Q: I would like information on Raynaud's disease and what can be done about it.
A: People with Raynaud's phenomenon exhibit dramatic sensitivity to cold and emotional stress which cause narrowing of the blood vessels (vasoconstriction) to the hands. As a result of the diminished supply of blood and oxygen, the fingers turn chalky white. When the tissue oxygen is depleted, the fingers turn blue. Finally the fingers turn red as the blood vessels open and blood supply is restored. These changes in appearance are accompanied by numbness, tingling and burning pain.
Most often, Raynaud's phenomenon occurs by itself. When it occurs in association with some underlying disorder, such as rheumatoid arthritis, lupus or scleroderma, the term Raynaud's disease is applied.
The most effective way to prevent episodes of Raynaud's phenomenon is to avoid stimuli that cause vasoconstriction, including cold, emotional stress, nicotine and even caffeine. It is important to keep the whole body warm, as well as to protect the hands from cold exposure. Some helpful suggestions include wearing:
*Cotton or woolen underwear, which absorb perspiration better than Orlon or nylon, during cold weather;
*Thermal socks or several pairs of socks;
*Mittens because they trap heat better than gloves;
*A hat to reduce the loss of body heat from the head.
You should, of course, avoid placing your hands in cold water and use gloves or tongs to remove foods from the freezer. If you haven't done so already, you must stop smoking.
Should symptoms persist despite these preventive measures, medications may prove helpful. A drug often effective is nifedipine, one of the calcium-channel blockers commonly used to treat high blood pressure.
Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine and associate dean for faculty affairs at the school.