Treatment for Skin Thickening

Nitroglycerin is a rapidly acting nitrate and is used as an ointment (Nitro-Bid, Nitrol, Nitrong, Nitrostat) to treat hardened skin. Before applying it, any ointment that remains from the previous application should be removed.

Phototherapy

UVA-1 Phototherapy. Phototherapy (light therapy), specifically an approach called ultraviolet A-1 (UVA-1) radiation, is now considered the treatment of choice for local scleroderma by some experts. This treatment produces long UVA wave lengths that do not promote sunburn and may actually repair DNA in damaged skin cells. Research suggests that UVA-1 therapy blocks inflammatory immune factors and the process leading to overproliferation of collagen, addressing the underlying mechanisms of scleroderma. The procedure is effective for all stages of morphea and increases skin elasticity and, and in some cases, achieves complete clearance of symptoms. In one small study, patients with localized scleroderma received 30 treatments over a period of 12 weeks. In a majority of the patients, 80% of the skin patches disappeared or significantly improved. There were no side effects.

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UVA-1 phototherapy is quite expensive and requires a special light source not readily available everywhere. In addition, studies are reporting an increased risk with UVA radiation. Whether this applies to UVA-1 phototherapy is not yet clear. Nonetheless, phototherapy is still an effective and important treatment of scleroderma. It may prove to be even more beneficial when combined with certain medications, such as calcipotriene (Dovonex) a form of vitamin D3.