topical nitroglycerin reduces the severity and frequency of vasospastic episodes in primary and secondary RP.

• #1 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Nifedipine is the customary first choice. The usual dosage is 30-120 mg of the extended-release formulation taken once daily. Start with the lowest dose and titrate up as tolerated. If adverse effects occur, decrease the dosage or use another agent, such as nicardipine, or a non-dihydropyridine calcium channel blocker such as such as diltiazem. […] Topical calcium channel blockers promote healing of digital ulcers in these patients. […] Other medications that have been studied in Raynaud phenomenon include the following: Topical nitroglycerin (1% or 2%), Iloprost (prostaglandin analog), Selective serotonin reuptake inhibitors (SSRIs), Phosphodiesterase-5 enzyme inhibitors (sildenafil, tadalafil, vardenafil), Losartan, Bosentan (endothelin receptor antagonist) Orphan drug for treating new digital ulcers in patients with systemic sclerosis, Botulinum toxin injection, N-acetylcysteine In patients with systemic sclerosis and digital ulcers.

• #1 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  The use of bosentan in the treatment of digital ulcers in 26 patients with systemic sclerosis unresponsive to CCB, ARBs, and sildenafil has also been described. Bosentan 62.5 mg twice daily for the first month, then 125 mg twice daily for an additional 35 weeks was administered. Healing of ulcers was reported in 65% of patients after a median of 25 weeks. […] Nitric oxide vasodilates and inhibits platelet activation by generating cyclic guanosine 5-monophosphate. cGMP is hydrolyzed by phosphodiesterases, particularly the cGMP-specific phosphodiesterase-5 isoenzyme. Sildenafil, tadalafil, and vardenafil are selective inhibitors of cGMP-specific phosphodiesterase type 5 which increases cGMP, resulting in enhanced cGMP-dependent microvascular and macrovascular dilation. The use of PDE5 inhibitors is being explored in patients with RP because of their potential effects on the microvascular and macrovascular circulation.

• #1 Prescribed drug treatments | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/prescribed-treatments/

  These help relax blood vessels. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance in your body that narrows your blood vessels and releases hormones that can restrict blood vessels. […] Some people find relief with drugs called alpha blockers, which counteract the actions of norepinephrine, a hormone that constricts blood vessels. Examples include prazosin (Minipress) and doxazosin (Cardura).

• #1 Raynaud’s disease: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/176713

  There is no cure for Raynauds disease, but there are ways to manage symptoms. […] For mild forms of Raynauds disease, covering exposed skin before leaving the house can help. If an attack occurs, soaking the affected parts in warm, not hot water can ease symptoms and prevent them from worsening. […] For moderate to severe cases, medication may be necessary. These may include: Alpha-1 blockers: These can counter the effect of norepinephrine, which constricts blood vessels. Examples include doxazosin and prazosin. […] Dihydropyridine calcium channel blockers: These relax the smaller blood vessels of the hands and feet. Examples include amlodipine, nifedipine, and felodipine. […] Topical nitroglycerin ointment: Applying creams near the affected area may relieve symptoms. […] Other vasodilators: These dilate the veins, easing symptoms. Examples include losartan, sildenafil (Viagra), fluoxetine (Prozac), and prostaglandin.

• #1 Raynaud’s phenomenon | Causes, symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/raynauds-phenomenon/

  A drug called fluoxetine can help improve circulation. Fluoxetine can also be used to treat depression. This is an entirely different use and if youve been prescribed it for Raynauds, it doesnt mean your doctor thinks youre depressed. […] In severe cases almost always in cases of secondary Raynauds some treatments may be given as a drip directly into a vein, otherwise known as an intravenous injection. These intravenous drugs act directly on the blood vessels and cause them to open up. The most commonly used intravenous drug for this condition is iloprost. […] Another family of drugs used to treat severe Raynauds are the phosphodiesterase inhibitors (foss-fo-dye-ess-tur-aze in-hib-e-turs), which include sildenafil trade name Viagra. These are drugs that can treat a number of conditions, including high blood pressure in the blood vessels supplying the lungs and erectile dysfunction. They can help with Raynauds because they improve blood flow around the body.

• #1 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  For patients with an insufficient response to traditional vasodilators, prostaglandin analogs are sometimes given. Most of the literature involves the investigational use of iloprost, a stable analog of epoprostenol (prostaglandin I2), which has demonstrated variable activity in RP associated with systemic sclerosis. Iloprost is a potent vasodilator and inhibitor of platelet aggregation. […] More recently studies have assessed the use of oral endothelin receptor antagonists as an alternative to prostaglandins in patients with severe RP not responding to other therapies. Endothelin-A (ETA) receptors are found primarily in vascular smooth muscle cells and mediate vasoconstriction and cell proliferation. Endothelin-B (ETB) receptors are found primarily on endothelial cells and mediate vasodilatation via nitric oxide. Bosentan acts as an antagonist primarily at ETA receptors, reducing vasoconstriction mediated by endogenous endothelin.

• #1 Raynaud’s Syndrome: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/9849-raynauds-phenomenon

  Treatment depends on the severity of your condition and whether you have the primary or secondary form. Treatment goals include: […] For many people, lifestyle changes are enough to manage their condition. These include: […] However, if you have severe symptoms, you may need medication. Your provider may prescribe one or more of the following medications: […] If you have severe Raynauds and other treatment methods dont work, your provider may recommend a procedure called a sympathectomy. A sympathectomy temporarily blocks or cuts tiny nerves near your affected blood vessels. This prevents the nerves from sending signals that make your blood vessels get too narrow. The procedure should relieve your symptoms for one or two years, but you may need it again in the future. […] Call your provider if you: […] As with any condition, see your provider any time youre worried, frightened or have questions about how to care for yourself.

• #1 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Botulinum toxin injection, typically in the vicinity of the palmar digital neurovascular bundle, has been used in both primary and secondary Raynaud syndrome. […] Improvement in symptoms and healing of digital ulcers has been reported. […] Critical digital ischemia, which is more likely to occur in secondary Raynaud phenomenon, necessitates aggressive management. […] It is considered a medical emergency that requires hospitalization. […] Local infiltration of lidocaine or bupivacaine at the base of the involved digits decreases sympathomimetic input, reduces ischemic pain, and improves blood flow. […] In patients with rapidly advancing ischemia, anticoagulant therapy may be necessary. […] While treatment is proceeding, further workup for underlying conditions must be performed.

• #1 Warming Cold Hands: A New Treatment for Raynaud’s Syndrome

  https://blog.radiology.virginia.edu/new-treatment-for-raynauds-syndrome/

  UVA Health is one of the first hospitals in the country to offer a revolutionary treatment technique for severe Raynauds syndrome. […] Image-guided botox injections performed by radiologists can help fight against the symptoms of Raynauds disease for up to 6 months. […] For some time now, Botox injections have been performed as a treatment for severe Raynauds syndrome. […] Botox is actually a brand name of a toxin produced by the bacterium Clostridium botulinum. When injected into the hands or feet of patients with Raynauds disease, it acts to decrease the shrinkage of blood vessels which may help heal skin ulcers and lessen the painful symptoms associated with this disorder. […] Patients have found improvement in symptoms of Raynauds syndrome for up to 6 months after their Botox injections. This safe, relatively simple procedure is revolutionizing treatment for Raynauds disease. […] If you or a loved one is dealing with severe symptoms of known or suspected Raynauds Disease, ask you care provider about image-guided Botox injections performed by UVA Radiologists.

• #1 Prescribed drug treatments | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/prescribed-treatments/

  The below treatments help improve circulation and your Raynaud’s attacks should improve, or the length between attacks should improve. This sort of medication can also treat and help to prevent skin ulcers on your fingers and toes know as digital ulcers. […] These drugs relax and open small blood vessels in your hands and feet, decreasing the frequency and severity of attacks in most people with Raynaud’s. These drugs can also help heal digital ulcers. Examples include nifedipine (Afeditab CR, Procardia), amlodipine (Norvasc), felodipine (Plendil) and Diltiazem. […] Some doctors prescribe a drug that relaxes blood vessels (vasodilator), such as nitroglycerin cream applied to the base of your fingers to help heal skin ulcers. Some vasodilators commonly used to treat other conditions, including the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra, Revatio), the antidepressant medication fluoxetine (Prozac, Sarafem), and a class of medications called prostaglandins, may relieve the symptoms of Raynaud’s.

• #1 Natural therapies | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/raynauds-natural-therapies/

  There are many different treatments that could help with Raynaud’s. You may need to try using a combination of them, either together, or separately at different times of the year to find a regime that works for you. […] Many natural remedies are available over the counter, but it’s important to go over any treatment changes with your care provider, even when it comes to natural remedies. […] Gingko biloba is the best-researched natural remedy for Raynaud’s, and some people find that it produces a significant reduction in their Raynaud’s symptoms. […] Both vitamins C and E contain antioxidants, so could help to protect blood vessels. […] Many people find that GLA is very effective, however it may take up to eight weeks to see the full benefit. […] Ginger, hawthorn, cayenne, magnesium, horse chestnut, dong quai, and prickly ash are also often used for treatment of circulation problems and some people report benefits in Raynaud’s Phenomenon.

• #1 Natural therapies | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/raynauds-natural-therapies/

  All the above treatments should be avoided if you are taking warfarin or other blood-thinning treatments, and all should only be trialled in consultation with your primary care provider, particularly if you’re taking any other medications. […] Dietary changes to try to help Raynaud’s Phenomenon include increasing consumption of omega-3 oils and antioxidant vitamins (particularly C E).

• #1 Classical Conditioning Raynaud’s Therapy – Raynaud’s Association

  https://www.raynauds.org/2019/09/26/classical-conditioning-raynauds-therapy/

  Promising recent scientific research in classical conditioning therapy indicates that Raynauds patients may be able to train themselves to avoid the painful spasms that occur when theyre exposed to cold temperatures. […] Could Raynauds patients be conditioned so that when they encountered cold, their hand circulation opened up? […] The good news is that the answer is yes. He and many other researchers have found that improvements in circulation can be trained. […] If classical conditioning works, why doesnt it get more exposure? […] For people who cannot or do not want to take calcium channel blocking drugs, classical conditioning has shown excellent potential for helping people live well with Raynauds phenomenon.

• #1 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Patients with Raynaud phenomenon (RP) should avoid situations and stressors that aggravate the disease (eg, vibration, cold exposure, digital trauma). […] Patients should avoid medications and drugs that aggravate the disease (eg, smoking, cocaine, other medications listed above). […] Biofeedback was reported to enable a pediatric patient to raise her digit temperature by 12o C and to aid some adult patients. […] Trials of biofeedback have yielded mixed results with some reporting benefits and others not. […] Auricular electroacupuncture was reported to decrease the frequency and severity of attacks in primary Raynaud phenomenon patients in an uncontrolled study. […] Low-level laser irradiation has also been reported to significantly reduce the frequency and severity of attacks in primary Raynaud phenomenon and secondary Raynaud phenomenon compared with sham irradiation.

• #1 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  In patients with primary RP, nonpharmacologic lifestyle modifications remain the first-line therapy. Calcium channel blockers or topical nitrates may be considered for those without an adequate response to lifestyle modification. Other therapies have not been demonstrated to be effective in this population. In patients with secondary RP, lifestyle modifications should also be applied; however, pharmacologic management is more likely to be necessary. In addition to calcium channel blockers, there may be a role for topical nitrates, PDE5 inhibitors, endothelin antagonists, or prostaglandin derivatives.

• #1 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  For many patients with primary or secondary Raynaud phenomenon, nonpharmacologic interventions are all that are required to decrease the frequency of attacks and improve quality of life. The goal should not be to eliminate attacks completely, as aggressive drug treatment may cause more harm than benefit. From our perspective, the goals of treatment should be to improve quality of life and prevent ischemic complications. […] Pharmacologic therapies should be added only if attacks remain poorly controlled with incapacitating symptoms, or if the patient has digital ischemic ulcers. Calcium channel blockers are first-line therapy, given proven efficacy and low cost, and should be titrated to the maximum tolerated dose before adding or substituting other agents.

• #1 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  Raynaud phenomenon is an overactive vascular response to cold and emotional stress that results in cutaneous color changes and sensory symptoms in the digits. If nonpharmacologic interventions prove inadequate, then vasodilator agents are used. […] Nonpharmacologic interventions, ie, cold avoidance and stress management, are first-line for all patients. […] Calcium channel blockers are first-line drugs and should be titrated to the maximum tolerated dose before adding or switching to other agents. […] The goal of treatment should not be to eliminate Raynaud attacks completely but to improve quality of life and prevent ischemic complications. […] Cold avoidance and stress management are first-line therapies for preventing Raynaud attacks and must be part of any treatment strategy. […] For many patients, nonpharmacologic interventions are enough to decrease the severity and frequency of attacks. However, if Raynaud phenomenon continues to negatively affect quality of life, drug therapy can be added.

• #2 Raynaud’s Phenomenon: A Current Update on Pathogenesis, Diagnostic Workup, and Treatment

  https://www.vsijournal.org/journal/view.html?uid=1349&vmd=Full

  Raynaud’s phenomenon (RP) is a condition characterized by episodic, excessive vasoconstriction in the fingers and toes, triggered by cold or stress. […] Management of RP focuses on alleviating symptoms and preventing tissue damage. Vasodilator medications are the first-line treatment when general measures like warmth and stress management are not sufficient. Dihydropyridine calcium channel blockers (CCBs), such as nifedipine, are commonly used for vasodilation. […] Bosentan, an endothelin-1 receptor antagonist, has shown effectiveness in treating and preventing digital ulcers, especially in patients with multiple ulcers. For severe cases, botulinum toxin injections or sympathectomy surgery can be used to control RP symptoms. […] Fat grafting is a promising surgical therapy for promoting healing and preventing tissue injury.

• #2 Raynaud’s Syndrome: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/9849-raynauds-phenomenon

  Treatment depends on the severity of your condition and whether you have the primary or secondary form. Treatment goals include: […] For many people, lifestyle changes are enough to manage their condition. These include: […] However, if you have severe symptoms, you may need medication. Your provider may prescribe one or more of the following medications: […] If you have severe Raynauds and other treatment methods dont work, your provider may recommend a procedure called a sympathectomy. A sympathectomy temporarily blocks or cuts tiny nerves near your affected blood vessels. This prevents the nerves from sending signals that make your blood vessels get too narrow. The procedure should relieve your symptoms for one or two years, but you may need it again in the future. […] Call your provider if you: […] As with any condition, see your provider any time youre worried, frightened or have questions about how to care for yourself.

• #2 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  General measures for Raynaud phenomenon include education, warming of the affected body part, and cessation of vasoconstricting agents such as nicotine. A number of pharmacologic treatments have been studied, but none provide a cure and none has been approved for this indication in the United States. In an international study of patients with self-reported Raynaud phenomenon, 82% reported that at least one currently used medication was tolerated, but only 16% reported that at least one current medication was effective. […] For primary Raynaud phenomenon, the first line of therapy consists of lifestyle measures, such as avoidance of precipitating factors and use of gloves. […] If these prove inadequate, calcium channel blocker treatment may be considered; nifedipine is the usual choice. Topical nitroglycerin (1% or 2%) has been found to help if applied locally.

• #2 Treatment of Raynaud phenomenon: Initial management – UpToDate

  https://www.uptodate.com/contents/treatment-of-raynaud-phenomenon-initial-management

  Treatment of Raynaud phenomenon: Initial management […] Initial treatment includes patient education and general measures taken by the patient to prevent and treat attacks. In severe cases, treatment may include pharmacologic interventions and/or sympathetic blockade to prevent and treat digital ischemia. […] The goals of therapy are to improve quality of life and to prevent tissue loss (ie, ulceration, gangrene). At least a moderate reduction in the intensity of attacks and the prevention of tissue loss are achievable in most patients. However, abolishing cold sensitivity and eliminating all Raynaud events is not likely with available treatment options, particularly in patients with secondary Raynaud phenomenon (RP), due to the complexity and sensitivity of the regulation of thermoregulatory vessels in the skin. […] All patients should be educated about the potential causes of a Raynaud attack as well as the nonpharmacologic measures to help prevent and terminate an episode. These nonpharmacologic measures include avoidance of provoking factors such as cold temperature and vasoconstricting drugs, smoking cessation (when applicable), and other measures discussed further below.

• #2 Raynaud’s Disease & Syndrome: Symptoms, Causes, Treatment

  https://www.webmd.com/arthritis/raynauds-phenomenon

  Treatment goals include preventing Raynauds episodes or limiting them when they do happen. You can focus on keeping your hands and feet warm and dry, controlling stress, and getting regular exercise. […] Your doctor might ask you to avoid some drugs, including over-the-counter cold medicines that contain pseudoephedrine. They can make your symptoms worse by causing your blood vessels to narrow. […] If you have secondary Raynauds, your doctor might prescribe medicines to control your blood pressure and relax your blood vessels. If you get sores on your skin as a result, you might need to apply a cream that contains one of these drugs. These include: […] If your condition doesnt improve after these steps and youre at risk of severe problems, such as losing parts of your fingers or toes, your doctor might consider surgery. These procedures involve cutting the nerves to the blood vessels in your skin to limit how much they open and close. The doctor might also inject drugs into your hands or feet to block those nerves.

• #2 Raynaud’s Phenomenon: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/raynauds-phenomenon/diagnosis-treatment-and-steps-to-take

  Raynauds phenomenon is primarily treated by: […] Other specialists who may be involved in your care include: […] In most people, Raynauds phenomenon can be controlled by making lifestyle changes. […] Regular exercise and a healthy diet can help you deal with stress and improve blood flow. […] Remember to visit your health care providers regularly and to follow their recommendations.

• #2 Raynaud’s Phenomenon

  https://rheumatology.org/patients/raynauds-phenomenon

  Raynauds can be managed with both lifestyle modifications and medications. Patients can use mittens/gloves, thick socks, and insertable warmers to help keep their hands and feet warm. Stress reduction and smoking cessation are also recommended to help decrease Raynauds attacks. Medications such as calcium channel blockers (amlodipine, nifedipine, felodipine, and others) and angiotensin-receptor blockers increase blood flow to the fingers and toes. For patients with more severe symptoms or who have developed complications such as ulcers, other medications can be used including sildenafil or prostacyclins. […] Wear warm, protective clothing like socks, boots, mittens or gloves in the fall and winter. In the summer months, avoid keeping the temperature of the AC too low. Wear oven mitts or gloves when taking food out of the freezer or refrigerator. Exercise regularly as this can boost healthy circulation and try to decrease stressful triggers. If symptoms occur, rewarm your body, place hands under the armpits, wiggle fingers and toes, run fingers or toes under warm (not hot) water, or massage the hands and feet.

• #2 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  Raynaud phenomenon is an overactive vascular response to cold and emotional stress that results in cutaneous color changes and sensory symptoms in the digits. If nonpharmacologic interventions prove inadequate, then vasodilator agents are used. […] Nonpharmacologic interventions, ie, cold avoidance and stress management, are first-line for all patients. […] Calcium channel blockers are first-line drugs and should be titrated to the maximum tolerated dose before adding or switching to other agents. […] The goal of treatment should not be to eliminate Raynaud attacks completely but to improve quality of life and prevent ischemic complications. […] Cold avoidance and stress management are first-line therapies for preventing Raynaud attacks and must be part of any treatment strategy. […] For many patients, nonpharmacologic interventions are enough to decrease the severity and frequency of attacks. However, if Raynaud phenomenon continues to negatively affect quality of life, drug therapy can be added.

• #2 Prescribed drug treatments | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/prescribed-treatments/

  The below treatments help improve circulation and your Raynaud’s attacks should improve, or the length between attacks should improve. This sort of medication can also treat and help to prevent skin ulcers on your fingers and toes know as digital ulcers. […] These drugs relax and open small blood vessels in your hands and feet, decreasing the frequency and severity of attacks in most people with Raynaud’s. These drugs can also help heal digital ulcers. Examples include nifedipine (Afeditab CR, Procardia), amlodipine (Norvasc), felodipine (Plendil) and Diltiazem. […] Some doctors prescribe a drug that relaxes blood vessels (vasodilator), such as nitroglycerin cream applied to the base of your fingers to help heal skin ulcers. Some vasodilators commonly used to treat other conditions, including the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra, Revatio), the antidepressant medication fluoxetine (Prozac, Sarafem), and a class of medications called prostaglandins, may relieve the symptoms of Raynaud’s.

• #2 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  Calcium channel blockers are first-line agents for both primary and secondary Raynaud phenomenon that does not adequately respond to nonpharmacologic interventions. […] When calcium channel blockers do not adequately control symptoms, phosphodiesterase type 5 (PDE5) inhibitors can be added or substituted. […] Patients who have an unsatisfactory response to calcium channel blockers with or without PDE5 inhibitors can try topical nitrates, available as sustained-release transdermal patches, tapes, creams, gels, and ointments. […] Overall, we move to other options only in patients with persistent symptoms that impair quality of life, or in patients with recurrent digital ischemic lesions that have not responded to calcium channel blockers and PDE5 inhibitors or nitrates, either alone or in combination.

• #2 Raynaud’s phenomenon | Causes, symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/raynauds-phenomenon/

  There are several ways to help ease the symptoms of Raynauds phenomenon. Many of these are things you can do in your day-to-day life, but there are also a number of medications that may help. […] A number of drugs can be prescribed for Raynauds phenomenon. Most of these work by making the blood vessels wider. […] Examples include nifedipine and amlodipine. These are in groups of drugs known as calcium channel blockers. […] Unfortunately, theres no drug that will act only on the blood vessels in the fingers and toes, so these medications may also cause side effects such as skin flushing of the face, headaches or dizziness. This is because the drugs increase blood flow elsewhere. However, many people experience no side effects from the drugs and find them very useful. […] Losartan and ACE inhibitors are more commonly used to treat high blood pressure, but they can also help control symptoms of Raynauds. These drugs also relax blood vessels and stop them from narrowing.

• #2 Raynaud’s Disease Clinic – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/services/raynauds-disease-clinic

  The Raynaud’s Disease Clinic at Brigham and Women’s Hospital is one of only a few clinics in New England exclusively dedicated to the evaluation and treatment of patients with Raynaud’s disease (Raynaud’s phenomenon). […] Following a thorough evaluation, the physician team will develop a treatment plan based on the type and extent of the disease, the patients overall health, and the patient’s preferences. […] Although there is no cure for Raynauds, it normally can be well managed with appropriate treatment, such as: […] Prescribing alpha blockers, which suppress the sympathetic nervous system response that leads to vasoconstriction (blood vessel narrowing). […] Prescribing other medications that also improve blood flow to the fingers and toes by dilating (expanding) blood vessels, such as calcium channel blockers or phosphodiesterase inhibitors.

• #2 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  The role of serotonin in the pathophysiology and management of RP is not clearly established. Remission of RP symptoms has been described in a patient treated with fluoxetine; possibly as a result of depletion of platelet serotonin. […] N-Acetylcysteine has also demonstrated activity in patients with RP secondary to systemic sclerosis. The use of N-acetylcysteine in the treatment of RP has been described in an open-label pilot study enrolling 22 patients with RP secondary to systemic sclerosis. […] The observed effects of the statins on endothelial function prompted assessment of statins in the therapy of RP associated with systemic sclerosis. One randomized study enrolled 84 patients with RP secondary to systemic sclerosis despite ongoing vasodilator therapy. […] Decreased pain and numbness, decreased frequency of vasospastic attacks, healing of digital ulcers, and increased blood flow was observed in three case series and a case report assessing interdigital injections of botulinum toxin in patients with primary and secondary RP.

• #2 New Outpatient Raynaud Treatment Saves Fingers and Toes < Yale School of Medicine

  https://medicine.yale.edu/news-article/treating-threatened-digit-loss-due-to-raynaud-phenomenon/

  In a new outpatient treatment at Yale, epoprostenol infusions are safely given to patients whose fingers and toes are damaged by severe Raynaud phenomenon, also known as Raynauds phenomenon, to prevent amputation. […] But the medication epoprostenol, administered intravenously, can prevent or treat these ulcers and gangrene by relaxing blood vessels and improving circulation. […] The treatment is used as a last resort in patients who have autoimmune disease and acute circulatory problems, that have not responded to standard medical therapy, explains Vaidehi Chowdhary, MD, associate professor of medicine and clinical chief (rheumatology, allergy and immunology). […] Epoprostenol is now given by the Saint Raphael Hospital Outpatient Infusion Therapy (HOIT) team. […] Now that the outpatient treatment is in place, Yale researchers are assessing its effectiveness by administering a newly developed patient questionnaire specifically for Raynaud phenomenon and using a handheld digital camera to capture images of patients finger nailfold capillaries.

• #2 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  The use of bosentan in the treatment of digital ulcers in 26 patients with systemic sclerosis unresponsive to CCB, ARBs, and sildenafil has also been described. Bosentan 62.5 mg twice daily for the first month, then 125 mg twice daily for an additional 35 weeks was administered. Healing of ulcers was reported in 65% of patients after a median of 25 weeks. […] Nitric oxide vasodilates and inhibits platelet activation by generating cyclic guanosine 5-monophosphate. cGMP is hydrolyzed by phosphodiesterases, particularly the cGMP-specific phosphodiesterase-5 isoenzyme. Sildenafil, tadalafil, and vardenafil are selective inhibitors of cGMP-specific phosphodiesterase type 5 which increases cGMP, resulting in enhanced cGMP-dependent microvascular and macrovascular dilation. The use of PDE5 inhibitors is being explored in patients with RP because of their potential effects on the microvascular and macrovascular circulation.

• #2 Raynaud’s disease: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/176713

  In very severe cases, more invasive procedures, such as sympathectomy, are an option. […] A surgeon can perform a sympathectomy by making small incisions and stripping the nerves away from the blood vessels to decrease the frequency or severity of attacks. However, this is not always effective. […] Injecting certain chemicals that block sympathetic nerve fibers from carrying out vasoconstriction can be effective. […] Local anesthetics or Botox work well for some people. However, the effect will wear off, and repeat treatments are necessary. […] Treatments involve managing symptoms, medications, and, in some cases, surgery or chemical injections to control the nerves in the blood vessels.

• #2 Raynaud Phenomenon | Universitair Pijn Centrum Maastricht

  https://www.pijn.com/en/raynaud-phenomenon

  The primary form of Raynaud syndrome has a benign course and can generally be conservatively treated without medication. It should be enough to inform the patient and to advise him to avoid eliciting factors by dressing up warmly, stopping smoking, taking adequate exercise, and avoiding drugs with a vasoconstrictive effect. […] The treatment of the secondary form of Raynaud syndrome is primarily focussed on the underlying disease. […] Pharmacological treatment: Anti-inflammatories: Nifedipine (Ca+-antagonist) and prazosine (1-blokker). […] Analgesics: Gabapentin, ketamine IV are probably effective. […] Vasodilatators: Calcium influx blockers, ketanserine. […] Spasmolytics: Oral benzodiazepines or baclofen. […] Other Treatments: Physiotherapy […] Interventional Pain Treatment: Stellate ganglion test block (arm), Stellate ganglion RF treatment (arm), Lumbar sympathetic test block (leg), Lumbar sympathetic RF treatment (leg), Spinal cord test stimulation, Spinal cord stimulation.

• #2 Battling the Chill: How to Treat Raynaud’s Disease

  https://www.hackensackmeridianhealth.org/en/healthu/2025/03/26/battling-the-chill-how-to-treat-raynauds-disease

  Botox Injections Botox isnt just for cosmetic purposes. If you have a severe case of Raynauds, it can help block nerve reactions. You may need more than one round of injections before seeing improvements. […] Nerve Resection Surgery Nerve resection surgery can help stop nerve responses. This procedure is not always effective. Dr. Broder cautions you should only consider it as a last resort.

• #2 Raynaud’s Disease Clinic – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/services/raynauds-disease-clinic

  For patients who are at risk of losing their fingers, plastic surgeon Christian E. Sampson, MD, offers of a variety of surgical techniques. One such innovative technique is to remove the sheath of nerves surrounding the hands blood vessels, thereby eliminating the nerves responsible for triggering vasospasms.

• #2 Raynaud’s

  https://www.nhs.uk/conditions/raynauds/

  Raynaud’s is sometimes caused by another health condition, taking certain medicines, or working with vibrating tools for a long time. […] If you have Raynaud’s and your symptoms are very bad or getting worse, a GP may prescribe a medicine to help improve your circulation. For example, you may be offered nifedipine, which is used to treat high blood pressure. […] A GP may arrange tests if they think Raynaud’s could be a sign of a more serious condition, such as rheumatoid arthritis or lupus.

• #2 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  Raynauds phenomenon is a common condition characterized by vasospasm of the digital arteries and resulting cyanosis and redness. It often does not require pharmacologic management, but in some cases symptoms are severe and pharmacologic management is necessary. Calcium channel blockers are often used first-line, but in some patients are ineffective. Patients with severe symptoms or intolerance to available therapies have prompted exploration of alternative therapies, including endothelin antagonists, phosphodiesterase-5 inhibitors, antioxidants, newer vasodilators, statins, and botulinum toxin. These newer therapies provide the focus for this review. […] Nonpharmacologic therapies include avoidance of cold temperatures, emotional stress, caffeine, and smoking, as well as avoidance of vasoconstrictive medications. Pharmacologic therapy has historically included dihydropyridine calcium channel blockers, alpha1-adrenergic blockers, angiotensin II receptor antagonists, topical nitroglycerin, and pentoxifylline. Patients with primary RP only occasionally require pharmacologic therapy; while such therapy is more common in patients with secondary RP.

• #2 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Botulinum toxin injection, typically in the vicinity of the palmar digital neurovascular bundle, has been used in both primary and secondary Raynaud syndrome. […] Improvement in symptoms and healing of digital ulcers has been reported. […] Critical digital ischemia, which is more likely to occur in secondary Raynaud phenomenon, necessitates aggressive management. […] It is considered a medical emergency that requires hospitalization. […] Local infiltration of lidocaine or bupivacaine at the base of the involved digits decreases sympathomimetic input, reduces ischemic pain, and improves blood flow. […] In patients with rapidly advancing ischemia, anticoagulant therapy may be necessary. […] While treatment is proceeding, further workup for underlying conditions must be performed.

• #2 Managing Raynaud’s phenomenon – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/managing-raynauds-phenomenon

  Other peripheral vasodilators such as naftidrofuryl and inositol nicotinate are sometimes used but are of uncertain value. They may have application in those who are intolerant to calcium antagonists. Pentoxifylline, prazosin and moxisylyte are also licensed for use in Raynaud’s, but are not established as being effective. […] For patients with severe symptoms and who do not respond to other treatments, a sympathectomy — cutting the nerves that supply the affected part — may be performed. […] In the event of an acute ischaemic crisis (ie, where there is danger of the loss of tissue), the person should be directed to hospital immediately. Treatment includes vasodilation (eg, intravenous infusion of iloprost, oral nifedipine), pain relief (eg, lidocaine orbupivicaine), surgery and anticoagulation (eg, low-dose aspirin or short-term heparin if there is persistent critical ischaemia or occlusive disease of large arteries). Ischaemic crises are rare and most likely in patients with scleroderma.

• #2 Treatment for Raynaud’s Phenomenon | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/raynauds-phenomenon/treatment.html

  If you have Raynaud’s that is caused by another disease, your doctor can treat that disease. This may relieve your symptoms. […] There is no cure for Raynaud’s that occurs on its own (primary Raynaud’s). But you may be able to control it by avoiding the things that trigger it. […] If you can’t control your symptoms with these steps, your doctor may give you medicine such as calcium channel blockers. This may increase blood flow to your hands and feet and relieve symptoms. […] Some alternative treatments, such as herbal supplements and biofeedback training, have shown promise in treating Raynaud’s. But they haven’t been shown to work for everyone. Talk with your doctor if you’re interested in trying any of these.

• #2 Natural therapies | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/raynauds-natural-therapies/

  All the above treatments should be avoided if you are taking warfarin or other blood-thinning treatments, and all should only be trialled in consultation with your primary care provider, particularly if you’re taking any other medications. […] Dietary changes to try to help Raynaud’s Phenomenon include increasing consumption of omega-3 oils and antioxidant vitamins (particularly C E).

• #2 Raynaud’s Syndrome: Autoimmune, Causes, Symptoms, Treatment, & Test

  https://www.emedicinehealth.com/raynaud_phenomenon/article_em.htm

  Are There Alternative Medicine Treatments for Raynaud’s Syndrome? […] Many alternative care products and health supplements are sold for the treatment of Raynaud’s syndrome. Some alternative care practitioners recommend fish oil, gingko biloba, and biofeedback therapy. Unfortunately, there are no clinical studies to validate the claims made by the manufacturers of these therapies. It is best to speak to your doctor before you start with any of these therapies. […] When Is Surgery Appropriate for Raynaud’s Syndrome? […] Surgery is rarely offered as a treatment for Raynaud’s syndrome. When symptoms cannot be managed and medications are inadequate or have too many side effects, surgical sympathectomy may be offered. This is a rare procedure and is almost never done, since the sympathetic discharge is already at its maximum. Surgical sympathectomy was done in the past with almost no benefit. If the tip of the toe or fingertip is necrotic or gangrenous, debridement (cleaning dead tissue) or amputation may be required, but this is not common.

• #2 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Patients with Raynaud phenomenon (RP) should avoid situations and stressors that aggravate the disease (eg, vibration, cold exposure, digital trauma). […] Patients should avoid medications and drugs that aggravate the disease (eg, smoking, cocaine, other medications listed above). […] Biofeedback was reported to enable a pediatric patient to raise her digit temperature by 12o C and to aid some adult patients. […] Trials of biofeedback have yielded mixed results with some reporting benefits and others not. […] Auricular electroacupuncture was reported to decrease the frequency and severity of attacks in primary Raynaud phenomenon patients in an uncontrolled study. […] Low-level laser irradiation has also been reported to significantly reduce the frequency and severity of attacks in primary Raynaud phenomenon and secondary Raynaud phenomenon compared with sham irradiation.

• #2 Raynaud’s Phenomenon: Symptoms, Causes, And Treatment – Foot & Ankle Center of Arizona

  https://arizonafoot.com/raynauds-phenomenon/

  The cornerstone of managing Raynauds is preventing and protecting against episodes. This includes dressing warmly, avoiding rapid temperature changes, and steering clear of stressors when possible. Simple strategies like wearing gloves or avoiding air conditioning can go a long way in minimizing occurrences. […] For those whose lives are significantly impacted by Raynauds, there are medical interventions. Certain medications can dilate blood vessels and improve circulation, while severe cases may call for surgical options to sever nerves controlling the constriction of blood vessels. […] Individuals with an aversion to medication or surgery often seek natural remedies. Practices like stress-relief therapies (think meditation or biofeedback) or adopting an anti-inflammatory diet might offer relief. Supplements are also explored, although they should be approached with caution and under medical supervision. […] Management focuses on prevention and protection, with lifestyle changes at the forefront of treatment. […] Medicinal and surgical options exist for severe cases, although natural remedies are also worth exploring.

• #2 The pathogenesis, diagnosis and treatment of Raynaud phenomenon | Nature Reviews Rheumatology

  https://www.nature.com/articles/nrrheum.2012.96

  The past 10 years have seen the publication of results from several multicentre clinical trials in primary and systemic sclerosis (SSc)-related Raynaud phenomenon. […] The ultimate aim is to translate the advances made in the pathophysiology and early diagnosis into development of treatments to prevent and reverse digital vascular dysfunction and injury. […] Current and future treatment approaches are discussed, and some key unanswered questions are highlighted. […] New treatment approaches for Raynaud phenomenon include phosphodiesterase inhibitors and, for patients with SSc and recurrent digital ulcers, endothelin-1 receptor antagonists.

• #2 Raynaud’s Syndrome | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/raynauds-syndrome/

  In cases of severe symptoms, vasodilating drugs might be recommended. Surgical interventions including botulinum toxin may also be indicated in some circumstances. In cases that do not respond to other treatments, injections or digital sympathectomy may be recommended. Utilizing the Raynaud Condition Score (RCS) as a tool for evaluating treatment response is essential for providing personalized care.

• #2 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  For many patients with primary or secondary Raynaud phenomenon, nonpharmacologic interventions are all that are required to decrease the frequency of attacks and improve quality of life. The goal should not be to eliminate attacks completely, as aggressive drug treatment may cause more harm than benefit. From our perspective, the goals of treatment should be to improve quality of life and prevent ischemic complications. […] Pharmacologic therapies should be added only if attacks remain poorly controlled with incapacitating symptoms, or if the patient has digital ischemic ulcers. Calcium channel blockers are first-line therapy, given proven efficacy and low cost, and should be titrated to the maximum tolerated dose before adding or substituting other agents.

• #2 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  In patients with primary RP, nonpharmacologic lifestyle modifications remain the first-line therapy. Calcium channel blockers or topical nitrates may be considered for those without an adequate response to lifestyle modification. Other therapies have not been demonstrated to be effective in this population. In patients with secondary RP, lifestyle modifications should also be applied; however, pharmacologic management is more likely to be necessary. In addition to calcium channel blockers, there may be a role for topical nitrates, PDE5 inhibitors, endothelin antagonists, or prostaglandin derivatives.

• #2

• #3 Treatment of Raynaud phenomenon: Initial management – UpToDate

  https://www.uptodate.com/contents/treatment-of-raynaud-phenomenon-initial-management

  Treatment of Raynaud phenomenon: Initial management […] Initial treatment includes patient education and general measures taken by the patient to prevent and treat attacks. In severe cases, treatment may include pharmacologic interventions and/or sympathetic blockade to prevent and treat digital ischemia. […] The goals of therapy are to improve quality of life and to prevent tissue loss (ie, ulceration, gangrene). At least a moderate reduction in the intensity of attacks and the prevention of tissue loss are achievable in most patients. However, abolishing cold sensitivity and eliminating all Raynaud events is not likely with available treatment options, particularly in patients with secondary Raynaud phenomenon (RP), due to the complexity and sensitivity of the regulation of thermoregulatory vessels in the skin. […] All patients should be educated about the potential causes of a Raynaud attack as well as the nonpharmacologic measures to help prevent and terminate an episode. These nonpharmacologic measures include avoidance of provoking factors such as cold temperature and vasoconstricting drugs, smoking cessation (when applicable), and other measures discussed further below.

• #3 Raynaud’s Disease (Causes, Symptoms and Treatment)

  https://patient.info/doctor/raynauds-phenomenon-pro

  Management of primary Raynaud’s disease […] Smoking cessation – this is the most important self-help measure. […] Avoid exposure to cold and take precautionary measures before exposure to cold; use gloves or electrically heated mittens in the winter (available from patient support groups via specialist outfitters – see 'Further reading references’ section, below). […] Topical agents […] Evidence on topical nitrates is limited but studies have shown that topical glyceryl trinitrate applied to the dorsum of the finger results in digital vasodilatation with fewer systemic side-effects than with oral nitrates. […] Nitroglycerin applied to the affected finger reduces the severity of Raynaud’s phenomenon but not the duration or frequency of attacks. […] Systemic agents […] Calcium-channel blockers: these are most widely used in the treatment of Raynaud’s phenomenon. Nifedipine promotes relaxation of vascular smooth muscle cells and leads to vasodilatation.

• #3 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Patients with Raynaud phenomenon (RP) should avoid situations and stressors that aggravate the disease (eg, vibration, cold exposure, digital trauma). […] Patients should avoid medications and drugs that aggravate the disease (eg, smoking, cocaine, other medications listed above). […] Biofeedback was reported to enable a pediatric patient to raise her digit temperature by 12o C and to aid some adult patients. […] Trials of biofeedback have yielded mixed results with some reporting benefits and others not. […] Auricular electroacupuncture was reported to decrease the frequency and severity of attacks in primary Raynaud phenomenon patients in an uncontrolled study. […] Low-level laser irradiation has also been reported to significantly reduce the frequency and severity of attacks in primary Raynaud phenomenon and secondary Raynaud phenomenon compared with sham irradiation.

• #3 Raynaud’s Phenomenon | UW Orthopaedic Surgery and Sports Medicine

  https://orthop.washington.edu/patient-care/articles/arthritis/raynauds-phenomenon.html

  Most people with primary Raynaud’s phenomenon don’t require medical treatment although many choose to take medication during the winter months. […] The goal of treatment of Raynaud’s phenomenon is to prevent episodes and in secondary Raynaud’s phenomenon to prevent tissue damage. […] In some cases a doctor may prescribe medication. […] Exercise may have some benefit to people with Raynaud’s phenomenon. A doctor may be able to advise if an aerobic exercise program would be helpful. […] No drugs are specifically approved by them U.S. Food and Drug Administration for treatment of Raynaud’s. However, many drugs used to treat high blood pressure or angina pectoris have been shown effective and safe in treating Raynaud’s phenomenon. These include calcium channel blockers such as nifedipine, amlodipine, isradipine, and others. […] In rare cases a doctor may recommend sympathectomy to treat Raynaud’s phenomenon. This operation involves cutting the nerves that may be making the narrowing of the blood vessels worse. The procedure is done mainly for secondary Raynaud’s phenomenon and usually is not necessary.

• #3 Raynaud’s Disease & Syndrome: Symptoms, Causes, Treatment

  https://www.webmd.com/arthritis/raynauds-phenomenon

  These steps can also help you control your condition: […] Specialty gloves can help keep your hands warm to prevent or relieve a Raynaud’s attack. Glove options include: […] While Raynaud’s can’t kill you, serious cases of secondary Raynaud’s syndrome can cut off the blood flow to your skin and lead to tissue damage. A completely blocked artery can lead to skin sores (ulcers) or dead tissue (gangrene). Its rare, but if this happens, your doctor might have to remove a finger or toe. […] While there’s no cure for Raynaud’s, it can be treated with a combination of medication, home remedies, and lifestyle changes.

• #3 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  Calcium channel blockers remain the most widely used class of drugs in the management of RP. The dihydropyridine calcium channel blockers are most effective; nifedipine has been the most extensively studied. In a meta-analysis in primary RP, calcium channel blockers reduced frequency of attacks by 2.8 to 5 fewer attacks per week and severity by 33%. In another meta-analysis in RP secondary to systemic sclerosis, calcium channel blockers reduced RP attack frequency by 8.3 attacks over 2 weeks and severity by 35%. […] Nitroglycerin ointments, sublingual tablets, and transdermal patches have also been used in the therapy of RP, demonstrating improvements in finger temperature and perfusion, but with a high incidence of side effects including headache and dizziness. Topical nitroglycerin reduces the severity and frequency of vasospastic episodes in primary and secondary RP.

• #3 Raynaud’s phenomenon | Causes, symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/raynauds-phenomenon/

  A drug called fluoxetine can help improve circulation. Fluoxetine can also be used to treat depression. This is an entirely different use and if youve been prescribed it for Raynauds, it doesnt mean your doctor thinks youre depressed. […] In severe cases almost always in cases of secondary Raynauds some treatments may be given as a drip directly into a vein, otherwise known as an intravenous injection. These intravenous drugs act directly on the blood vessels and cause them to open up. The most commonly used intravenous drug for this condition is iloprost. […] Another family of drugs used to treat severe Raynauds are the phosphodiesterase inhibitors (foss-fo-dye-ess-tur-aze in-hib-e-turs), which include sildenafil trade name Viagra. These are drugs that can treat a number of conditions, including high blood pressure in the blood vessels supplying the lungs and erectile dysfunction. They can help with Raynauds because they improve blood flow around the body.

• #3 Management of Raynaud’s disease/phenomenon – GPnotebook

  https://gpnotebook.com/pages/dermatology/treatment-of-specific-complications/management-of-raynauds-diseasephenomenon

  prostaglandins […] the European League Against Rheumatism recommends prostaglandins in patients who do not have any improvement with calcium channel blockers […] intravenous ilopros has shown to reduces the frequency and severity of attacks […] phosphodiesterase type 5 inhibitors (sildenafil, tadalafil, and vardenafil) […] oral sildenafil has been reported to decrease in the frequency and severity of attacks […] angiotensin receptor antagonists […] trials have shown that losartan reduces the frequency and severity of attacks to a greater extent than nifedipine but there is lack of sufficient evidence […] endothelin receptor antagonists (bosentan) […] the European League Against Rheumatism recommends in patients with refractory symptoms to treatment with calcium channel blockers and prostaglandins

• #3 Raynaud Disease Treatment: Improving Blood Flow

  https://lonestarneurology.net/blog/raynaud-disease-treatment/

  Physiotherapy may be used as a supportive treatment for Raynauds syndrome. […] Massage as Raynaud disease treatment can also help increase blood flow and promote relaxation. […] The best treatment for Raynaud is medications. However, lifestyle modifications can effectively manage symptoms and prevent complications. […] Raynaud’s medication includes calcium channel blockers, such as: nifedipine; amlodipine. […] Alpha-blockers, such as prazosin, are another type of Raynauds medication. […] This Raynaud disease treatment can help individuals to: develop a more positive outlook; reduce stress and anxiety; improve their quality of life.

• #3 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Patients should carefully monitor symptoms in situations that may precipitate an episode. […] Calcium-channel blockers for Raynaud’s phenomenon in systemic sclerosis. […] Efficacy of Rho kinase inhibitor fasudil in secondary Raynaud’s phenomenon. […] Botulinum toxin A treatment of Raynaud’s phenomenon: a review. […] Statins: potentially useful in therapy of systemic sclerosis-related Raynaud’s phenomenon and digital ulcers.

• #3 New Outpatient Raynaud Treatment Saves Fingers and Toes < Yale School of Medicine

  https://medicine.yale.edu/news-article/treating-threatened-digit-loss-due-to-raynaud-phenomenon/

  The goal, Hinchcliff says, is to identify which patients benefit most from epoprostenol and to determine the optimal duration of treatment, including how many times to administer infusions each month and for how many months. […] Hinchcliff sees Yale as a model for how epoprostenol can be offered intravenously in an outpatient setting in the US.

• #3

  https://link.springer.com/article/10.1007/s40674-014-0006-z

  The dual endothelin-1 receptor antagonist bosentan is licenced for the prevention of digital ulcers in patients with SSc and recurrent digital ulcers. […] Injections of botulinun toxin are being increasingly used in the treatment of severe RP. […] The aim of surgery is to prevent or minimise tissue damage, preserve hand function and improve quality of life. […] A minority of patients is unresponsive to the treatments outlined above and progress to critical digital ischemia. […] The management of RP presents many challenges, especially in those patients with severe RP (for example those with SSc) who progress to digital ulceration or critical ischemia.

• #3 Raynaud’s Phenomenon & Raynaud’s Syndrome | HSS Rheumatology

  https://www.hss.edu/condition-list_raynauds-phenomenon.asp

  For those whose Raynauds does not respond to behavior changes alone, medications can be added that dilate the blood vessels in the small extremities. These vasodilators help to prevent recurrences or to make them milder. […] In more severe cases, a nerve block that quiets the sympathetic nerves at the wrist can help the blood vessels dilate and end a painful episode. […] In the most severe cases that fail to respond to other treatments, a surgical procedure called a sympathectomy can allow the finger blood vessels to dilate. […] Its especially important to seek treatment if the Raynauds is severe enough to cause major, continuing pain or is associated with ulcers or infections of the fingers. […] Hospital for Special Surgerys specialists in rheumatology and pediatric rheumatology manage cases of both primary and secondary Raynaud’s phenomenon.

• #3 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  The role of serotonin in the pathophysiology and management of RP is not clearly established. Remission of RP symptoms has been described in a patient treated with fluoxetine; possibly as a result of depletion of platelet serotonin. […] N-Acetylcysteine has also demonstrated activity in patients with RP secondary to systemic sclerosis. The use of N-acetylcysteine in the treatment of RP has been described in an open-label pilot study enrolling 22 patients with RP secondary to systemic sclerosis. […] The observed effects of the statins on endothelial function prompted assessment of statins in the therapy of RP associated with systemic sclerosis. One randomized study enrolled 84 patients with RP secondary to systemic sclerosis despite ongoing vasodilator therapy. […] Decreased pain and numbness, decreased frequency of vasospastic attacks, healing of digital ulcers, and increased blood flow was observed in three case series and a case report assessing interdigital injections of botulinum toxin in patients with primary and secondary RP.

• #3 Treatment for Raynaud’s Phenomenon | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/raynauds-phenomenon/treatment.html

  If you have Raynaud’s that is caused by another disease, your doctor can treat that disease. This may relieve your symptoms. […] There is no cure for Raynaud’s that occurs on its own (primary Raynaud’s). But you may be able to control it by avoiding the things that trigger it. […] If you can’t control your symptoms with these steps, your doctor may give you medicine such as calcium channel blockers. This may increase blood flow to your hands and feet and relieve symptoms. […] Some alternative treatments, such as herbal supplements and biofeedback training, have shown promise in treating Raynaud’s. But they haven’t been shown to work for everyone. Talk with your doctor if you’re interested in trying any of these.

• #3

  https://link.springer.com/article/10.1007/s40674-014-0006-z

  A disadvantage of calcium channel blockers is that many patients experience side effects, mainly vasodilatory including headaches, flushing and oedema. […] Angiotensin II receptor blockers are favoured by some clinicians. […] Currently, these are seldom used. […] Up to now, these have tended to be reserved for use in patients with severe RP. […] Some clinicians prescribe these especially in patients who are prone to vasodilatory side effects and who are intolerant of other vasodilators. […] Patients who have progressed to digital ulcers require more aggressive therapy. […] A key point in management is early intervention: patients should be instructed to report ulcers early so that vasodilator therapy can be maximised. […] Intravenous (IV) iloprost is most commonly prescribed.

• #3 Managing Raynaud’s Symptoms: 6 Potential Alternatives to Medicine – Raynaud’s Association

  https://www.raynauds.org/2018/03/11/managing-raynauds-symptoms-6-potential-alternatives-to-medicine/

  Tai Chi This non-contact Chinese martial art has similar benefits. […] Non-Thermal Laser Treatments For people who develop Raynauds secondary to a main primary ailment like scleroderma, frequent and prolonged Raynauds spasms can actually result in necrotic lesions, or ulcers, that develop on places like the fingers and toes. […] Some anecdotal evidence is shedding light on the potential efficacy of cold laser therapy (non-thermal laser therapy) in healing digital ulcers. […] Massage Foremost as a tool to combat stress, promote better sleep, and ease muscle tension, massage may indirectly but positively help boost circulation to help combat painful Raynauds symptoms, or at least aid in day-to-day management of the condition. […] Biofeedback The concept of biofeedback is fairly astounding you can train your brain to take control of what would normally be an automatic bodily function, essentially making it voluntary and more manageable.

• #3 RP, Raynaud’s Syndrome, Causes, Triggers, Treatment, Stem Cells Clinic, Costa Rica

  https://stemcellstransplantinstitute.com/2020/07/11/treating-raynauds-syndrome-with-stem-cell-therapy/

  Raynauds Syndrome also called Raynaud phenomenon (RP) is a poorly understood condition that can cause many people distress. […] Newer research into stem cell treatment is shedding light on a new, effective therapy for RP. […] stem cell therapy remains a viable management option for RP. […] Medical therapy is often used in the treatment of RP. […] Stem cells are a new popular treatment option for difficult-to-treat conditions. […] They then measured many objective factors. […] These researchers found that the outcomes of the patients that underwent stem cell treatment were better than patients that did not. […] The researchers conclude that this treatment is safe, low cost, and effective for people with RP. […] Fortunately, researchers have found that stem cells may be a viable treatment for RP.

• #3

• #3 Raynaud’s Phenomenon (Guidelines) | Right Decisions

  https://rightdecisions.scot.nhs.uk/tam-treatments-and-medicines-nhs-highland/adult-therapeutic-guidelines/rheumatology/raynauds-phenomenon-guidelines/

  In people with primary Raynauds phenomenon, consider periodically stopping treatment as the disease may go into remission. […] Referral to the specialist service: Secondary care referral should be considered in cases where secondary RP is likely (e.g. late onset RP plus features/signs of a connective tissue disease or positive autoantibodies) and particularly when there is evidence of tissue damage. […] Other pharmacological options considered by the specialist include: Iloprost (hospital only) Reserved for patients with severe disease and ischaemic complications. […] Botulinum toxin type A injections can also be considered, especially in patients with digital ulcerations, if other pharmacological treatments not well tolerated or not effective. […] Bosentan (specialist initiation only) May be considered in patients with systemic sclerosis with digital ulceration (to reduce number of new digital ulcers).

• #4 Raynaud’s Disease

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/raynaud-s-disease/

  Raynauds disease has no cure. However, treatments can reduce the number and severity of the attacks. Treatment options include the following: […] Avoid living in cold temperatures. […] Avoid certain medicines used to treat for migraine, cancer, cold/allergy, among others. […] Limit your caffeine use. […] Avoid smoking. […] Exercise under the directions of your doctor. […] Make and keep appointments to see your doctor for routine check-ups and follow-up tests. […] ACE inhibitors will help blood vessels relax and open up, leading to a lower blood pressure. […] Beta blockers will help reduce your blood pressure. […] Alpha blockers will help reduce the arteries resistance and relax the muscle tone of the vascular walls. […] Calcium channel blockers will help relax and open up narrowed blood vessels, and reduce heart rate and lower blood pressure.

• #4 Raynaud’s Syndrome + 6 Ways to Manage Symptoms – Dr. Axe

  https://draxe.com/health/raynauds-syndrome/

  Emotional or physical stress can cause vasoconstriction and induce Raynauds symptoms, so incorporating natural stress relievers into your daily routine can be helpful in reducing attacks. […] Research shows that blood flow is reduced in the fingers of people who regularly smoke. For this reason, smokers with both primary and secondary Raynauds syndrome should absolutely quit smoking. […] Secondary Raynauds is commonly associated with autoimmune disease symptoms, so working to reverse or relieve the condition can also reduce Raynauds attacks. […] There is some research to suggest that acupuncture can be helpful in reducing pain and inflammation and improving joint stiffness in patients with Raynauds phenomenon. […] If you are using a medication that can lead to reduced blood flow and increase your risk of having a Raynauds attack, talk to your doctor about some alternatives.

• #4 Managing Raynaud’s Symptoms: 6 Potential Alternatives to Medicine – Raynaud’s Association

  https://www.raynauds.org/2018/03/11/managing-raynauds-symptoms-6-potential-alternatives-to-medicine/

  Raynaud’s Alternatives to Medicine If your Raynauds symptoms are simply not abated by traditional measures, at some point the topic of calcium channel blockers is bound to come up in conversation with your doctor. The first line in drug treatment for Raynauds phenomenon, calcium channel blockers like Nifedipine, alter the way calcium passes into certain muscle cells, reducing electrical signaling and causing blood vessels to dilate. […] For some Raynauds sufferers, these types of drugs may lessen the frequency or severity of attacks. […] If you are in the latter group and looking for alternative pain remedies. dont miss this quick list: […] Yoga Overall, yoga stretches muscles and increases blood flow to certain parts of the body. […] Yoga has some positive chemical effects as well, mostly with regard to reduced cortisol levels.

• #4 Raynaud’s Phenomenon After Childhood Cancer | CureSearch

  https://curesearch.org/Raynauds-Phenomenon-Summary/

  Some childhood cancer survivors who received treatment with vinblastine or vincristine develop a condition called Raynaud’s phenomenon. […] Raynaud’s is a life-long condition for most people who have it, but symptoms can get better slowly over several years. The goal of treatment is to reduce the number and severity of attacks to prevent tissue damage. […] Medicine that dilates blood vessels and aids in circulation is sometimes prescribed to help control severe symptoms. […] Using your mind to control stress and body temperature may help to improve symptoms, too. This could include guided imagery, deep breathing exercises, or both. A psychologist may be able to help you design a biofeedback program that meets your needs. […] Also, putting an affected body part in warm water may stop an attack triggered by exposure to cold.

• #4 Managing Raynaud’s phenomenon – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/managing-raynauds-phenomenon

  Raynaud’s phenomenon has been linked to some autoimmune diseases. Up to 5 per cent of patients with rheumatoid arthritis have Raynaud’s symptoms as do up to 30 per cent of people with systemic lupus erythematosus. […] When non-pharmacological strategies are insufficient and symptoms interfere with daily life, drug treatment should be considered. Treatment is usually more successful in people with primary disease. Several drugs have been investigated for use in Raynaud’s phenomenon, but interpretation of studies is difficult because of the different criteria used. […] Calcium channel blockers are commonly the first choice in Raynaud’s when drug treatment is indicated, although there is limited evidence of their efficacy. One meta-analysis found that calcium channel blockers reduced the frequency of ischaemic attacks by an average of 2.8–5.0 per week and reduced severity by 33 per cent.

• #4 Raynaud’s disease: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/176713

  There is no cure for Raynauds disease, but there are ways to manage symptoms. […] For mild forms of Raynauds disease, covering exposed skin before leaving the house can help. If an attack occurs, soaking the affected parts in warm, not hot water can ease symptoms and prevent them from worsening. […] For moderate to severe cases, medication may be necessary. These may include: Alpha-1 blockers: These can counter the effect of norepinephrine, which constricts blood vessels. Examples include doxazosin and prazosin. […] Dihydropyridine calcium channel blockers: These relax the smaller blood vessels of the hands and feet. Examples include amlodipine, nifedipine, and felodipine. […] Topical nitroglycerin ointment: Applying creams near the affected area may relieve symptoms. […] Other vasodilators: These dilate the veins, easing symptoms. Examples include losartan, sildenafil (Viagra), fluoxetine (Prozac), and prostaglandin.

• #4 Raynaud’s Syndrome (Phenomenon): Symptoms and More

  https://www.healthline.com/health/raynauds-phenomenon

  Raynauds phenomenon can occur with episodes where blood vessels constrict and reduce blood flow to your extremities. Treatment can include medications to widen your blood vessels. […] There is no cure for primary or secondary Raynauds. However, different treatments and lifestyle changes may help manage your symptoms and reduce the number of attacks experienced. Treatment options for symptoms are the same for both. […] Lifestyle changes are a large part of the treatment process for Raynauds phenomenon. Avoiding substances that cause your blood vessels to constrict is the first line of treatment, such as caffeine and nicotine products. […] Medications used to treat Raynauds work to dilate or widen your blood vessels. These drugs include: calcium channel blockers: first line of defense and includes amlodipine and nifedipine; phosphodiesterase (PDE) inhibitor: treats other circulation ailments, such as erectile dysfunction, and includes sildenafil; topical nitrates: absorbed in the skin and includes nitroglycerin; other blood pressure medications: such as losartan and prazosin; low-dose aspirin: 81-milligram aspirin daily is recommended.

• #4 List of 17 Raynaud’s Syndrome Medications Compared

  https://www.drugs.com/condition/raynaud-s-syndrome.html

  Raynaud’s Syndrome is a condition in which cold temperatures or strong emotions cause blood vessel spasms that block blood flow to the fingers, toes, ears, and nose. […] The medications listed below are related to or used in the treatment of this condition. […] Amlodipine is used off-label to treat Raynaud’s Syndrome. […] Nifedipine is used off-label to treat Raynaud’s Syndrome. […] Diltiazem is used off-label to treat Raynaud’s Syndrome. […] Nitro-Bid is used to treat Raynaud’s Syndrome. […] Nitroglycerin is used to treat Raynaud’s Syndrome. […] Prazosin is used to treat Raynaud’s Syndrome. […] Felodipine is used to treat Raynaud’s Syndrome. […] Trolamine salicylate is used off-label to treat Raynaud’s Syndrome. […] Doxazosin is used to treat Raynaud’s Syndrome. […] Isoxsuprine is used to treat Raynaud’s Syndrome.

• #4 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  The role of serotonin in the pathophysiology and management of RP is not clearly established. Remission of RP symptoms has been described in a patient treated with fluoxetine; possibly as a result of depletion of platelet serotonin. […] N-Acetylcysteine has also demonstrated activity in patients with RP secondary to systemic sclerosis. The use of N-acetylcysteine in the treatment of RP has been described in an open-label pilot study enrolling 22 patients with RP secondary to systemic sclerosis. […] The observed effects of the statins on endothelial function prompted assessment of statins in the therapy of RP associated with systemic sclerosis. One randomized study enrolled 84 patients with RP secondary to systemic sclerosis despite ongoing vasodilator therapy. […] Decreased pain and numbness, decreased frequency of vasospastic attacks, healing of digital ulcers, and increased blood flow was observed in three case series and a case report assessing interdigital injections of botulinum toxin in patients with primary and secondary RP.

• #4 Management of Raynaud’s disease/phenomenon – GPnotebook

  https://gpnotebook.com/pages/dermatology/treatment-of-specific-complications/management-of-raynauds-diseasephenomenon

  prostaglandins […] the European League Against Rheumatism recommends prostaglandins in patients who do not have any improvement with calcium channel blockers […] intravenous ilopros has shown to reduces the frequency and severity of attacks […] phosphodiesterase type 5 inhibitors (sildenafil, tadalafil, and vardenafil) […] oral sildenafil has been reported to decrease in the frequency and severity of attacks […] angiotensin receptor antagonists […] trials have shown that losartan reduces the frequency and severity of attacks to a greater extent than nifedipine but there is lack of sufficient evidence […] endothelin receptor antagonists (bosentan) […] the European League Against Rheumatism recommends in patients with refractory symptoms to treatment with calcium channel blockers and prostaglandins

• #4 Raynaud’s Phenomenon (Guidelines) | Right Decisions

  https://rightdecisions.scot.nhs.uk/tam-treatments-and-medicines-nhs-highland/adult-therapeutic-guidelines/rheumatology/raynauds-phenomenon-guidelines/

  In people with primary Raynauds phenomenon, consider periodically stopping treatment as the disease may go into remission. […] Referral to the specialist service: Secondary care referral should be considered in cases where secondary RP is likely (e.g. late onset RP plus features/signs of a connective tissue disease or positive autoantibodies) and particularly when there is evidence of tissue damage. […] Other pharmacological options considered by the specialist include: Iloprost (hospital only) Reserved for patients with severe disease and ischaemic complications. […] Botulinum toxin type A injections can also be considered, especially in patients with digital ulcerations, if other pharmacological treatments not well tolerated or not effective. […] Bosentan (specialist initiation only) May be considered in patients with systemic sclerosis with digital ulceration (to reduce number of new digital ulcers).

• #4 Raynaud’s disease: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/176713

  In very severe cases, more invasive procedures, such as sympathectomy, are an option. […] A surgeon can perform a sympathectomy by making small incisions and stripping the nerves away from the blood vessels to decrease the frequency or severity of attacks. However, this is not always effective. […] Injecting certain chemicals that block sympathetic nerve fibers from carrying out vasoconstriction can be effective. […] Local anesthetics or Botox work well for some people. However, the effect will wear off, and repeat treatments are necessary. […] Treatments involve managing symptoms, medications, and, in some cases, surgery or chemical injections to control the nerves in the blood vessels.

• #4 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Botulinum toxin injection, typically in the vicinity of the palmar digital neurovascular bundle, has been used in both primary and secondary Raynaud syndrome. Improvement in symptoms and healing of digital ulcers has been reported. […] Different surgical techniques have been used to improve Raynaud phenomenon symptoms, including balloon angioplasty, venous or arterial grafting, and digital or thorascopic sympathectomy. […] Sympathectomy may be required for intractable ischemia not responsive to medical treatment. […] Consultation with a surgeon may be needed for patients with threatened digit ischemia. […] Supplements such as fish oil and evening primrose have been reported to be beneficial in limited studies, but additional trials are needed for better evaluation of the effectiveness of these products.

• #4 Raynaud Syndrome – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/peripheral-arterial-disorders/raynaud-syndrome

  Treatment of uncomplicated cases includes avoidance of cold, biofeedback, smoking cessation, and, as needed, vasodilating calcium channel blockers (eg, nifedipine) or prazosin. […] Treatment of primary Raynaud syndrome involves avoidance of cold, smoking cessation, and, if stress is a triggering factor, relaxation techniques (eg, biofeedback) or counseling. Medications are used more often than behavioral treatments because of convenience. Vasodilating calcium channel blockers (eg, extended-release nifedipine 60 to 90 mg orally once a day, amlodipine 5 to 20 mg orally once a day, felodipine 2.5 to 10 mg orally twice a day, or isradipine 2.5 to 5 mg orally twice a day) are most effective, followed by prazosin 1 to 5 mg orally once a day or twice a day. […] Treatment of secondary Raynaud syndrome focuses on the underlying disorder. Calcium channel blockers or prazosin is also indicated, given as above for primary Raynaud syndrome. […] Cervical or local sympathectomy is controversial; it is reserved for patients with progressive disability unresponsive to all other measures, including treatment of underlying disorders. Sympathectomy often abolishes the symptoms, but relief may last only 1 to 2 years.

• #4 Some Meds Pose Risk for Raynaud’s

  https://www.arthritis.org/drug-guide/medication-topics/medications-can-cause-raynauds

  Some Meds Pose Risk for Raynauds […] If you develop symptoms of Raynauds, ask if they might be drug-related, and review a list of your medications with your doctor. […] Here are three drug classes known to increase the risk of Raynauds. […] Although the arthritis medication cyclosporin can cause Raynauds, propranolol (Inderol) and certain other high blood pressure drugs are a leading cause of drug-related Raynauds, even in people with arthritis. […] In some studies, more than one-third of patients treated with the chemotherapy drugs bleomycin and cisplatin developed Raynauds. […] Methylphenidate (Ritalin) and dextroamphetamine (Dexedrine), both used to treat ADHD, are associated with Raynauds in children. Even over-the-counter nasal sprays, such as Sudafed and Sudafed PE, which contain the stimulant pseudoephedrine, can cause symptoms of Raynauds in hands and feet.

• #4 Raynaud’s phenomenon – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/193

  Raynaud’s phenomenon (RP) is common, affecting between 3% and 5% of the population. […] Primary RP often needs no pharmacological treatment. Keeping warm, smoking cessation, regular exercise, and avoiding stress are recommended. Pharmacological treatment can be considered in people with mild disease who do not respond to lifestyle measures. Potential treatment options include calcium-channel blockers, angiotensin-II receptor antagonists, selective serotonin-reuptake inhibitors (SSRIs), topical nitrates, alpha-blockers, and ACE inhibitors. […] In severe secondary RP, calcium-channel blockers, phosphodiesterase-5 inhibitors, prostacyclins, atorvastatin, and bosentan are potential treatment options, with only the most severe cases warranting surgical intervention. […] Pain relief and wound care of digital ulcers may be important adjunctive treatments.

• #4 Raynaud’s Disease & Syndrome: Symptoms, Causes, Treatment

  https://www.webmd.com/arthritis/raynauds-phenomenon

  These steps can also help you control your condition: […] Specialty gloves can help keep your hands warm to prevent or relieve a Raynaud’s attack. Glove options include: […] While Raynaud’s can’t kill you, serious cases of secondary Raynaud’s syndrome can cut off the blood flow to your skin and lead to tissue damage. A completely blocked artery can lead to skin sores (ulcers) or dead tissue (gangrene). Its rare, but if this happens, your doctor might have to remove a finger or toe. […] While there’s no cure for Raynaud’s, it can be treated with a combination of medication, home remedies, and lifestyle changes.

• #4 Raynaud’s Phenomenon Disease Causes, Symptoms, Treatment, Medications, Prevention

  https://www.medicinenet.com/raynauds_phenomenon/article.htm

  Those with RP should guard their hands and feet from direct trauma and wounds. Any wounds or infections should be treated early to prevent more serious infections. Avoiding emotional stresses and tools that vibrate the hand may reduce the frequency of attacks. Biofeedback can also help to decrease the severity and frequency of RP in some patients. […] Patients with persistent or bothersome symptoms may be helped by taking oral medications that open (dilate) blood vessels. (Sometimes these medications are decreased or eliminated when the environment is warmer, such as during the summer months.) These include calcium antagonists (or calcium channel blockers), such as diltiazem (Cardizem, Dilacor), nicardipine (Cardene), nifedipine (Procardia), and other medicines used in blood pressure treatment, such as methyldopa (Aldomet) and prazosin (Minipress). Recent research has shown that the blood-pressure drug losartan (Cozaar, Hyzaar) can reduce the severity of episodes of RP.

• #4 Raynaud’s Syndrome Treatment | LENS Neurofeedback | Marin | San Francisco | Mill Valley

  https://echoneurotherapy.com/condition-treated/raynauds-syndrome/

  Echo Neurotherapy provides medication-free treatment for chronic cold hands and feet. Raynaud’s Syndrome occurs when the brain overreacts and reduces adequate circulation to the extremities. EchoNeuro treatment protocols combined with LENS Neurofeedback restore better circulation after the first and subsequent treatments. […] LENS Neurofeedback is a non-invasive treatment that accelerates neuroregeneration of brain receptors and neural pathways to support optimal blood circulation throughout the body. […] Most clients feel the benefits after the first treatment, with steady improvement in just a few sessions. […] Often, a single neurofeedback treatment relieves Raynaud’s symptoms. Several treatment sessions are generally necessary to fully solidify the desired results. Treatments typically restore optimal circulation, greater endurance, mental clarity, and emotional resilience.

• #4 Students see an Opportunity to treat Raynaud’s Phenomenon Symptoms with Blue Light | Medical School

  https://med.umn.edu/iem/news/students-see-opportunity-treat-raynauds-phenomenon-symptoms-blue-light

  A multidisciplinary team of undergraduate students develop a potential new pathway to treating the disabling symptoms of Raynauds phenomenon and disease. […] Saliterman suspected that blue light could be a potential treatment. […] The team also brainstormed several translational medical devices (such as wearable light-emitting gloves and stockings) that could be used as mobile forms of the therapy. […] The team and the University received a utility patent (U.S. 11,865,357) for the light-based treatment devices and methods on January 9, 2024. […] An Experimental Phototherapy Device for Studying the Effects of Blue Light on Patients with Raynauds Phenomenon. […] It is this shared belief that allowed our students to work well beyond receiving academic credit, meeting artificial deadlines, or even the promise of acknowledgement, to accomplish something remarkable.

• #4 Raynaud’s Disease Clinic – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/services/raynauds-disease-clinic

  The Raynaud’s Disease Clinic at Brigham and Women’s Hospital is one of only a few clinics in New England exclusively dedicated to the evaluation and treatment of patients with Raynaud’s disease (Raynaud’s phenomenon). […] Following a thorough evaluation, the physician team will develop a treatment plan based on the type and extent of the disease, the patients overall health, and the patient’s preferences. […] Although there is no cure for Raynauds, it normally can be well managed with appropriate treatment, such as: […] Prescribing alpha blockers, which suppress the sympathetic nervous system response that leads to vasoconstriction (blood vessel narrowing). […] Prescribing other medications that also improve blood flow to the fingers and toes by dilating (expanding) blood vessels, such as calcium channel blockers or phosphodiesterase inhibitors.

• #4

  https://link.springer.com/article/10.1007/s40674-014-0006-z

  This review describes the principles of approach to, and management of, the patient with Raynauds phenomenon (RP). […] If RP is secondary to systemic sclerosis (the type of RP which has been most researched), then the patient will have structural as well as functional vascular changes which may progress to digital ulceration and critical ischemia. […] The approach to drug treatment is described for patients with mild, moderate and severe RP (severe meaning complicated by the development of digital ulcers or critical ischemia). […] Non-drug therapy should be used in every case including cold avoidance, elimination of smoking, stopping aggravating drugs and providing support and education to reduce stress. […] Drug therapy is helpful to improve QOL and prevent secondary complications, but ideal studies are lacking to provide solid evidence for best options.

• #4 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  For many patients with primary or secondary Raynaud phenomenon, nonpharmacologic interventions are all that are required to decrease the frequency of attacks and improve quality of life. The goal should not be to eliminate attacks completely, as aggressive drug treatment may cause more harm than benefit. From our perspective, the goals of treatment should be to improve quality of life and prevent ischemic complications. […] Pharmacologic therapies should be added only if attacks remain poorly controlled with incapacitating symptoms, or if the patient has digital ischemic ulcers. Calcium channel blockers are first-line therapy, given proven efficacy and low cost, and should be titrated to the maximum tolerated dose before adding or substituting other agents.

• #4 Advances in the treatment of Raynaud’s phenomenon

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2860448/

  In patients with primary RP, nonpharmacologic lifestyle modifications remain the first-line therapy. Calcium channel blockers or topical nitrates may be considered for those without an adequate response to lifestyle modification. Other therapies have not been demonstrated to be effective in this population. In patients with secondary RP, lifestyle modifications should also be applied; however, pharmacologic management is more likely to be necessary. In addition to calcium channel blockers, there may be a role for topical nitrates, PDE5 inhibitors, endothelin antagonists, or prostaglandin derivatives.

• #5

  https://link.springer.com/article/10.1007/s40674-014-0006-z

  We prefer calcium channel blockers alone for moderate cases and prostaglandins for severe RP. […] Patients with systemic sclerosis (SSc; scleroderma) and secondary digital ulcers or those with critical ischemia require more intense therapy with both vasodilation therapy and agents that have the potential to prevent further vascular insult. […] Digital sympathectomy may provide benefit (but which may only be transient) for critical ischemia. […] The final section of the review discusses novel (possible future) therapies. […] Drug treatment is required when general (non-drug) measures are insufficient to control symptoms. […] Most clinicians agree that calcium channel blockers are first line. […] A recent Cochrane review of calcium channel blockers for primary RP concluded that the seven randomised trials which included 296 participants, provided moderate-quality evidence that calcium channel blockers were minimally effective, as measured by frequency of attacks.

• #6 Management of Raynaud’s disease/phenomenon – GPnotebook

  https://gpnotebook.com/pages/dermatology/treatment-of-specific-complications/management-of-raynauds-diseasephenomenon

  The first step in management of Raynauds phenomenon is lifestyle modification. Majority will respond to conservative measures and need no further treatment but patients suspected of having an underlying cause should be referred to secondary care (1). […] For patients who do not respond to conservative measures, various groups of drugs have been used in the management. These should be used on a case by case basis: vasodilators […] calcium channel blockers is the only drug licensed for use in Raynauds phenomenon […] considered to be the drugs of choice (2) […] non-cardioselective dihydropyridine calcium channel blockers are used commonly […] nifedipine is useful for reducing the severity and frequency of vasospastic attacks […] topical nitrates […] large randomized control trials have reported that topical nitrates applied to the dorsum of the finger reduces the severity of Raynauds phenomenon, but not the duration or frequency of attacks

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