What is scleroderma
An introduction to this challenging condition
Most people living with Raynaud's have the primary form of the condition where there is no link to any other disease, including scleroderma.
Secondary Raynaud's can be a sign of scleroderma however, as scleroderma is a common cause of the secondary form of Raynaud's. Nearly everyone with scleroderma experiences Raynaud's symptoms at some point, usually at the onset of their condition.
As Raynaud's is often the first symptom of scleroderma to be noticed, it is very important to get tested and establish whether you have the primary or secondary form of Raynaud's. Your doctor will be able to organise these tests.
Like primary Raynaud's, scleroderma is also more common in women, but often presents later in life – because of this, scleroderma doctors will carefully assess patients who develop Raynaud's over the age of 30 years.
Although we talk about people with scleroderma having 'Raynaud's symptoms', there are important differences in the actual disease processes of the two conditions.
Unlike in primary Raynaud's phenomenon, where the blood vessels narrow then return to normal size, the small blood vessels in the skin in scleroderma gradually change in size, becoming increasingly smaller and sometimes disappearing over time.
In people with scleroderma, the blood vessels lose the ability to return to their normal size in-between attacks, and this reduces the supply of oxygen and nutrients to the skin.
If the skin does not receive enough nutrients, it can become dry and cracked, and small ulcers can form on the tips of the fingers (or thumbs). In severe cases, gangrene can develop.
In people with scleroderma, problems with the blood vessels can spread into other parts of the body and internal organs. This never happens in primary Raynaud's. So although the problem with fingers and toes appears the same initially, the ways the two conditions develop are very different.
It is important to keep a steady core temperature, protect your hands from exposure to the cold and avoid smoking, as cigarettes contain chemicals that encourage blood vessels to narrow and cause furring of the blood vessels over time.