Signs and symptoms of Raynaud's disease include:

• Cold fingers or toes
• Color changes in your skin in response to cold or stress
• Numb, prickly feeling or stinging pain upon warming or stress relief

During an attack of Raynaud's, affected areas of your skin usually first turn white. Then, they often turn blue and feel cold and numb. As you warm and circulation improves, the affected areas may turn red, throb, tingle or swell.

Although Raynaud's most commonly affects your fingers and toes, it can also affect other areas of your body, such as your nose, lips, ears and even nipples. After warming, it can take 15 minutes for normal blood flow to return to the area.

Doctors don't completely understand the cause of Raynaud's attacks, but blood vessels in the hands and feet appear to overreact to cold temperatures or stress.

Blood vessels in spasm

With Raynaud's, arteries to your fingers and toes go into vasospasm when exposed to cold or stress, narrowing your vessels and temporarily limiting blood supply. Over time, these small arteries can thicken slightly, further limiting blood flow.

Cold temperatures are most likely to trigger an attack. Exposure to cold, such as putting your hands in cold water, taking something from a freezer or being in cold air, is the most likely trigger. For some people, emotional stress can trigger an episode.

Primary vs. secondary Raynaud's

There are two main types of the condition.

• Primary Raynaud's. Also called Raynaud's disease, this most common form isn't the result of an associated medical condition. It can be so mild that many people with primary Raynaud's don't seek treatment. And it can resolve on its own.
• Secondary Raynaud's. Also called Raynaud's phenomenon, this form is caused by an underlying problem. Although secondary Raynaud's is less common than the primary form, it tends to be more serious.

Signs and symptoms of secondary Raynaud's usually appear around age 40, later than they do for primary Raynaud's.

Causes of secondary Raynaud's include:

• Connective tissue diseases. Most people who have a rare disease that leads to hardening and scarring of the skin (scleroderma) have Raynaud's. Other diseases that increase the risk of Raynaud's include lupus, rheumatoid arthritis and Sjogren's syndrome.
• Diseases of the arteries. These include a buildup of plaques in blood vessels that feed the heart (atherosclerosis), a disorder in which the blood vessels of the hands and feet become inflamed (Buerger's disease), and a type of high blood pressure that affects the arteries of the lungs (primary pulmonary hypertension).
• Carpal tunnel syndrome. This condition involves pressure on a major nerve to your hand, producing numbness and pain in the hand that can make the hand more susceptible to cold temperatures.
• Repetitive action or vibration. Typing, playing piano or doing similar movements for long periods and operating vibrating tools, such as jackhammers, can lead to overuse injuries.
• Smoking. Smoking constricts blood vessels.
• Injuries to the hands or feet. These include wrist fracture, surgery or frostbite.
• Certain medications. These include beta blockers, used to treat high blood pressure; migraine medications that contain ergotamine or sumatriptan; attention-deficit/hyperactivity disorder medications; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications.

Risk factors for primary Raynaud's include:

• Sex. More women than men are affected.
• Age. Although anyone can develop the condition, primary Raynaud's often begins between the ages of 15 and 30.
• Climate. The disorder is also more common in people who live in colder climates.
• Family history. A first-degree relative — a parent, sibling or child — having the disease appears to increase your risk of primary Raynaud's.

Risk factors for secondary Raynaud's include:

• Associated diseases. These include conditions such as scleroderma and lupus.
• Certain occupations. These include jobs that cause repetitive trauma, such as operating tools that vibrate.
• Exposure to certain substances. This includes smoking, taking medications that affect the blood vessels and being exposed to certain chemicals, such as vinyl chloride.

If secondary Raynaud's is severe — which is rare — diminished blood circulation to your fingers or toes could cause tissue damage.

A completely blocked artery can lead to sores (skin ulcers) or dead tissue (gangrene), both of which can be difficult to treat. Rarely, extreme untreated cases might require removing the affected part of your body (amputation).