...less medical jargon in a 'Quick Glance' format!
Scleroderma has no known cure — there's no treatment to stop the overproduction of collagen. Your doctor may recommend a number of medications to make it easier for you to live with scleroderma by treating its symptoms. Your doctor may also suggest medications to prevent complications of scleroderma that may affect various organs. Here are some of the many treatments prescribed for the symptoms and complications of this condition.
. . . Skin changes
If you have localized scleroderma, your doctor may recommend a topical treatment, such as a moisturizer or corticosteroid medication that you apply to your skin. Corticosteroid medications impede your body's ability to make substances that can cause inflammation.
If your condition involves a large area of skin, your doctor may recommend additional treatments. Doctors sometimes prescribe minocycline (Minocin, Dynacin) to control the skin-related symptoms of scleroderma, although no studies have addressed its long-term effectiveness. In preliminary studies, light therapy also has proved effective in treating the lesions that are associated with scleroderma, but more research is needed.
Cosmetic treatments are another consideration. Some people with scleroderma are discouraged or embarrassed by lesions and marks on the skin, including tiny dilated blood vessels that often appear on the face. Specialized brands of foundation makeup and pulsed dye laser surgery can help camouflage or eliminate these lesions. Consult a dermatologist about treatments for skin changes.
. . . Circulation problems
As part of your scleroderma treatment, your doctor may also prescribe medications to dilate blood vessels and promote circulation. These medications can prevent high blood pressure and kidney problems and help treat Raynaud's phenomenon.
Medications that help with blood circulation include:
Calcium channel blockers
Angiotensin-converting enzyme inhibitors
Angiotensin II receptor blockers
Low-dose enteric-coated aspirin
Creams containing nitroglycerin also may help promote circulation.
. . . Joint stiffness, pain and inflammation
As part of your scleroderma treatment, your doctor may prescribe anti-inflammatory medications such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose corticosteroids to relieve joint pain and stiffness.
Often, along with NSAIDs, doctors prescribe certain medications called disease-modifying antirheumatic drugs (DMARDs). These medications seem to do their job by having an effect on immune systems that have gone out of control, but doctors don't understand exactly how DMARDs work. Common DMARDs include:
Hydroxychloroquine (Plaquenil). This drug has relatively few side effects, and it's also effective for the arthritis that can be associated with scleroderma. Apart from hydroxychloroquine's apparent ability to affect the way immune cells work, scientists don't completely understand how it helps tame the disease process.
Penicillamine (Cuprimine, Depen). Similar to other DMARDs, penicillamine can reduce inflammation. Its full effect may require many months to develop, but its beneficial effects may be longer lasting. However, because of a relatively high incidence of adverse reactions to this drug and studies casting doubt on its effectiveness, its use has declined in recent years.
Methotrexate (Rheumatrex, Trexall). This drug does its job by affecting cells that are responsible for some of the pain, inflammation and joint swelling that accompany scleroderma. Trials have shown conflicting results regarding the effectiveness of methotrexate in treating scleroderma.
Immunosuppresents are another class of medications that can help manage out-of-control immune systems. Cyclophosphamide (Cytoxan) is one example. This extremely potent medication works by damaging cells' genetic information. In particular, it kills white blood cells called lymphocytes that are part of autoimmune disease.
. . . Lung damage
As part of your scleroderma treatment, you may need additional medications if your scleroderma affects your lungs. Cyclophosphamide (Cytoxan) is sometimes used to treat pulmonary fibrosis. A 2006 study of people with scleroderma-related lung disease found cyclophosphamide modestly improved lung function and quality of life. The long-term effects of cyclophosphamide treatment in people with scleroderma are unknown. Bosentan (Tracleer) is an oral medication that has been approved for pulmonary hypertension in people with scleroderma.
. . . Digestive difficulties
If scleroderma has affected your esophagus and you're experiencing heartburn, your doctor may suggest prescription medications that decrease stomach acid production. These medications include H-2-receptor blockers and proton pump inhibitors. Your doctor may also suggest antibiotics, special diets and medications that improve your gut's ability to contract.
Scleroderma Treatment . . . What you can do
You can take a number of steps to help manage your symptoms of scleroderma:
Stay active Exercise keeps your body flexible, improves circulation and relieves stiffness. Range-of-motion exercises can help keep your skin and joints flexible.
Don't smoke Nicotine causes blood vessels to contract, making Raynaud's phenomenon worse. Smoking can also cause permanent narrowing of your blood vessels. Quitting smoking is difficult — ask your doctor for help.
Manage heartburn Avoid foods that give you heartburn or gas. Also avoid late-night meals. Elevate the head of your bed to keep stomach acid from backing up into your esophagus as you sleep. Try over-the-counter antacids for relief of symptoms.
Protect yourself from the cold Wear warm mittens for protection when your hands encounter cold temperatures — such as when you reach into a freezer. When you're outside in the cold, cover your face and head and wear layers of warm clothing.