Treatment for Raynaud's Phenomenon
The following are some lifestyle tips for managing Raynauds phenomenon:
- Keeping warm is the primary goal for preventing the onset of Raynauds phenomenon. Air-conditioning and exposure to refrigeration can trigger this syndrome. If patients go out in cold weather, they should dress warmly with many layers. Wearing a hat is essential.
- Living in a warm climate may help relieve symptoms, although a recent study found that weather changes themselves had little effect on the disorder.
- Exercise is helpful in maintaining a sense of well being, in keeping warm, and helping to sustain skin pliability. (Patients with Raynauds phenomenon may want to avoid exercising outdoors in cold weather, however.)
- Quitting smoking is, of course, essential for anyone, but it is critical for people with scleroderma.
- Patients would be wise to seek relaxation and anti-stress techniques, which might help reduce some triggers of Raynauds phenomenon. Many effective methods are available.
- Moisturizers and antibiotic ointments may be helpful for keeping skin pliable and preventing infections in the fingers.
- Patients should avoid certain medications that could aggravate Raynauds phenomenon, including nonselective beta blockers (e.g., propranolol), certain common cold preparations, and narcotics.
Agents Used in Raynauds Phenomenon
Vasodilators. Vasodilators open blood vessels and so are important for Raynauds phenomenon. Some studies reporting their effects including the following:
- Calcium-channel blockers, including diltiazem (Cardizem, Dilacor) and nifedipine (Adalat, Procardia) are the standard vasodilating agents used for Raynaud's phenomenon. Side effects vary among different preparations, and may include fluid accumulation in the feet, constipation, fatigue, impotence, gingivitis, flushing, and allergic symptoms. Grapefruit juice appears to boost the effects of these drugs.
- Nitrates, both topical and oral agents, are vasodilators that are also used for Raynauds phenomenon. For example, in a 2002 a nitroglycerin tape improved circulation within an hour. A gel containing nitric oxide was found effective in a 1999 study in improving the blood circulation in hands and arms of Raynaud's patients. A single application increased circulation to the arms 10-fold and tripled the circulation to the fingers, and it caused no adverse side effects.
Prostacylins. Iloprost and other prostacylins are proving to be effective agents for Raynauds phenomenon. A 2001 one analysis reported that intravenous iloprost was effective for treating Raynauds phenomenon and reduced the frequency of attacks and prevented and healed ulcers. (Oral iloprost was not as effective.) One earlier comparison study found that iloprost was even more effective than the calcium channel blocker nifedipine.
Anti-Platelet Drugs. Aspirin, dipyridamole, and other drugs that prevent blood clotting and keep blood flowing freely are sometimes recommended.
Estrogen Therapy in Women. Short-term administration of estrogen may benefit older women with Raynauds phenomenon and systemic sclerosis.
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