Adults
Primary Raynaud's phenomenon
Symmetric color change of the fingers starting in youth, with no tissue injury, a negative ANA and normal nailfold capillaries.
What to look for
- Onset usually between 15 and 30, symmetric episodes (white, then blue, then red)
- No pitting, ulcers or puffy fingers
- Negative or low-titer ANA and normal nailfold capillaries
What to do
- Keep the whole body warm, use gloves, stop smoking, and avoid vasoconstrictors.
- A dihydropyridine calcium channel blocker (nifedipine or amlodipine) helps frequent attacks.
Refer if
- Secondary features appear: digital ulcers or pitting, a positive specific antibody, abnormal capillaries, onset after about 30–40, or asymmetry
About this urgency level
Common in referral queues. Many can be managed in primary care with the guidance below, though some rheumatology practices are happy to see them. A pre-referral e-consult can help decide.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.