Summary

• Raynaud's phenomenon (RP) is common, affecting between 1% and 3% of the population.
• The diagnosis is made clinically: digits turn white (pallor) then blue with deoxygenation and/or red with reperfusion; pallor is well demarcated.
• Primary RP often needs no pharmacological treatment. Keeping warm, smoking cessation, regular exercise, and avoiding stress are recommended.
• Secondary RP can be severe, especially when associated with scleroderma. Other connective tissue diseases, malignancy, and atherosclerosis may also be the underlying cause.
• In secondary RP, calcium channel blockers, angiotensin receptor antagonists, ACE inhibitors, SSRIs, systemic and topical nitrates, phosphodiesterase-5 inhibitors, and prostacyclins are recommended treatment options.
• Complications in secondary RP include severe digital ischaemia, gangrene, digital ulcers, and infection.
• Pain relief and complementary therapies are important adjunctive treatments.