Unfortunately, CREST syndrome has no known cure. Treatment generally focuses on relieving symptoms and preventing complications:
Calcinosis: No treatment seems to be available to prevent or eliminate calcinosis. Large or painful calcium deposits sometimes need to be surgically removed, and amputation of fingertips may be necessary if the skin ulcers progress to gangrene. One or a combination of the following treatments may be tried on a case-by-case basis; however, larger studies are needed to prove efficacy.
- Corticoids oral or injected inside the lesion (intralesional)
- Probenecid
- Diltiazem
- Warfarin
- Aluminum hydroxide
- Bisphosphonate
- Minocycline
- Colchicine
- Intravenous immunoglobulin therapy
Raynaud phenomenon: The following treatment is suggested for the treatment of people with Raynaud phenomenon:
- Reduce and remove risk factors and possible triggers such as smoking, avoid a medication known as beta-blockers, and avoid any other remediable underlying cause (eg, use of vibratory equipment)
- Keep hands and body warm
- Take a medication that are long-acting formulations of calcium channel blockers
- Use topical nitroglycerin paste if needed.
Esophageal dysmotility: The treatment of esophageal dysmotility and gastroesophageal reflux in people with scleroderma is the same as in patients without scleroderma. Treatment involves behavior changes, medication (H2 blockers), and a surgical procedure (esophageal dilatation) in more severe cases. Esophageal dilatation can help when severe feeding difficulty or regurgitation occur due to an esophageal narrowing.
Sclerodactyly: Treatments include medication (corticosteroids, nonsteroidal anti-inflammatory drugs, D-penicillamine, IFN-gamma, cyclosporine, and cytostatic drugs). Skin involvement in CREST syndrome typically is not severe; therefore, treatment is not need in many cases.
Telangiectasia: Pulsed-dye laser treatment seems effective for the treatment the telangiectasia in the face, but this has not been specifically studied in CREST patients. Treatment may include estrogen-progesterone or desmopressin, laser ablation, or sclerotherapy.
Other treatment may include stretching exercises for the finger joints, and facial exercises that may help keep the face and mouth flexible, under a physical therapist supervision. If CREST syndrome is making it difficult to do daily tasks, an occupational therapist can help individuals learn new ways of doing things. For example, special toothbrushes and flossing devices can make it easier to care for the teeth. Surgery may be necessary for some affected individuals.
About 45% of people with systemic sclerosis may have depression and 64% also develop anxiety, so it is recommended to have an early assessment and treatment..
For pain management, studies have shown that oxycodone is effective and safe for pain due to severe skin ulcers, while topical lidocaine helps reduce pain of the finger's ulcers in people with systemic scleroderma.
There are also some lifestyle changes and home remedies that may be helpful for some people with CREST syndrome. For example:
- Wearing gloves and mittens is the weather is cool and/or dressing in layers and wear a hat, thermal socks and boots to maintain the body's core temperature and to reduce Raynaud's symptoms
- Quit smoking because nicotine constricts the blood vessels, making Raynaud's phenomenon worse
- Eating soft, moist foods and chewing food well when having swallowing difficulties
- Eating small, frequent meals; avoiding spicy or fatty foods, chocolate, caffeine, and alcohol; and avoid exercising immediately before or after eating to improve symptoms of acid reflux.
- Use of skin moisturizers and using an humidifier at home to improving moisture levels in the home to ease skin and breathing symptoms.
The information provided here is for general educational purposes only. Individuals interested in learning about specific treatment options for themselves or family members should speak with their doctors.