Scleroderma (systemic sclerosis) is a connective tissue disease characterised by excessive collagen deposition in skin and internal organs. Localised forms affect only skin; systemic forms damage lungs, kidneys, heart, and gastrointestinal tract. Prognosis depends on extent and organ involvement. Treatment aims to slow fibrosis and manage complications.
No drug halts systemic sclerosis directly, but immunosuppressants—methotrexate, mycophenolate, azathioprine—slow skin and lung progression in some patients. ACE inhibitors protect kidneys from scleroderma renal crisis. Bosentan and ambrisentan, endothelin receptor antagonists, improve pulmonary hypertension and digital ulcer healing. Phosphodiesterase-5 inhibitors (sildenafil) treat pulmonary hypertension and vascularity. NSAIDs manage joint pain. Proton pump inhibitors address reflux. Physiotherapy maintains skin mobility and joint function. Lung and kidney screening are essential.
Herbal remedies, traditional Chinese medicine, and homeopathy are pursued by some; evidence is absent. Alternative medicine cannot replace immunosuppression or organ-protective therapy.
Stem cell therapy, particularly autologous haematopoietic stem cell transplantation (AHSCT), has shown promise in early-phase systemic sclerosis by resetting immune activity and reducing skin thickening and lung fibrosis progression. Clinical trials are limited; outcomes are variable. Mesenchymal stem cells are being studied for anti-fibrotic potential. Regenerative approaches are investigational; not standard.
| Option | Type | Evidence | Indicative cost | Invasiveness | Recovery |
|---|---|---|---|---|---|
| Methotrexate (Immunosuppressant) | Standard | Moderate | €50–120/month | Low | Weekly injection; slows skin thickening and lung involvement in some |
| Mycophenolate Mofetil (Immunosuppressant) | Standard | Moderate | €200–400/month | Low | Oral; slows lung fibrosis; monitoring required |
| ACE Inhibitors (Kidney Protection) | Standard | Strong | €30–80/month | Low | Daily oral; prevents renal crisis; essential in systemic sclerosis |
| Bosentan & Ambrisentan (Endothelin Antagonists) | Standard | Moderate | €2,000–4,000/month | Low | Oral; improves pulmonary hypertension and digital ulcers |
| Phosphodiesterase-5 Inhibitors (Sildenafil) | Standard | Moderate | €150–300/month | Low | Oral; improves pulmonary hypertension and Raynaud's |
| NSAIDs (Joint Pain, Reflux Management) | Standard | Moderate | €40–100/month | Low | Rapid symptom relief; used with gastric protection |
| Autologous Haematopoietic Stem Cell Transplantation (AHSCT) | Regenerative | Moderate | €40,000–70,000 | High | 3–6 months; improves skin thickening and lung function in some; high procedure risk |
| Physiotherapy & Skin Care | Standard | Moderate | €60–100/session | Low | Ongoing; maintains skin suppleness and joint mobility |
No cure exists. Immunosuppressants slow skin thickening and organ progression in some patients; organ-protective drugs (ACE inhibitors, endothelin antagonists) improve outcomes substantially. Prognosis depends on extent and early intervention.
AHSCT shows promise in early trials—improving skin thickening and slowing lung fibrosis in some patients—but outcomes are variable and procedure risk is high. Mesenchymal stem cell therapy remains investigational.
Early ACE inhibitor use prevents renal crisis (a major cause of death). Screening for pulmonary hypertension and interstitial lung disease allows timely treatment. Immunosuppression may slow progression; individualised care is essential.
We link primary regulators, registries and peer-reviewed research so you can verify everything yourself — plus the treating clinic's own materials.
Educational overview of treatment options; not medical advice. Standard treatments reflect mainstream guidance; regenerative/stem-cell uses are largely investigational. Reviewed by the StemCellAtlas editorial team.
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