Managing Raynaud's phenomenon: a practical approach.

Raynaud's phenomenon is characterized by vasospasm of the digits, most commonly the fingers, although the toes, ears, nose and even the tip of the tongue may be involved. The disorder is commonly precipitated by exposure to cold, although vasoconstrictive drugs and emotional distress may be triggers. Patients with Raynaud's phenomenon should avoid these triggers. Behavioral therapies, including stress management, relaxation training and biofeedback, are effective in some patients. When lifestyle changes fail to control symptoms, medications may be prescribed to correct various underlying pathophysiologic mechanisms. Medications that may be effective include calcium channel blockers, angiotensin converting enzyme inhibitors, alpha-adrenergic blockers, pentoxifylline, dipyridamole and low-dose acetylsalicylic acid.