By Xiaomei Cai, L.Ac., Ph.D. and Qineng Tan, L.Ac., Ph.D.
Hard, thickening, tight skin? Itchy, dry skin that is shiny? Changing skin color? These could be symptoms of scleroderma, an autoimmune disorder that causes your body to produce too much collagen. Acupuncture and TCM treatment can help relieve inflammation and pain while helping to resolve the underlying cause of scleroderma.
Scleroderma can be considered a type of dermatosis (skin lesion), and also a type of connective tissue disease (negatively impacting tissues that connect structures in the body), as it usually affects skin and cartilage, often starting in the extremities, and then extending up the limbs towards the trunk.
Collagen is a form of fibrous protein that the body produces to maintain the structure of skin cells, muscles, bones, and connective tissue. The immune system triggers collagen production when we are injured, but in the case of scleroderma, the body is overproducing and accumulating too much collagen.
Localized scleroderma affects primarily the skin tissue, but can also spread to subcutaneous tissues, like fascia and muscles.
In some cases, scleroderma can also impact internal organs, like the esophagus, lungs, heart, and kidneys. This is known as systemic scleroderma.
Top 3 Types of Scleroderma
Localized scleroderma can be differentiated into 3 types:
- Localized scleroderma – a few patches of discolored skin (circumscribed morphea); these skin lesions can vary in size, may be oval shaped, and are usually yellow in the center with a red border.
- Generalized scleroderma – also called generalized morphea, with this type there are more patches of thick, hard skin on various parts of the body, which may overlap.
- Linear scleroderma – more common in children, may show up as one band of affected skin on a limb or on the trunk, with a few patches of morphea. Linear scleroderma on arms and legs may affect the growth and development of that limb, as scleroderma may impact the muscle and bone tissues as well as the skin.
Systemic scleroderma is rare, but happens more commonly in women between the ages of 30 and 50. This type of scleroderma can manifest in different ways.
Systemic scleroderma can sometimes first show up as Raynaud’s phenomenon, or Raynaud’s syndrome, in which the blood vessels in the hands and feet close up when the weather is cold and cause color changes to the skin, as well as sensations of numbness, prickling, tingling, or pain. Stress can also trigger Raynaud’s.
Systemic scleroderma can cause scarring on the skin and internal organs, which can lead to gastrointestinal problems like acid reflux, cardiovascular and pulmonary problems, or renal disease.
Acupuncture treatment can be used as an adjunct treatment to help relieve symptoms of pain related to skin hardening, as well as helping to alleviate heartburn and GERD type symptoms in patients with esophageal symptoms of scleroderma. TCM can also help address the root causes of scleroderma and other autoimmune disorders.
What Causes Scleroderma?
As with most autoimmune disorders, medical science has not yet discovered exactly why some people develop this condition. While it is not passed from parent to child the way genetic diseases are, you are more likely to have scleroderma if someone else in your immediate family has it, too.
It is believed that factors like environmental toxins and/or viral infections can trigger scleroderma symptoms to flare up. The overproduction of collagen is due to abnormal functioning of the immune system.
Because women develop scleroderma more often than men do, it may be that there is a hormonal factor that affects the disease, as well.
Diagnosis and Medical Treatment for Scleroderma
There is no cure for scleroderma, so conventional medical treatments aim to alleviate symptoms and slow down the progression of the disease. The treatment plan may vary depending on the specific manifestations and severity of the disease.
To diagnose scleroderma, doctors rely on a combination of clinical assessments, medical history review, physical examinations, and lab tests. A doctor will first observe skin changes, such as thickening and hardening, then look for internal organ involvement and other symptoms.
Blood tests can help identify specific antibodies associated with scleroderma, such as antinuclear antibodies (ANA), anti-centromere antibodies (ACA), and anti-Scl-70 (anti-topoisomerase I) antibodies. Additionally, blood tests can assess organ function, including kidney and liver function, as well as inflammatory markers.
X-rays, ultrasound, or CT scans may be used to evaluate internal organ involvement, such as lung fibrosis, gastrointestinal complications, and cardiac abnormalities.
A skin biopsy sample may be taken to confirm the presence of fibrosis and assess the degree of inflammation.
Medications that may be recommended for treating scleroderma symptoms include:
- Immunosuppressants: Medications such as methotrexate, mycophenolate mofetil, and azathioprine may be prescribed to suppress the immune response and reduce inflammation.
- Corticosteroids: Oral or topical corticosteroids can help manage inflammation and alleviate symptoms in certain cases. However, long-term use may have potential side effects and is usually minimized.
- Vasodilators: Medications like calcium channel blockers and prostacyclin analogs may be prescribed to improve blood flow and manage Raynaud’s phenomenon.
- Proton pump inhibitors (PPIs): These medications can help manage gastroesophageal reflux disease (GERD) symptoms, which are common in scleroderma patients.
Patients are often advised to make lifestyle changes to manage their condition effectively. These may include:using skin moisturizers and avoiding excessive sun exposure, and using sunscreen with a high SPF, avoiding cold temperatures and stress to prevent triggering Raynaud’s, quitting smoking, and eating an anti-inflammatory diet.
Can Acupuncture Help Scleroderma?
TCM treatment for scleroderma focuses more on addressing the underlying causes of the condition, rather than simply trying to relieve symptoms. An acupuncturist will look closely at the whole person, listen carefully to hear all the symptoms they are experiencing, even those which may seem unrelated, feel their pulse and make other observations, and then ascertain which diagnostic pattern may apply.
According to TCM theory, scleroderma symptoms may occur due to:
- Blood stagnation
- Yang deficiency
- Kidney Qi deficiency or yang deficiency
- Liver and Gallbladder damp heat
- Liver blood deficiency
- Liver win
- Spleen yang deficiency
- Stagnation of cold, wind, and/or damp
Depending on the diagnosis, the TCM practitioner will then plan a treatment protocol to address the root cause, using acupuncture and herbs. For example, herbs can help move stagnant blood, relieving the skin conditions related to scleroderma. Herbs can even help to inhibit collagen production, to help reduce skin hardening.
Acupuncture has been shown to help reduce the number of Raynaud’s attacks.
Moxibustion treatment may also be used to help relieve symptoms related to Raynaud’s phenomenon.
The use of acupuncture for stress relief is also integral to treatment for scleroderma, as stress can trigger a worsening of symptoms.
Acupuncture can help reduce esophageal reflux in cases where esophageal strictures have developed due to scleroderma in the digestive tract and help improve kidney function when kidneys have been impacted by fibrosis.
TCM herbal formulations for scleroderma will be individualized for each patient’s needs. Herbs may be used to help warm and nourish the organs, while clearing dampness and activating stagnant blood and Qi.
Acupuncture Near Me for Scleroderma in Los Angeles
Acupuncture and TCM herbal medicine can be excellent modalities for helping with difficult to treat skin conditions, connective tissue disorders, and autoimmune disorders, including:
- Rheumatoid Arthritis
- Herpes simplex
- Hives, urticaria
- Ehlers-Danlos syndrome (EDS)
If you are experiencing painful skin problems or digestive problems, consider seeking out alternative care in addition to conventional treatments.
*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.