What’s the Best Treatment for Raynaud’s Phenomenon? Images, Medications, and More

Raynaud’s phenomenon is a condition that causes pain and color changes in your fingers and toes. This rarely leads to long-term complications. But experiencing the symptoms can be uncomfortable. Fortunately, there are many lifestyle changes and medications that can help. 

Let’s review the treatment options for Raynaud’s phenomenon. Here, we also discuss when secondary Raynaud’s can become an emergency.

What is Raynaud’s disease?

Raynaud’s phenomenon — also called Raynaud’s disease or Raynaud’s syndrome — occurs when blood vessels in the digits (fingers or toes) clamp down in response to cold temperatures or emotional stress. It’s normal for blood vessels to clamp down a little bit when you’re cold or stressed. But in Raynaud’s phenomenon, the blood vessels constrict too much for too long. Less blood flows to the digits, and the digits don’t get the oxygen they need. 

Without oxygen, digits turn white, blue, or purple in color — as if they’ve been dipped in paint. Numbness, tingling, and pain may occur with the color changes. When blood vessels relax and blood flow returns, fingers may look red.

What does Raynaud’s syndrome look like?

Here are some pictures of Raynaud’s syndrome that show the typical color changes in fingers and toes in different skin tones. 

Raynaud’s syndrome on several toes.

Close-up of Raynaud’s syndrome on the toes.

Raynaud’s syndrome on the fingers.

Color changes from Raynaud’s syndrome on the fingers.

How do you treat Raynaud’s phenomenon?

There’s no cure for Raynaud’s phenomenon, and it may not be possible to get rid of all Raynaud’s attacks. But there are a lot of treatments, including medications, that can help. 

The goals of treatment include:

• Decreasing the frequency of attacks

• Improving quality of life

• Preventing complications (like ulcers or loss of fingers or toes)

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Raynaud’s phenomenon occurs when blood vessels clamp down. There are a couple of options to get blood vessels to relax. You can:

• Prevent your body from getting cold too quickly

• Use medications to relax blood vessels and increase blood flow to your fingers and toes

What medications treat Raynaud’s phenomenon?

It’s worth noting that there are no FDA-approved medications for treating Raynaud’s phenomenon. Healthcare professionals commonly prescribe other medications, which are approved for other conditions, because studies show they can help. This is called off-label use. 

Most medications prescribed for Raynaud’s phenomenon are vasodilators. Vasodilators relax blood vessels so blood can return to your fingers and toes. 

Most studies on Raynaud’s treatment focus on people with Raynaud’s due to scleroderma (an autoimmune disease). Medications that work for these people can also be helpful for people with Raynaud’s due to other reasons.

But medications that work well for some people might cause side effects for others. And some people may combine certain medications. Together with a healthcare professional, you can find a regimen that works for you.

Medication won’t prevent all Raynaud’s attacks. But it can decrease the frequency and severity. 

First-choice medications

First-choice medication for Raynaud’s often involves dihydropyridine calcium channel blockers (CCBs) — like amlodipine or nifedipine. Data shows that CCBs can decrease the number of Raynaud’s attacks by about three episodes per week. CCBs can also make attacks shorter and less painful. 

Experts generally agree that people should try CCBs first due to their effectiveness and low cost. Guidelines also recommend them for treating Raynaud’s phenomenon that’s due to scleroderma. 

Second-choice medications

If CCBs don’t help, experts recommend trying phosphodiesterase type 5 inhibitors (PDE5 inhibitors), like Viagra (sildenafil) or Cialis (tadalafil). These may also be an option if you can’t take CCBs due to side effects. You may recognize these vasodilators as treatment options for erectile dysfunction. For this condition, they increase blood flow to the penis. But they can also be helpful for other conditions. 

For Raynaud’s phenomenon, PDE5 inhibitors increase blood flow to the fingers and toes. PDE5 inhibitors may increase libido in people of all genders. But this type of medication doesn't cause erection without sexual stimulation of some kind.

Other options

If CCBs and PDE5 inhibitors don’t treat your symptoms, a variety of other options exist. For severe cases with complications, like ulcers, experts recommend: 

• Prostanoids: Ventavis (iloprost) is a strong vasodilator that goes directly into the vein. 

• Endothelin receptor antagonists: Bosentan is another vasodilator that helps prevent more ulcers in people with Raynaud’s who already have them.

• Certain procedures: When everything else fails, you may try procedures like a botox injection or digital periarterial sympathectomy, which involves cutting the small nerves in the finger that trigger blood vessels to clamp down. More studies are needed to figure out how helpful these procedures are.

For milder cases, a healthcare professional may consider other vasodilators for your treatment. These include angiotensin II receptor blockers (like losartan) or topical nitrate paste. But experts consider them less effective, since small studies show only small benefits. 

Risks of Raynaud’s medication

Low blood pressure is the most risky side effect of vasodilators, especially CCBs and PDE5 inhibitors. In addition to low blood pressure, side effects of vasodilators may also include:

• Lightheadedness

• Dizziness

• Headaches

• Leg swelling 

Because of these risks, a healthcare professional will often begin with low doses of medications to see how you tolerate them. 

What lifestyle changes can help with Raynaud’s phenomenon?

In some cases, simple lifestyle changes might be all you need to keep Raynaud’s under control.

Lifestyle changes include:

• Staying warm: Socks and gloves are important. But keeping your entire body warm works even better. Adding multiple layers and a warm hat can go a long way. 

• Preventing rapid changes in temperature: Going from hot to cold quickly can trigger Raynaud’s attacks, too. 

• Decreasing stress levels: Stress and heightened emotions can lead to Raynaud’s attacks. 

• Stopping smoking: Nicotine causes blood vessels to clamp down, so it’s helpful to quit smoking. 

• Reviewing your medication list: Certain medications also clamp down blood vessels. For example, some migraine medications and medications for attention-deficit hyperactivity disorder (ADHD) can make Raynaud’s worse.

Lifestyle changes are more effective for people with Raynaud’s phenomenon that isn’t associated with another condition. 

Can natural remedies or alternative medicines help Raynaud’s?

There are some natural and alternative medications for Raynaud’s disease. These natural remedies for Raynaud’s phenomenon include:

• Omega-3 fatty acids

• Evening primrose oil

• Ginkgo biloba 

• Acupuncture

Keep in mind that supplements can cause side effects and interact with other medications. So, it’s important to talk to a healthcare professional before starting anything new. 

How serious is Raynaud’s phenomenon?

Most of the time Raynaud’s phenomenon flare-ups don’t last long and don’t cause serious problems. 

But sometimes people with Raynaud’s phenomenon can develop a serious complication: acute digital ischemia. This means lack of blood flow to a digit for a dangerous amount of time. You might think of acute digital ischemia as a heart attack of the finger or toe. Digits need blood and oxygen to stay healthy, just like the heart. When blood flow stops, the skin breaks down and tissues die. If your finger or toe doesn’t get blood for long enough, it’s possible to lose the digit entirely. 

Symptoms of acute digital ischemia include:

• One or more of your digits remains white, blue, or purple for more than 45 minutes

• Severe pain and tenderness of the affected digit

Acute digital ischemia is a medical emergency. It’s most likely to happen if you have Raynaud’s phenomenon due to other associated medical conditions. If you experience symptoms of acute digital ischemia, go to an emergency room as soon as possible. You may need hospitalization, medications in your vein, or a procedure to save the digit.

What can I do to stop a Raynaud’s phenomenon attack?

If you experience a Raynaud’s attack, don’t fret. There are techniques you can use to help restore blood flow to your digits faster. Examples include:

• Flicking your wrist like you’re pretending to throw a Frisbee

• Burying your hands in your armpits

• Running your hands under warm water

Frequently asked questions 

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Written by:

Samantha C. Shapiro, MD

Samantha Shapiro, MD, is a board-certified rheumatologist and internist with expertise in autoimmune and inflammatory conditions. She founded the division of rheumatology at Dell Medical School at The University of Texas at Austin.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

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