Raynaud’s Treatments and Medications

Everyone’s fingers can go cold and pale in freezing temperatures, since the body limits blood flow to conserve heat. For people with Raynaud's disease, however, that response becomes amplified from triggers like cold weather or even emotional stress. It affects about 1 in 20 people, and most cases are mild, although secondary Raynaud’s phenomenon is more severe and can occur in conditions such as scleroderma or lupus. There is no cure, but treatment can help reduce how often and how severely attacks happen. See a healthcare provider if attacks are frequent and painful, affect only one hand, or cause skin sores.

How is Raynaud's disease diagnosed?

A healthcare provider usually diagnoses Raynaud’s based on a physical exam and a person’s overall medical history. While there is no single test for it, a healthcare provider can often ask specific questions and examine the fingers for signs of blood vessel damage. A diagnosis may come from the following:

• A review of symptom patterns: Do your fingers turn white, then blue, then red? What triggers them, how long do they last, and do they affect one hand or both?

• An evaluation of risk factors: A person’s age, sex, smoking habits, work, and current medications may help identify potential causes.

• Blood and antibody tests: An antinuclear antibody (ANA) test and other blood work can help check for a potential autoimmune condition.

• Nailfold capillaroscopy: A rheumatologist can use a microscope to analyze the tiny capillaries at the fingernail base and look for any blood vessel damage caused by scleroderma or related diseases.

An early diagnosis can help confirm what’s causing the color changes and whether any treatment is needed. If symptoms are painful or worsening, it’s best to contact a healthcare provider.

Raynaud's disease treatment options

There is no cure for Raynaud’s disease. Instead, treatment focuses on reducing the severity and frequency of flare-ups. That usually involves avoiding any triggers, such as smoking, certain chemicals, or medications that constrict the blood vessels. Many people can manage primary Raynaud’s with lifestyle changes, but more severe cases usually need vasodilator medications. In rare cases, surgery may be needed to interrupt the nerves that constrict blood vessels (sympathectomy). A healthcare provider can make additional recommendations based on how a person responds to lifestyle changes and the severity of their attacks. 

Types of Raynaud's disease medication

For symptoms that don’t improve with lifestyle changes, a healthcare provider may recommend vasodilators. These medications can help relax and widen blood vessels to improve blood flow. 

Calcium channel blockers

Calcium channel blockers are the first-line medication for Raynaud’s disease. Procardia (nifedipine) is usually the first choice, while Norvasc (amlodipine) is often used as an alternative. Both medications relax the blood vessels, allowing more blood to flow to the fingers and toes. 

PDE5 inhibitors

These medications are best known for treating erectile dysfunction, with popular brand names such as Viagra (sildenafil) and Cialis (tadalafil). PDE inhibitors widen the arteries by preserving nitric oxide, a natural molecule that relaxes blood vessels. They can be added to a calcium channel blocker or used on their own when attacks are hard to control.

Topical nitrates

Nitrates are considered direct vasodilators that directly release nitric oxide into the blood vessels. Nitro-Bid (nitroglycerin) ointment is a common option applied to the affected finger to increase blood flow before or during a flare-up. 

Other prescription options

If first-line medications don’t help, a healthcare provider may prescribe other blood pressure medications, such as the angiotensin receptor blocker Cozaar (losartan) or the alpha blocker Minipress (prazosin). For severe secondary Raynaud’s with scleroderma, the endothelin blocker bosentan or intravenous prostaglandins such as iloprost are sometimes used off-label to prevent skin sores and ease attacks.

Over-the-counter Raynaud’s disease medicine

There are no over-the-counter medicines that treat the underlying cause of Raynaud’s. In fact, some over-the-counter medicines can worsen the condition. For example, decongestants like pseudoephedrine can narrow blood vessels and trigger an episode. Non-medicinal products, such as hand and foot warmers, can help manage symptoms.

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