CREST Syndrome Treatment London

CREST Syndrome Treatment LondonCREST Syndrome treatment London:  At our Guardian featured clinic, we focus on the underlying issues and not just the symptoms.

CREST Syndrome Treatment London: What is CREST Syndrome?

CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) syndrome is a member of the group of sclerodermas.

Its name is an acronym for the main clinical features of the syndrome, which are briefly explained below:


CREST causes thickening and tightening of the skin with deposition of calcific nodules or calcinosis.

Raynaud’s phenomenon

Raynaud’s phenomenon is frequently the first sign of CREST, often preceding other symptoms by years. Stress and cold temperature induces a constriction of the small arteries, arterioles, and thermoregulatory vessels of the skin of the fingers and toes. Fingers and toes turn very pale and even blue until they warm up again. This occurrence is often painful. Sometimes this phenomenon leads to ulcerations, which can predispose to chronic infections of the involved site.

Esophageal dysmotility

This condition presents as a sensation of food getting stuck – dysphagia – in the mid or lower esophagus, chest pain, or cough. Patients often state they must drink liquids to swallow solid food. This motility problem results from atrophy of the gastrointestinal tract wall smooth muscle.


Though it is the most easily recognizable manifestation, it is not evident in all patients. Thickening generally only involves the skin of the fingers distal to the metacarpophalangeal joints in CREST. Early on in the course of the disease, the skin may appear swollen and inflamed. Eventually fibroblasts overproduce extracellular matrix, which leads to increased collage deposition in the skin. Collagen cross-linking then causes a skin tightening. Ulcers commonly form on the distal fingers in 30-50% of patients.


Marked telangiectasias (dilated capillaries) occur on the skin of the face, the palms of the hands, and the mucous membranes. The number of telangiectasias and the sites involved tend to increase over time.

Our approach to CREST Syndrome treatment London clinic is to diagnose and address any underlying issues, which may be causing this condition. We do not give purely symptomatic treatment. We use carefully chosen functional medicine tests for each patient along with treatment using non pharmaceutical medicine based on the test results and tailored to meet each patient’s unique needs.

We also address any gut issues, which are often associated with this condition.


Clinical and image improvement of Raynaud’s phenomenon after botulinum toxin type A treatment. Zhao H, Lian Y.Australas J Dermatol. 2015 Aug;56(3):202-5. doi: 10.1111/ajd.12326. Epub 2015 Mar 29.PMID: 25817568
The effect of diltiazem on calcinosis in a patient with the CREST syndrome. Farah MJ, Palmieri GM, Sebes JI, Cremer MA, Massie JD, Pinals RS.Arthritis Rheum. 1990 Aug;33(8):1287-93. doi: 10.1002/art.1780330834.PMID: 2390132
Recent advances in the pathogenesis and management of Raynaud’s phenomenon and digital ulcers. Herrick AL.Curr Opin Rheumatol. 2016 Nov;28(6):577-85. doi: 10.1097/BOR.0000000000000332.PMID: 27541182 Review.
The role of botulinum toxin in vasospastic disorders of the hand. Neumeister MW.Hand Clin. 2015 Feb;31(1):23-37. doi: 10.1016/j.hcl.2014.09.003. Epub 2014 Nov 25.PMID: 25455354 Review.

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