The goal of treatment for scleroderma is to improve your quality of life. There is no cure for this disease and no treatment to stop it from progressing. However, newer medications that treat the complications of scleroderma have dramatically improved the quality of life for many patients.

Scleroderma rarely affects two people in the same manner. Therefore, treatment programs are based on each patient's needs. It is not possible to list every treatment that may be used for patients with scleroderma, but in general, treatment consists of drugs and lifestyle changes to manage symptoms.

Several drugs have been used in efforts to alter the course of scleroderma. Because it is an uncommon disease that can affect each patient differently, information about drug effectiveness in treating scleroderma is based, at times, on studies with only a few patients. Larger studies are often needed before conclusive results can be given.

To read more about the medications below and their side effects, please click on the underlined drugs.

Drugs for scleroderma

D-penicillamine decreases immune system activity and interferes with collagen production, and some studies have shown that using it to treat diffuse scleroderma results in skin softening and reduced organ damage. However, studies are inconclusive and its use has declined in recent years. In addition, the drug has been linked to many serious side effects, including kidney and blood cell damage, so patients who use this drug over a long period of time should be tested regularly.

Since systemic scleroderma is thought to result in part from an overactive immune system, another group of drugs used to treat it are immunosuppressive medications such as methotrexate, hydroxychloroquine, azathiorprine, and cyclophosphamide. These drugs decrease the activity of the immune system, and each of them can cause serious side effects. Regular testing is recommended for patients using an immunosuppressant drug long-term.

Drugs to treat related problems

Drugs may also be used to treat the typical ailments associated with scleroderma.

Low doses of prednisone may help reduce inflammation in joints. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) may also be used to help reduce joint inflammation, pain and swelling.

Proton-pump inhibitors reduce the amount of acid produced in the stomach. Drugs in this class help reduce symptoms such as heartburn. Broad-spectrum antibiotics may control diarrhea caused by bacterial overgrowth.

Calcium-channel blockers and ACE-inhibitors help manage kidney problems caused by scleroderma. Calcium-channel blockers are also helpful in managing a blood vessel problem called Raynaud's phenomenon, a condition in which blood vessels constrict, interfering with blood flow.

Cyclophosphamide may help to improve interstitial lung disease.

Excessive cold often triggers Raynaud's phenomenon. Therefore, it is important for patients with scleroderma to stay as warm as possible. Extra layers of clothing are usually most helpful. Stress can also touch off Raynaud's. Stress management programs such as biofeedback can help patients reduce the physical impact of stress. Patients should avoid smoking, which can aggravate Raynaud's and any lung disease that may be present.

Proper exercise helps improve muscle strength and conditioning. The tissue hardening in scleroderma can make skin and muscles around joints stiff and inflexible, but regular exercise can improve flexibility and keep joints in the fingers and elsewhere from hardening into a bent position. (Some patients with scleroderma, however, avoid water exercises because the cool water temperature aggravates Raynaud's phenomenon.) A physical therapist can help you identify an exercise program that's most beneficial for you.

Good skin care is important for patients with scleroderma. Using sun protection reduces skin damage that might further complicate the disease. Likewise, the use of a humidifier and/or creams to help keep the skin moist can reduce skin irritation. Creams can also reduce the itchiness that many patients with scleroderma experience.

Researchers continue to study the possible causes and treatments for scleroderma. Significant progress has been made in recent years, and in the future scleroderma may be more effectively treated, cured, and even prevented.

References

First published April 1, 2000
Last updated September 10, 2003
Copyright © 2000 Accordant Health Services, Inc. All Rights Reserved.

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