From the Guidelines
No, with Raynaud's phenomenon, the feet and nose typically do not turn red when you get too hot. Raynaud's is characterized by episodes where extremities (usually fingers and toes, but sometimes affecting the nose, ears, or nipples) turn white and then blue in response to cold temperatures or stress, followed by redness when blood flow returns. These color changes occur due to vasospasm, where small blood vessels temporarily narrow, restricting blood flow. When you get too hot, Raynaud's symptoms generally improve rather than worsen, as heat causes blood vessels to dilate. The redness that occurs in Raynaud's is part of the recovery phase after a vasospastic episode, not a direct response to heat.
Key Points to Consider
- The most recent and highest quality study, 1, provides state-of-the-art evidence in the treatment of systemic sclerosis, but does not specifically address the response of feet and nose to heat in patients with Raynaud's disease.
- However, the study 1 discusses various treatments for Raynaud phenomenon, including phosphodiesterase type 5 (PDE-5) inhibitors, dihydropyridine-type calcium antagonists, and prostacyclin analogues, which can help reduce the frequency and severity of attacks.
- Another study, 1, suggests that avoiding triggers such as cold, trauma, stress, smoking, vibration injury, or certain drugs, and wearing proper clothing in cold conditions, can be helpful in reducing the frequency and severity of Raynaud's attacks.
- It is essential to note that if you experience persistent redness, swelling, or heat in your extremities, this could indicate a different condition such as erythromelalgia or could be related to inflammation, and should be evaluated by a healthcare provider.
Management and Treatment
- The study 1 recommends dihydropyridine-type calcium antagonists, usually oral nifedipine, as first-line therapy for Raynaud's phenomenon, and PDE-5 inhibitors as an alternative option.
- Other treatments, such as topical nitrates, losartan, aspirin, atorvastatin, and fluoxetine, may also be beneficial, but have limited evidence or potential adverse effects.
- Surgical and procedural treatments, such as digital sympathectomy or botulinum toxin injections, have limited evidence and are not widely recommended.
From the Research
Color Changes in Raynaud's Disease
- The color changes associated with Raynaud's disease typically occur in response to cold or emotional stress, and are characterized by a triphasic color change: white (ischaemia), blue (deoxygenation), and red (reperfusion) 2.
- These color changes can occur in the fingers, toes, ears, nose, and tongue, although the fingers are most commonly affected 3, 4.
- The red phase is due to hyperemia as the attack subsides and blood flow is restored to the affected area 2.
Affected Areas
- The areas most commonly affected by Raynaud's disease include the fingers, toes, ears, nose, and tongue 3.
- The condition can cause episodic color changes in these areas, typically in response to cold exposure or stress 5.
- The nose and feet can be affected, although the fingers are most commonly affected 3, 4.