Raynaud’s Big Chill

The disorder nips at fingers and toes—even in warm weather.

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Illustration by Dàv BordeleauAllison B. Weer was in her final semester as a painting major at the University of Delaware when she fell and broke three fingers on her right hand. Once she got her cast off and completed her degree in 1991, she thought nothing more about it— until one cool day, nearly three years later, when she felt chilled to the bone and noticed her fingertips were white.

Her doctor told her she had Raynaud’s phenomenon, a lifelong condition associated with blood circulation and characterized by fingers and toes that turn “frostbite white.”

There are two types of Raynaud’s. Weer has the less common form, caused by an underlying problem. Regardless of the type, experts call it a hyperactive or exaggerated response to cold temperatures or emotional stress.

Cold and stress normally narrow small blood vessels in the skin. This is nature’s way of redirecting blood flow away from the extremities and toward the internal organs. It conserves heat and—in situations that induce a fight-or-flight reaction—prevents excessive blood loss in case of injury.

But, rather than slowing the flow to extremities, the arteries in Raynaud’s sufferers undergo a vasospasm, temporarily disrupting blood flow. It’s most noticeable in the hands—and so pronounced that it looks as though the fingers were dipped in a whitening solution. It can also affect the nose, lips, knees and ears.

For Weer, the disorder is mostly an inconvenience, though the “frostbite look” still takes her by surprise. “I never know when it’s going to hit—suddenly, I feel cold, and I have white fingertips,” she says. “It’s freaky.”

In a typical episode, the tips of the fingers and toes turn bone-white, then a bruise-like blue, then fiery red. The last phase, considered part of normal recovery, is generally the only uncomfortable stage and one of the reasons people turn to medications to manage symptoms, which range from an itchy, pinpricked sensation to outright numbness.

You’re more likely to have primary Raynaud’s if you experience these kind of attacks before the age of 40, and have no other symptoms and normal blood work. You are also more likely to learn to monitor your triggers—an easy thing to do in summer, right?

Actually, an episode of Raynaud’s is more likely to occur during the warmer months, judging from comments on support blogs. Summer opens up another set of triggers, like picking up a cold soda, reaching into the freezer, or sitting in an air-conditioned theater.

In certain occupations, Raynaud’s is taken in stride. Those who work with pneumatic drills, for instance, call it “vibration-induced white finger.” For concert pianists and violists, it can derail a career for good. Data-entry clerks often have to look for other forms of work.

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