In our February Virtual Education session, we were joined again by dermatologist A/Prof Amanda Saracino. She shared her valuable experience and learnings on scleroderma and skin. 

Here’s a recap of what happened during this month’s session. 


Morphea vs Systemic Sclerosis

One of the hallmarks of scleroderma is the thickening or hardening of the skin. This is literally what the word means in Greek (sclero=hard, derma=skin). 

A/Prof Saracino explained the difference between morphea and systemic sclerosis. Both are characterised by overproduction of collagen in the skin leading to its hardening and firmness. The biopsy of the skin in both diseases appears similar down the microscope, so the term scleroderma is used interchangeably for both conditions.

However, the key difference between morphea and systemic sclerosis lies in where the overproduction of collagen occurs. In morphea, the overproduction of collagen is limited to the skin, and there is no overproduction of collagen in the internal organs. On the other hand, in systemic sclerosis, there is overproduction of collagen in both the skin and internal organs.

Moreover, the pattern of scleroderma occurrence in the skin is also different in morphea and systemic sclerosis. In systemic sclerosis, the skin overlying the fingers is affected, which can cause tightness and joint stiffness. This does not happen in morphea, where the skin overlying the fingers is not fibrotic.

Morphea has three main patterns of scleroderma occurrence – limited, linear, and generalised, which affect different anatomical sites, while systemic sclerosis has two subtypes – limited and diffuse. 

General skin care in scleroderma

While people with scleroderma often focus on internal issues, the skin can also be a concern.

A/Prof Saracino said that having a dermatologist involved in your care can help provide additional support and alleviate worries.

A/Prof Saracino also talked us through some product recommendations for different needs:

  • Itching: QV Intensive, Dermeeze Treatment Ointment
  • Mid-range greasiness creams: QV Moisturising or Cerave Moisturising Cream
  • Compounded creams: Urea, propylene glycol
  • Fissures: Zinc oxide paste, olive oil, salicylic acid in zinc oxide paste.
  • Non-greasy Lotions: Aveeno, Cerave, Cetaphil
  • Paraffin free (non-flammable): Neutrogena Norwegian Hand cream, Eucerin 10% urea lotion  


What’s the best moisturiser? The one that you like!


What’s the best cleanser? The one that does not contain lauryl sulfate!


What’s the best sunscreen? The one that is 50+ broad spectrum and ideally has a physical blocker in it!


A/Prof Saracino also talked about the skin features of systemic sclerosis (SSc) and some general skin care and management strategies for these features.

Tight skin

General Measures:

  • Stretching exercises and physiotherapy
  • Daily moisturisers and gentle skin care
  • Keep warm, avoid skin trauma

Prescription treatments:

  •  Mycophenolate Mofetil
  • Other specialised anti-fibrotic medications


Vascular light or laser treatments including:

  •  Intense pulse light
  • Pulsed dye laser

Itchy Skin

General Measures :

  • See a dermatologist to ascertain the cause of the itchy skin
  •  Use a ‘soap free’ cleanser and daily moisturiser

Specialised treatments:

  • Steroid ointments
  • Phototherapy
  •  Antihistamines, mast cell stabilisers
  •  Other specialist prescriptions, including for neuropathic itch 


General Measures:

  •  Keep warm
  • Keep the skin in good condition and avoid skin trauma
  • Treat the associated pain

Specialised treatments:

  • Strong steroid ointments
  •  Prescription medications that block calcium production or release such as calcium production or release, such as calcium channel blockers, sodium thiosulfate
  • Surgical procedures


Systemic Sclerosis affects the skin in many varied ways. This can impact how we function, our ability to perform daily activities, how we look, how we feel about ourselves and much more. Openly addressing these impacts with your treating doctors is vital, so that each complex aspect of skin involvement can be managed in the best way possible for you. 

Our brochure on SYSTEMIC SCLEROSIS AND THE SKIN will be available soon. We’ll keep you posted!


Loved this session recap?

If you enjoyed this blog, you’ll love attending our Virtual Education Sessions for yourself.

We always learn so much, and it’s a great way to connect with the scleroderma community, no matter where you are in Australia.

Be sure to register for the next event – we’re looking forward to seeing you there.