Unfortunately, no medication currently exists that can cause the fibroblast cells to stop producing too much collagen in people with scleroderma. Except for immunosuppression, treatments for scleroderma are symptomatic. Individuals with scleroderma are usually placed under the care of a rheumatologist, a medical professional who specializes in autoimmune diseases. A person with systemic scleroderma may have to consult with many different medical specialists, such as gastroenterologists and dermatologists, as symptoms arise.
People with scleroderma who have thick, dry skin due to excess collagen build-up can take steps to try to soften their skin. Using moisturizing lotions frequently can help. Lotions should have some oil content and be applied after bathing or showering. Humidifiers can help keep skin from drying out. Mild soaps should be used for cleaning the skin, and hot water should be avoided.
Joint pain and stiffness due to arthritis or the skin around the joints being tight can be treated with special joint stretching exercises and over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as naproxen (Aleve) or acetaminophen (Tylenol) can help reduce joint swelling and pain. A physical therapist can instruct a person with scleroderma about how to stretch their joints so that maximum mobility is retained. These exercises should be done regularly to decrease joint stiffness.
People with gastrointestinal problems due to scleroderma, such as acid reflux, trouble swallowing or bowel problems, will usually be referred to a gastroenterologist. Prescription medications may be used to treat these problems. If a patient has severe gastrointestinal symptoms, they may need to eat a special diet. People with acid reflux should not eat right before bed, and it helps to eat smaller meals more frequently. Caffeine and alcohol consumption can worsen gastrointestinal problems.
The lungs are frequently affected in people with scleroderma. If a person has high blood pressure in the lungs, or pulmonary hypertension, medication may be prescribed to dilate the blood vessels in the lungs and reduce hypertension. In some cases, these medications are used to prevent kidney and lung problems in patients with systemic scleroderma. If the lung damage is caused by collagen deposits, this is called pulmonary fibrosis. A patient with pulmonary fibrosis may benefit from corticosteroids or immune suppression, although immune suppression increases a patient’s risk of developing an infection. Lung function is monitored frequently in patients with systemic scleroderma.
Raynaud’s phenomenon, or loss of circulation in the small blood vessels of the fingers and toes, is usually not a problem that requires treatment. However, some people with scleroderma have this symptom in a severe form that can cause sores and ulcers on the fingers. Medications that dilate the blood vessels may help in these severe cases. If you smoke, quitting smoking can improve both lung function and circulation to the hands and feet. Protecting your hands and feet from the cold can also improve this symptom.
People with scleroderma are more prone to dental problems such as tooth decay because the salivary glands may be affected by scleroderma. This causes a dry mouth and it makes it easier for bacteria to grow in the mouth. People with scleroderma should see a dentist regularly and maintain good oral hygiene. Drinking fluids and chewing gum (sugarless) can keep the mouth from becoming too dry. If dry mouth is severe, there are some prescription medications that can improve this symptom.
Heart problems in people with scleroderma can be treated with medications and, in some cases, surgery. Heart problems that may be complications of scleroderma include myocarditis, cardiomyopathy and arrhythmia. Kidney problems can often be prevented by treating hypertension; dangerously high blood pressure can lead to kidney failure. Hypertension can be treated with medications.
Patients with scleroderma may opt to treat telangiectasia, the small red spots that appear in some patients with systemic scleroderma, with laser treatments for cosmetic purposes. Cosmetic surgery can also be used for patients with facial skin involvement, as long as the disease is not currently active. If collagen is still being deposited in an area in which surgery is performed, the scarring can be worse.
In the future, research into scleroderma may provide a cure for the condition. Although this goal may be far off, current research is constantly coming up with results that can lead to better treatments for scleroderma. For example, a scientific study has identified some of the immune system’s signaling chemicals that lead fibroblasts to secrete collagen. If a drug could be developed to inhibit these signals, the main problem involved in scleroderma could be treated directly. Research also helps to improve symptomatic treatments, such as drugs to treat pulmonary hypertension, Raynaud’s phenomenon, renal hypertension and lung fibrosis. Genetic studies can determine which genes make a person more susceptible to developing scleroderma and, along with immune system research, they can provide insight into the causes of scleroderma.