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Raynaud's phenomenon
Fingers that turn white, then blue, then red in the cold. Usually harmless — sometimes an early clue to something more important.
What is Raynaud's phenomenon?
In Raynaud's phenomenon, the small blood vessels in the fingers and toes spasm in response to cold or stress. The fingers turn white, then often blue, then red as blood flow returns, with numbness, tingling or throbbing.
It is very common, especially in young women. In most people it is primary Raynaud's — uncomfortable but harmless. In a smaller group it is secondary to another condition, most importantly scleroderma or other connective tissue diseases.
Primary or secondary? The clues
| Feature | More likely primary | Suggests secondary — see a rheumatologist |
|---|---|---|
| Age at onset | Teens to 20s | After 30–40 |
| Severity | Mild, symmetrical | Severe, painful, asymmetric |
| Skin | Normal between attacks | Sores or pits on the fingertips, puffy fingers, tight skin |
| Other symptoms | None | Joint pain, rash, dry eyes or mouth, heartburn, breathlessness |
| Tests | Normal nailfold capillaries, negative ANA | Abnormal nailfold capillaries, positive ANA or scleroderma antibodies |
How it is assessed
- History and examination of the hands
- Nailfold capillaroscopy — looking at the tiny vessels at the base of the nails
- ANA and, if positive, more specific antibodies
- Further tests if a connective tissue disease is suspected
How it is treated
- Keep the whole body warm, not just the hands — layers, gloves, warm socks
- Stop smoking; avoid nicotine and limit caffeine
- Warm the hands under lukewarm (not hot) water during an attack
- Medicines that relax blood vessels — nifedipine or amlodipine — for frequent or severe attacks
- For fingertip ulcers: urgent specialist care and stronger treatments
A fingertip sore, or a finger that stays white or blue, needs prompt medical attention.
Common questions
Is Raynaud's dangerous?+
Primary Raynaud's is not dangerous. Secondary Raynaud's can be associated with scleroderma or other conditions and can cause fingertip ulcers, so it needs assessment.
Can Raynaud's be the first sign of scleroderma?+
Yes — Raynaud's often appears years before other features of scleroderma, which is why the warning clues matter.
Which medicine helps Raynaud's?+
Calcium channel blockers such as nifedipine or amlodipine are commonly used. Keeping the whole body warm is the foundation.
Raynaud's with other symptoms?
A quick assessment tells primary from secondary Raynaud's. Walk-in, no appointment needed.
Clinic timings & location