Scleroderma is an autoimmune disorder that affects the connective tissues of the body. This disease can affect multiple different parts of the body, resulting in different symptomology and, sometimes, different approaches to treatment. Scleroderma results from an overproduction and accumulation of collagen in the body’s tissues. This accumulation hardens and tightens the skin and connective tissues, oftentimes causing a loss of flexibility, joint pain, stiffness, and swelling. Generally, scleroderma only affects the skin, but it can affect internal structures such as blood vessels, the digestive tract, and other internal organs. The damage caused by internal scleroderma is often has more serious complications than if the disease is concentrated to the external skin. Scleroderma typically affects women more often than men, and affects individuals of African American or Choctaw Native Americans more than Americans of European descent.

While the signs and symptoms of scleroderma vary depending on which parts of the body are impacted, there are a few areas that are more commonly affected than others.

• External skin: Almost all cases of scleroderma involve the patient reporting a hardening and/or tightening of patches of skin. The severity of the condition will determine the quantity and appearance of affected areas. The tightening of the skin can cause the skin to appear shiny and irritated, while movement may be restricted.
• Digestive system: Individuals with scleroderma that reaches their digestive system will report issues with acid reflux, indicating that the tissues of the esophagus nearest the stomach are being damaged. Additionally, problems with nutrient absorption (AKA malabsorption) can result from intestinal muscles that are impaired and unable to properly pass food through the digestive tract.
• Fingers and toes: One early indicator of scleroderma is the intensified response to cold temperatures and/or emotional stress. The hands and feet will sometimes become numb, with a noticeable change to the coloration of affected areas. Occasionally, ulcers can develop on the hands and feet of individuals with scleroderma.
• Lungs, heart, and kidneys: It’s rare when scleroderma affects the tissues and functions of the heart, lungs, or kidneys. However, if the disease does progress to these areas, the condition can become life threatening and immediate medical assistance may be necessary.

The overproduction of collagen seems to be associated with the body’s own immune system, but the exact cause of the condition is currently unknown. While there is no definite cure for scleroderma, there are various methods and treatments that can help individuals better cope with the symptoms that may arise. The symptoms of scleroderma can range from mild to severe, with the potential to affect the fingertips, lungs, kidneys, heart, teeth, digestive system, and reproductive system. Occasionally, the symptoms associated with scleroderma fade away on their own after two to five years. However, if an individual has the type of scleroderma that affects an internal organ system, symptoms typically worsen with time rather than fading away.

If you or someone you know notices that they are experiencing any of the symptoms listed above, it may be necessary to acquire a referral to a rheumatologist. However, because of the versatile nature of scleroderma, more than one kind of treatment may be necessary to address all the symptoms and underlying causes.

Self Help

While one cannot control whether or not they have scleroderma, there are lifestyle choices and home remedies that can help alleviate or better manage symptoms.

• Staying active: Keeping the body flexible and ensuring good circulation can relieve the stiffness and joint immobility that can come with scleroderma. Regular exercise can help one remain fit and, in some cases, more comfortable.
• Treat your heartburn. Constant heartburn and acid reflux can cause serious damage to the lining of the esophagus. Avoid foods that aggravate symptoms of heartburn or indigestion. If the heartburn is especially severe, elevating the head of the bed while sleeping may keep stomach acid from making its way into your esophagus.
• Protect yourself from the cold. Scleroderma often affects the fingers and toes, making them especially vulnerable to cold temperatures. Wear mittens to protect your hands from cold weather exposure. If the symptoms of scleroderma are especially acute, it may be advisable to wear protection on the hands when reaching into the freezer.
• Quit smoking. The nicotine in cigarettes and other tobacco products causes the blood vessels to contract, making the damage done to the extremities more severe. Nicotine may also permanently contract the blood vessels. Quitting a nicotine habit can be the first proactive step one can take to help manage their symptoms.

Western Treatments

Currently, no single medication or treatment exists to treat the overproduction of collagen—the underlying cause of scleroderma. For this reason, it’s common for practitioners in the Western world to prescribe different medications to address the different symptoms that a patient may be experiencing. These medications can include drugs that dilate blood vessels, suppress the immune system, reduce stomach acid, prevent infection, and alleviate pain. While surgery is only needed in the most extreme cases, other types of Western therapies include occupational or physical approaches to help increase overall mobility and manage pain.

Treatments based in TCM Practices

A 39-year-old African American woman with a diagnosis of scleroderma and issues with her digestive system and colon, suspected of being Crohn’s disease, was looking for complimentary treatment options to address her more severe symptoms. She complained of arthritis in the knees, pain in her left abdomen, and the feeling of constantly having to use the restroom. Traditional Chinese diagnosis revealed that her pulse was fast and her tongue red. She was given two herbal mixtures—one including red peony root, tang kuei root, ligusticum root, cooked rehmannia root, persica kernel, white atractylodes rhizome, poria sclerotium, citrus peel, silver root, and vitex fruit. The other mixture contained isatis extract leaf & root, oldenlandia herb, lonicera flower, prunella herb, andrographis root, and laminaria leaf. When combined, these herbal mixtures helped clear toxins, tonify the kidney, and alleviate pain. After one week, the patient reported having more energy, less pain, and less urgency to go to the restroom.