Signs and Symptoms

• Raynauds phenomenon – reversible digital ischaemia, with classic triphasic colour change, due to digital arterial vasospasm
• Common – ~10% of the population, females>males
• Usual age of onset 20-40yrs
• 90% is idiopathic or Primary
• Secondary Raynauds can occur in SLE, Sjogren`s, Scleroderma & other Autoimmune Rheumatic Diseases
• Patient information

• FBC RFT LFT
• PV, CRP
• ANA (add ENA & DsDNA if ANA positive)
• Blood Pressure & urinalysis

• Review precipitating factors - B blockers, cigarettes, recreational drugs
• Keep arms & whole body warm
• Gloves, heated gloves
• Occupational health assessment if vibrating machinery involved
• Nutrients such as Vitamin C (ascorbic acid) 500 - 1000mg daily & Vitamin E (tocopheryl acetate) 200 - 400mg daily and Gamolenic Acid (GLA) approx 320mg daily (found in evening primrose, starflower and linseed/flaxseed oils & Omega-3 fish oils)
• Medications licensed for Raynauds: nifedipine. Unlicensed medication but may be helpful: lisinopril, losartan, sildenafil (now off patent and much cheaper), fluoxetine
• Regular moisturising for painful skin fissuring; consider Diprosalic ointment or Haelan Tape

Long-term Condition Self-Management Programme

GPs and patients can refer to Improving Lives Plymouth for patient support with any long-term physical or low level mental health condition. The service helps people to better manage their condition and to achieve a better quality of life.

Referral Criteria

Please refer if

• Onset over aged 40
• Not responding to Primary Care Treatments
• Evidence of Autoimmune Rheumatic Disease
• Digital ulceration
• (Refer to Vascular Surgeons if unilateral Raynauds)

Refer to Long Term Conditions Self-Management Programme

• Email: self-management@improvinglivesplymouth.org.uk
• Phone: 01752 201892
• Include a contact email address

Patient Information

Improving Lives Plymouth - Long Term Conditions Self-Management Programme

Pathway Group

This guideline has been signed off on behalf of NHS Devon.

Publication date: February 2017
Updated: October 2018