White fingertips: Raynaud’s Syndrome?

Your fingers are quickly white at the end when he does cold ? Your toes too? Maybe it’s the syndrome by Raynaud“. We talk about “Raynaud’s syndrome” but “the real term is ‘Raynaud’s phenomenon’ which is the clinical description”explains Dr Jean-Benoît Monfort, dermatologist and member of the French Society of Dermatology (SFD). This is a blood circulation disorder affecting the extremities. “The fingers are most often affected, more rarely the toes and exceptionally the ears or nose. specifies the doctor.

White, blue, red fingers: the 3 characteristic symptoms

► The fingers suddenly become whites with a feeling of numbness. This criterion is essential to say that it is Raynaud’s syndrome.

► Sometimes they then become blue

► Then after warming they become redsecondary to reflex vasodilation, with sensation of tingling

All of these disorders are reversible. A crisis can last from a few minutes to a few hours. Consult your doctor as soon as this phenomenon appears, so that he can refer you to a dermatologist or vascular doctor. “Any Raynaud phenomenon must be explored, even if it appears benign in a young woman” confirms Jean-Benoît Monfort. A Raynaud’s phenomenon is worrying when it occurs after approximately 35 years of age, that he touches the man, only one hand or when it is accompanied by small spontaneous ulcerations of the fingertips. In such cases, “treatment must be rapid because there is very probably an underlying disease of which Raynaud’s phenomenon is one of the manifestations”.

What is the cause of Raynaud’s syndrome?

It’s about a hyper-reactivity of the microcirculation during a exposure to cold. The vessels which irrigate the periphery of the body show a reduction in their diameter, this is what we call a “vasoconstriction“. There blood circulation which irrigates these extremities is slowed explaining their cooling. In a person with Raynaud’s syndrome or disease, the constriction of the arteries is excessive and reduces blood circulation. “Raynaud’s disease has no real cause. It typically occurs in young woman, often with a family context [souvent héréditaire]”, continues Jean-Benoît Monfort. Raynaud’s disease, which is benign, represents more than 80% of cases. In rarer cases, Raynaud’s phenomenon may be secondary to “autoimmune diseases (systemic sclerosis, lupus)there taking certain medications (beta blockers, tryptans used for migraines) or drugs (cocaine)professional causes (vibrating equipment disease in humans who regularly use a jackhammer)of the cancers (to be feared in men typically, smokers)but also some blood diseases (malignant hematological diseases, monoclonal gammopathies) or some endocrine pathologies (hypothyroidism, acromegaly)“.

The diagnosis is clinical. “It is done via a examination of the patient and sometimes thanks to Pictures that he brought.” Possible additional examinations will be carried out, such as blood tests to test for certain autoimmune diseases and capillaroscopya painless examination which allows the study of the capillary vessels of the skin. “If these two exams are normal, then it is a primary Raynaud’s phenomenon, without underlying disease, which does not require follow-up.” Furthermore, these examinations will make it possible not to confuse Raynaud’s phenomenon with acrocyanosisvery common, which also manifests itself by bluish fingers in winter. “This pathology also develops in classically thin young women. It is perfectly benign and does not require any work-up”reassures Jean-Benoît Monfort.

How to treat Raynaud’s syndrome?

There does not exist no treatment final. People affected by Raynaud’s disease never even take medication, unlike those affected by secondary (disease-related) Raynaud’s phenomenon.

► “The calcium channel blockers are then used as first intention. These are medications usually used for high blood pressure. They help dilate small vessels and relieve symptoms well.

► In severe cases, intravenous infusions are carried out in the hospital”, develops Jean-Benoît Monfort.

► Furthermore, for people with Raynaud’s disease, simple things can and should be put in place. “Protection against the cold is essential: glove ports, small heaters to put in the pocket… It must also protect the arms and trunkSO wear warm clothes.“ Finally, Raynaud’s phenomenon is improving in case of weight gain and tends to improve with age during primitive forms. Furthermore, stopping smoking is mandatory, because it is toxic to blood vessels and promotes vasospasm. “There is no way to prevent Raynaud’s phenomenon apart from avoiding smoking. Once reached, the best way remains prevention against the cold.”concludes Jean-Benoît Monfort.

Thanks to Dr Jean-Benoît Monfort, dermatologist and member of the French Society of Dermatology (SFD).