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SKIN

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Skin thickening
Hardening and thickening of the skin give scleroderma its name (“hard skin.”) There are no proven treatments as yet to prevent or alter the course of the skin changes in scleroderma. Many medications and treatments are being tested. The skin sometimes softens spontaneously over time.


Skin ulcerations
Sores, especially on the fingertips, are a common symptom of systemic scleroderma. They may be very slow or difficult to heal because of poor circulation. These sores or ulcerations may also occur on the knuckles, elbows, toes or other sites of the body where the skin is especially tight or stretched. The affected area should be kept warm to increase blood flow and carefully cleaned to avoid infection. If an infection develops, it may help to soak the affected area in warm water, apply an antiseptic such as Betadine® or use an antibiotic ointment. Should these remedies prove unsuccessful in relieving the pain or infection of ulcerated skin, your doctor may prescribe oral antibiotics or take other measures.


Calcinosis
This condition is characterized by deposits of calcium in the skin, which may be painful. The calcium deposits may occur just below the skin surface in the form of hard lumps or nodules. They may break through the skin, becoming visible as chalky white material, and may become infected. Care should be taken not to bump or injure affected areas. Warm-water soaks may be helpful. Antibiotics may be prescribed to prevent or control infection. In severe cases, surgery to remove calcium deposits may be required.


Telangiectasia
This abnormality consists of the dilation of small blood vessels near the surface of the skin, which become visible as small red spots, usually on the fingers, palms, face and lips. The spots usually fade with pressure, but turn red again when the pressure is released. These spots generally are not harmful. Special make-up may be used to mask the spots or to reduce their visibility.


Dry skin
Excessive dryness of the skin may lead to skin breakdown and ulcerations. Excessive bathing and hand washing should be avoided, and rubber gloves worn to avoid direct contact with household detergents. Keeping the skin moist and well-lubricated is important to avoid complications from dry skin. Bath oils and moisturizing soaps are preferable to harsh soaps which dry out the skin. Frequent use of moisturizing skin creams containing lanolin is advised. During the winter months, a humidifier may help.


Itchy skin
Pruritus, or itchy skin, is caused by irritation in the skin from the underlying inflammatory process associated with scleroderma. If moisturizing creams do not work, your doctor may prescribe a topical cortisone cream to rub on the skin to relieve itching. Antihistamines have been effective for some people.


Other skin symptoms
There may be a decrease in hair over affected areas of the skin, as well as a decrease in the ability to sweat. In addition, there may be an increase in pigment (which looks like a skin tan) or a spotty loss of pigment.

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