Lauren Graham, MD, PhD, from the Northwestern Department of Dermatology joined us in October to discuss ways to manage the skin in scleroderma patients. Topics included treatment of telangiectasia using laser lights, full coverage makeup, the scratch itch cycle, Raynaud’s, digital ulcers, and calcinosis.
Laser light treatment causes damage to the vessel and forces it to collapse and scar down so blood can no longer flow through the vessels. This can cause bruising and so Dr. Graham recommended talking to your doctor about which strength is best for you. She also noted that while a normal patient is typically happy with their results after 2 treatments, it could take 3-4 treatments for a patient with scleroderma to be satisfied. Insurance does not generally cover treating telangiectasia with laser lights, but it’s possible for your physician to appeal this decision.
There are multiple brands of makeup that offer full coverage and are recommended by many dermatologists. These include:
- Cover FX
- Cinema Secrets
- Microskin (only available in New York and California)
Dr. Graham also discussed the scratch itch cycle and had a few tips to help minimize the effects including:
- Keep your moisturizer in the fridge
- Cool water compress
- Buy fragrance free lotions and not unscented
- Ointments are the most effective moisturizers
- Having your doctor mix corticosteroids with Eucerin or CeraVe to lose some of the greasy texture
She specifically recommends Vaseline because it has the least amount of ingredients and is less likely to cause allergies.
For Raynaud’s Dr. Graham pointed out that some medications can make your symptoms worse. She discussed limiting your exposure to cold in places such as the freezer, grocery store, air conditioning, and while holding cold beverages. Another way to do this is by keeping gloves with you, wearing layers, using electric heaters, and not wearing cotton while working out because cotton gets cold when wet. Smoking is another trigger for worsening symptoms with Raynaud’s.
Digital Ulcers are worse when skin is stiff so it is important to keep moisturized. Dr. Graham recommended Bosentan because it can decrease the amount of new ulcers, but has no effect on existing ones. There has also been success with botox and localized digital sympathectomy. Other tips included avoiding infections, making sure your shoes aren’t too tight, and being honest about pain. Remember to visit the ER if your digits are blue/black.
Dr. Graham also talked about how there are 361 trials for Calcinosis, but many are for things other than Scleroderma.
Remember to always talk to your doctor about any possible treatments because they know what’s best for your condition.