Treatment and Prevention
There is no cure for scleroderma. However, there are medications that can reduce symptoms and organ damage. Pulmonary hypertension, for example, can usually be well controlled.
Limited scleroderma is usually treated with topical (applied to the skin) treatments such as moisturizers or topical corticosteroid creams. Generalized scleroderma (involving the internal organs) may be treated with medications that improve blood flow, promote esophagus and bowel function, keep the kidneys functioning, and control high blood pressure.
Here are some recommendations to reduce the risk of problems caused by Raynaud's phenomenon:
- Keep warm in cold weather by dressing appropriately (e.g., wear gloves or mittens).
- Try to avoid stressful situations, as stress can trigger an attack.
- Avoid or quit smoking because the nicotine found in cigarettes can decrease skin temperature and cause blood vessels to narrow.
- Exercise to keep the body flexible and improve blood circulation. Range of motion exercises can help keep skin and joints flexible. Physical and occupational therapy may also be helpful.
Medication treatment with calcium channel blockers may be prescribed to treat Raynaud's phenomenon. They work by causing blood vessels to expand, and this improves blood flow in the skin. Symptoms such as joint stiffness and pain can be relieved with anti-inflammatory medications such as aspirin*, NSAIDs (nonsteroidal anti-inflammatory drugs), or corticosteroids. Certain medications called DMARDs (disease modifying antirheumatic drugs) are often prescribed along with NSAIDs. Both help reduce joint inflammation. Another class of medications called immunosuppressants may be used to suppress the immune system and prevent inflammation.
For digestive problems associated with scleroderma, antacids and antibiotics (as prescribed by a doctor) may be helpful. The classes of medications known as H2 blockers and proton pump inhibitors can help reduce damage due to gastroesophageal reflux. The esophagus can begin to narrow, and may have to be physically stretched from time to time with an inflatable tube device called a balloon catheter.
Antibiotics can prevent bacterial infection of damaged parts of the intestines. Kidney problems used to be the major cause of death in scleroderma, but medications called ACE inhibitors can help prevent life-threatening high blood pressure caused by kidney damage related to scleroderma. In the case of complete renal (kidney) failure, a dialysis machine may be needed.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Jonathan Kantor, M.D., North Florida Dermatology Associates, Jacksonville, FL. Review provided by VeriMed Healthcare Network.