See how Botox is easing the pain of Raynaud’s phenomenon

Holly Shilstone, a Houston native, is all too familiar with the struggles of living with Raynaud’s phenomenon. For years, even a slight drop in temperature would cause her fingers to become cold, discolored and painful. She was in her 20s when a colleague noticed Shilstone’s unusually white, cold hands during a handshake and identified her condition.

Raynaud’s is a condition that affects blood flow to certain parts of the body – usually the fingers and toes – causing them to turn white or blue in response to cold or stress. It can be uncomfortable and even painful. This occurs when small blood vessels narrow more than they should, limiting circulation. It can occur on its own (primary Raynaud’s) or because of underlying conditions like autoimmune diseases, certain medications or repetitive trauma (secondary Raynaud’s).

“I remember one time going skiing with my family and having a severe episode,”  Shilstone said. “Despite wearing appropriate gloves and hand warmers on the slope, I just couldn’t get my hands to settle down and had painful, cold and white fingers. That was tough because I grew up loving to ski and that was the last time I went skiing. I ended up having to consult with my Houston doctors to help get through the ski trip.”

While treatment traditionally includes lifestyle changes, medications and, in severe cases, surgery, an innovative option offers relief: Botox injections. Although widely known for its cosmetic applications, Botox is increasingly being recognized as an effective treatment for Raynaud’s phenomenon. While not entirely new, it remains a less common option that is gaining attention for its ability to provide significant relief for patients, including Shilstone.

“My life changed with these treatments,” Shilstone said. “As soon as I started Botox, I’ve had little to no symptoms. The effect was nearly instant, with no pain during or after injections.  With our son’s football events, there was a significant noticeable change, and I was able to get through games during the colder weather with no issues.”

With both her sons playing sports, Shilstone is outdoors a lot. And having treatments that allow her to be more comfortable in cooler temperatures has been life changing.

“Before treatment, my fingers would turn white, blue, and even purple, which would be noticeable to others and, at times, painful,” Shilstone said. Her experience is not unique. With the help of Dr. Christine Yin, a Baylor Medicine plastic hand surgeon, patients like Shilstone are finding relief from Raynaud’s symptoms through this treatment.

How Botox helps

Botox relieves symptoms caused by Raynaud’s by temporarily relaxing smooth muscle in blood vessel walls. This relaxation improves blood flow to the hands and feet, alleviating symptoms such as pain and discoloration.

“Botox is a game-changer for many patients with Raynaud’s,” said Yin, assistant professor of surgery in the Division of Plastic Surgery. “By improving blood flow, it provides not only functional benefits but also greatly enhances quality of life by reducing symptoms.”

What to expect during the procedure

Botox injections for Raynaud’s are performed in a clinical setting and typically take about 10 minutes.

“We use small, targeted injections in the affected areas,” Yin said. “Patients often begin to notice improvement within a few days, with full effects appearing after a couple of weeks.”

Though the treatment only lasts three to six months, it is a minimally invasive procedure that requires little downtime, making it a convenient treatment option for those seeking relief.

Who is a candidate?

Botox injections may benefit patients with moderate to severe Raynaud’s who have not responded to other treatments or who do not want to take medication or have surgery.

“I’m very glad this option was introduced to me a few years ago by a plastic hand surgeon. It has changed my life and enabled me to do more outdoor activities with my family and friends,” Shilstone said.

By Tiffany Harston, senior communications specialist in the Michael E. DeBakey Department of Surgery