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When Your Client Has Scleroderma—What Every Esthetician Should Know

Sharon Monsky, founder of the Scleroderma Research Foundation, died from the disease in 2002. All photos courtesy of the Scleroderma Research Foundation, San Francisco.

By: Patricia Baker
Posted: July 30, 2013, from the August 2013 issue of Skin Inc. magazine.

When Mary noticed her skin tightening and thickening uncomfortably on her face and hands, she went to her primary care physician to get answers. There were other symptoms she had noticed, as well, and showed him the small, widened blood vessels near the surface of her skin—telangiectasia. Although Mary had visited a medical spa for several laser treatments to remove them, the telangiectasia always returned. Then there was the mysterious itching that never stopped. Mary could not identify the source, because there were no hives, bites or other visible causes. Her physician recognized that these symptoms could be pointing to the onset of an autoimmune disease and referred her to a rheumatologist. Lab tests were ordered and soon, Mary received the diagnosis of scleroderma.

What is scleroderma?

According to the Scleroderma Research Foundation website (, scleroderma, or systemic sclerosis, is a chronic connective tissue autoimmune disease. The word “scleroderma” comes from two Greek words: sclero meaning “hard” and derma meaning “skin.” Hardening and tightening of the skin are two of the most visible manifestations of the disease. Scleroderma, however, can be much more than this. Peripheral vascular damage can occur and, in some cases, the joints and muscles are affected, resulting in a loss of mobility. Scleroderma can produce chronic, complex and debilitating symptoms, often damaging internal organs with life-threatening consequences. Systemic scleroderma can damage the lungs, kidneys and gastrointestinal tract with deadly results. It can create deleterious effects throughout the body, and it falls under the heading of a vascular disease because it can constrict and injure tiny blood vessels. It is identified as a connective tissue disease because it can cause abnormal changes to the skin, tendons and bones and, like many other rheumatic disorders, scleroderma is believed to be an autoimmune disease because it can apparently trigger the body into a state of disregulation.

According to the same site, the course of the disease is unpredictable, and its symptoms and severity vary from one person to another. Women are most commonly afflicted with scleroderma; some estimates suggest as many as four out of every five patients are female, and the disease is most frequent between the ages of 20–50.

Three physicians speak out

As an esthetician, it is important to note that scleroderma is neither contagious nor infectious. Its effects can range from mild to life-threatening. The overproduction of collagen that causes the tightening and thickening of skin on the face and hands can also cause the same thickening and tightening on internal organs, such as the lungs. Prompt and proper diagnosis and treatment by qualified physicians may minimize the symptoms of scleroderma and may lessen the chance for irreversible damage, so if you suspect one of your clients may be experiencing the symptoms of scleroderma, recommend that she see her physician immediately.

Julia Hunter, MD, Beverly Hills, California. Hunter is a Beverly Hills, California-based dermatologist in private practice. Her treatment center, Skin Fitness Plus, utilizes only chirally correct, nontoxic, noninflammatory skin care products, and she employs a holistic dermatology method combining healthy diet, synergistic supplements and bioidentical hormone replacement designed to treat the cause rather than just the symptoms. According to Hunter, “Scleroderma patients are in a highly stressed, inflammatory state, and their skin tends to be very dehydrated.” Organic, chirally correct products, easily absorbed by the skin are what Hunter recommends for all her patients, but especially for scleroderma patients. “With a scleroderma client, estheticians should focus on relaxation, lymph drainage massage and super moisturizing treatments.” Hunter suggests that estheticians proceed cautiously with technology known to have a tightening effect and collagen-boosting treatments, because they can possibly make things worse for a scleroderma client.

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