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Question : I am a 62-year-old woman in generally good health. However, I have suffered from Raynaud's disease for many years. What treatments are currently available?
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The Trusted Source
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Howard LeWine, M.D.

Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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June 18, 2013
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Raynaud’s disease is a common condition. It affects up to 5% of women in the United States. It is characterized by excessive constriction of blood vessels — usually in the fingers and toes — triggered by cold or emotional stress.

Typically, the fingers turn white, then blue, then red with accompanying pain, numbness, burning and sometimes puffiness. The cause cannot be identified in 90% or more of cases. But sometimes Raynaud’s is associated with certain rheumatic conditions such as lupus or scleroderma.

Standard treatment includes staying warm and avoiding medicine that may bring on attacks. For example, good mittens or gloves, hand warmers, and cup insulators for cold beverages can help. Lowering the body temperature can bring on Raynaud’s attacks. So bundling up before heading out the door (rather than after) and turning up the thermostat a few degrees can make a big difference.

If possible, you should avoid certain drugs, such as beta-blockers and over-the-counter vasoconstrictors (such as pseudoephedrine).They may make Raynaud's worse.

If your symptoms are not well controlled, your doctor may prescribe medicine. This may include blood pressure pills that open up blood vessels. Calcium-channel blockers such as amlodipine or nifedipine are typically the first choice. If they are not effective or cause side effects, you can try hydralazine, losartan, prazosin or topical nitroglycerin ointment. 

Severe symptoms may respond to sildenafil (the active ingredient in Viagra) or related drugs.  Another option for the most server cases is nerve blocks. They interfere with the nerve signals that direct blood vessels to constrict.

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