Some people who have mild scleroderma may not need medication and some people can go off treatment when their scleroderma stops being active. Sometimes the skin symptoms associated with scleroderma fade away on their own in a few years, while the type of scleroderma that affects internal organs usually gets worse over time.
There are no drugs available that can cure or stop the process of scleroderma, but there are several categories of medications that can control symptoms or help prevent complications. These include blood pressure drugs to help with lung and kidney problems; immune suppressants; antacids for acid reflux; antibiotics to fight infection caused by ulcers on the fingertips and over-the-counter pain relievers (or prescription pain killers).
Because scleroderma can cause such a wide range of health issues, there are several categories of medication depending on the individual’s symptoms. Itchy skin can be relieved with over-the-counter lotions or prescription lotions containing cortisone. Raynaud’s phenomenon is typically treated with vasodilators such as calcium channel blockers and statins; ulcers on the fingers and toes are treated with iloprost or sildenafil; antacids or prokinetics like omeprazole are typically given for acid reflux; and severe kidney problems are treated with angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists.
If the person has secondary infection or malnutrition due to an overgrowth of bacteria in the intestines, antibiotics like tetracycline are given. Drugs that suppress the immune system may also be used, such as azathioprine, methotrexate, cyclophosphamide, mycophenolate, intravenous immunoglobulin and rituximab. Any increase in blood pressure must be taken very seriously, as this can lead to kidney failure. In these cases, blood pressure drugs in the angiotensin converting enzyme (ACE) inhibitor category, such as lisinopril, are frequently used.
Alternative therapies for scleroderma include massage, biofeedback, hypnotherapy, nutritional support, stress management (such as self-hypnosis and meditation), and hand warming and protection.