Ask Dr. Herazy…

Please review this list of almost 200 Q/As on a wide variety of topics concerning Dupuytren’s Contracture.


55 Responses to “Ask Dr. Herazy…”
  1. Suzanne says:

    What is your experience with the use of Castor Oil for Dupuytren’s or related fibromas on the bottom of the foot? There are many in the field of alternative medicine who swear by it. Also, what are your thoughts and experiences with acupuncture for this condition?

  2. BJ Ingwersen says:

    I am a type 1 diabetic, taking insulin for 46 years. Healthy, athletic. Will any of the therapies in the medium Dupuytren’s contracture plan affect my diabetes control? Raise or lower blood sugar, increase metabolism, affect TSH levels, increase any other hormone levels, etc…?

  3. DR Douglas Foster says:

    is there a role for SSKI in Treatment of Dupuytren’s contracture as recommended by Dr Jonathan Wright ? Can you comment on how effective his Tx protocol is? (sski, dmso and vitamin e)
    Thanks for your very informative web site and your work on this difficult disease.
    DR. Doug Foster

  4. Simon says:


    I’ve just read selling Large dose PABA has been banned in some countries including the US

    You are selling it as part of the Dupuytren’s contracture medium plan, is that safe? I bought the medium pack, absolutely no results after 1 month and have been diligent in use.. A little diarrhoea initially…

    The PABA also makes sulfur ineffective I have read.. Another supplement included in the medium plan

    Interested to get your thoughts on paba

  5. Denise says:

    Any comment on the use of Silica Gel as a method of reducing lumps in palm and finger for Dupuytren’s contracture? I was used as a guinea pig several years ago when I attended a hand clinic in a Sydney (Australia) hand clinic. It seemed to work, by reducing the size of the lump. I have now developed symptoms in the other hand and have purchased the brand Dexterity Visco-gel Silicone Scar Management Sheets onlone – they appear to reduce the size of the lumps in palm and little finger. Has this method been considered for Dupuytren’s contracture treatment?

  6. sanford evenchik` says:

    my pinky finger is now at a 90 degree angle to the rest of my hand. Can I expect it to continue downward towards my palm, or will it quit at 90 degrees?

  7. karen beyer says:

    Dear Dr. Herazy,

    I just received my packet of goodies for treatment. According to my instructions, before I start it says I must know the “exact size, shape, etc of my contracture”. I took pictures and I am using the caliper to measure. Do I need to do anything else? I’m on day one of my treatment.

    The Dmso gel didnot absorb in 5 minutes like the info says. I may have used too much, but had a hard time controlling getting the gel out of the bottle. any suggestions?

    Also, I could not get the vit E out of the pump bottle, so I opened the bottle & it went all over the place. suggestions please?

  8. Eric Martindale says:

    Dr. Herazy,

    I need help. My mother has a case of Dupuytrens Contracture that is likely to be the worst you have ever experienced. (She is told that by literally every doctor she sees.) She has had every treatment that we can find, starting with surgery twenty years ago. She has since traveled around the country to get all of the latest treatments, to include Xiaflex and Aponeurotomy. The latest treatments seem to give her some relief, but no one can seem to stop the re-growth of this fibrous tissue on her hands. Morever, no one seems to be able to do anything at all about her feet.

    My mother has all but given up with her Dupuytren’s contracture (although I haven’t). Only her thumbs and forefingers are really usable. Her feet are an absolute mess, and I’m not sure how much longer she is really going to be able to walk without assistance. It is extraordinarily painful to watch her. (I am a Marine major, and I have seen a lot; I don’t say that lightly.)

    Is there anything we can do?


  9. Gen says:

    Hello Dr Herazy,
    My half Dutch, woodworking hubby (37 years) has dupuytrens contracture. He has a small lump in the palm of one hand but not much hand contracture. But his ring finger on the same hand is quite contracted especially the last knuckle. It started a few years ago after he cut his finger. A surgeon has advised that only finger surgery would be necessary and it would not recur. He also has large nodules on the first knuckle on each of his little fingers. These are painful if bumped and often ache painfully.

    Two questions:
    1. Would just finger surgery be a one time solution?
    2. Are the lumps under the skin on his first little finger knuckles related to dupuytrens contracture or are they something else? They too have only developed in the last few years.

    Thank you for considering these questions.
    PS. His father “H” (fully Dutch and in his late 60s) also has dc in one hand. His hand is quite contracted and one of his fingers also but to a lesser extent than the hand itself. H’s late twin sister was a diabetic and H is paranoid about getting it too.

  10. Susan Wright says:

    I have a basic question about Dupuytren’s contracture treatment. How should you take Bromelain 5000 – with or without food? Right now I’m taking 3 per day on an empty stomach along with Neprinol, Inflazyme and Fibrozyme (along with the other supplements and external treatments listed in the Best Plan). But the panel on the Douglas Lab bottle mentions to take it with food. My Dupuytren’s contracture has decreased in size and I’m still playing around with dosages.

  11. Mike Christensen says:

    Am of Danish descent and noticed the first signs of Dupuytren’s contracture in my left hand in 2003. Has since progressed to having a strong cord up to my ring finger with a 1.5cm nodule at the base of the finger and swelling of the finger base, combined with a light cord to the little finger. Now am seeing first signs in my right hand & also the first signs of Peyronie’s Disease. Have avoided surgery so far for obvious reasons, and came across your website recently while looking for alternative treatments. Am going to purchase either your medium or large plan, but first have a query: In some of your posts, you mention using a Genesen Acutouch pen to treat Dupuytren’s contracture, but your large treatment plan includes the 3MHz Bellaire machine. Is there any difference between the two, or specific advantage for using one or the other? Or do you need both, e.g. one for DC the other for PD? Look forward to hearing from you so I can decide what to order. Many thanks.

  12. Denise Lai says:

    I am a 55 year old woman of Sa’ami (Northern Finnish) and Native American origin. I am legally blind, but I work as an artist in fiber arts, doing historical reconstructions of fiber techniques from the past. I also did finish carpentry and Mammoth ivory carving. A lot of hand held power tools. I had a CMC joint arthroplasty on June 25. In mid August the first node appeared. Within 10 weeks, I had 14 nodes in my left hand, and I was at 10• from flattening my hand. I have also lost most of the use of my thumb. I now have several nodes forming in my right hand. The orthopedic surgeon took one look at the CT, and I was in a radiation oncology office the following morning. I start radiation tomorrow. They never saw a case of such rapid and extreme onset. My mother also has Dupuytens Diathesis, which contracture all ten fingers at age 76, but she hardly ever used her hands in working. She has had surgery twice. Rapid recurrence. I only learned the name of the condition by searching her medical records ofter getting dementia. My grandmother also a less aggressive presentation of Dupuytren’s Contracture. I also lost 80 pounds in the past 9 months without really trying. I have well controlled, adult onset diabetes (last A1C=5.3%). Is it Dupuytrens? Is it dangerous? Could I lose the use of my hand? Is radiation the right place to start?

  13. Terri says:

    I am a 56 yr old female that was just diagnosed with dupy in my rt hand after an injury 7 mos ago to that hand. I dev the bumps and have swelling of the pads under the pinky, ring & mid finger. I asked my doc about why my knuckle on pinky finger was swollen and discolored and painful. He said to wait but I want to know if all this is related to dupy and how do I treat and stop. My hand hurts, burns and has no strength. What do I do?

  14. Dr.Herazy says:

    Greetings Denise,

    Based on your history and your general description your hand problem could certainly be Dupuytren’s contracture.

    Yes, it is possible to lose the use of the involved hand if the condition progresses.

    Yes, radiation is a reasonable starting point, but I would also look at using the DCI Alternative Medicine at the same time for your developing Dupuytren’s contracture. If you need additional information please contact me. TRH

  15. David Shrubshall says:

    Hi. I want to start Fibrozym. What is the best dosage for minor Dupuytren’s contracture?
    Thanks David

  16. Dr.Herazy says:

    Greetings David,

    The best staring dosage for Fibrozym in particular to treat Dupuytren’s contracture is the dosage stated on the product label, 2/day; these are taken between meals. But there is a lot more internal and external therapies that are needed to successfully reduce the fibrous tissue of Dupuytren’s contracture than this single enzyme product. As good as it is, Fibrozym will not be sufficient to get the job done for you. A larger plan will likely be required to help your body make the necessary changes at the cellular level. After starting with that 2/day dosage it is almost always necessary to slowly increase the dosage of the Fibrozym to higher levels in order to break down that fibrous mass that is bothering you.

    All the specific information required to use the DCI plans are included with your first order. I suggest you spend some time on the Dupuytren’s Contracture Institute homepage to learn a bit more about how we suggest you go about helping yourself reduce those hand nodules and cords. TRH

  17. Dr.Herazy says:

    Greetings Terri,

    Sorry to hear about your hand problems, but in addition to the Dupuytren’s contracture it also sounds like you might have an additional problem of Garrod’s pads starting.

    Garrod’s pads are a soft tissue problem in which the skin on the first knuckles of the hands (where the fingers join the hand) become darkened, thick, enlarged and often times painful. Sometimes all first knuckles are involved and other times only a few. When severe the condition can also affect the joints of the fingers. This condition can occur by itself, but it is often seen to occur with Dupuytren’s contracture.

    Many people who treat their Dupuytren’s contracture using the DCI Alternative Medicine approach successfully have also reported improvement of their Garrod’s pads; some people with just Garrod’s pads also use the DCI protocols with success.

    Your doctor wants you to wait until your hands are bad enough that surgery will be indicated. I suggest that you try to help yourself avoid that situation by helping your body heal the DC and Garrod’s pads before they get that bad. Please look over the DCI site for information how you can try to support your immune system to get rid of, or at least reduce, your Dupuytren’s contracture. TRH

  18. Dr.Herazy says:

    Greetings Gen,

    Dupuytren’s contracture recurrence rate after surgery is variable; sometimes it can be very rapid, like less than a year, and sometimes it can be slow, like 5-10 years. Bear in mind that recurrence will always develop and the hand lump and cord development will always be worse the second time around. Dupuytren’s contracture surgery cannot be done too many times because of these inevitable recurrences since a person eventually loses normal tissue each time to each surgery; a person gets to the point that no more hand surgery can be done, and amputation is the last option. I feel it is better to avoid Dupuytren’s contracture surgery as long as possible. Many people have found that the DCI approach can help them avoid or delay hand surgery.

    The lumps under the skin over the knuckles are probably related to the Dupuytren’s contracture since this sometimes happens to some people. TRH

  19. Dr.Herazy says:

    Greetings Karen,

    So glad to know you are trying to start your Dupuytren’s contracture treatment in the right way. Thanks for the questions, so here you are:

    Since the Dupuytrens hand lumps are on the surface I suggest carefully outlining each one with a black ball point pen. At the exact area where the abnormal fibrous tissue of the palm lump begins and the normal skin of your hand ends, place a small dot or line. Go over to the next area of the same palm lump and again find the where the abnormal fibrous tissue of the palm lump begins and the normal skin of your hand ends, and again make a small line. Do this all the way around each palm lump until you have outlined in pen a dotted line around the entire mass of fibrous tissue; you will have basically traced around the abnormal tissue. When you have done this, then go to a copy machine and place your hand down on the glass surface as flat as you can and copy the palm. The photocopy of the palm will be an exact and accurate picture of the size and shape of your Dupuytren’s contracture. Write the date on the photocopy and make notes about the density and how well the “lump moves around the face of the clock” which is explained in the DCI information sheet “How to Use the Current Strategy Form.” Make these photocopies in this way every month or so and keep them for comparison so you will know exactly how much progress you are making. TRH

  20. Dr.Herazy says:

    Greetings Sanford,

    Sorry to say, yes, your Dupuytren’s contracture can continue to draw your finger down toward your palm until it touches the surface and even forces it hard against the surface. Some cases do not progress all the way down to the palm, but most eventually go down at least to the point of touching the surface. Just because your Dupuytren’s contracture has developed to a right angle contracture does not mean all is necessarily lost for you. Many people have found complete or at least partial improvement of their DC while using the Alternative Medicine treatment information found on this website. I encourage you to look around and see if the ideas do not make sense to you. TRH

  21. Dr.Herazy says:

    Greetings Denise,

    This is a new one to me in regard to Dupuytren’s contracture treatment. Briefly, I can say that I believe silicone is often used in a homeopathic formula as a common ingredient for scar reduction. I just now looked this particular product up on the internet and could not find out much about it, other than it appears to it be created to treat superficial tissue scars; not sure if it would have any effect on the deep fibrous contractures of Dupuytren’s contracture. TRH

  22. Alba says:

    Is Nattokinase advisable for someone with low blood pressure? Is the blood thinning effects so great as to lower blood pressure significantly?

  23. Dr.Herazy says:

    Greetings Suzanne,

    Over the years I have heard of many people using castor oil for Dupuytren’s contracture, but not much in the way of positive results. That is not to say castor oil might not help Dupuytren’s contracture, it is just that I have just run across any people who report that it helped them. Castor oil has a lot of proponents for a wide variety of conditions, but these localized fibrotic conditions like Dupuytren’s contracture can be especially difficult to treat; this is why we recommend a wide display of various Alt Med approaches used concurrently to get ahead of the palm lumps and cords.

    Acupuncture is a great addition to arsenal that can be used against Dupuytren’s contracture. But by itself it is seldom effective and this is why, again, we have found that only when using several of these approaches can a person get ahead of this problem. TRH

  24. Dr.Herazy says:

    Greetings Alba,

    In my work using Nattokinase for Dupuytren’s contracture I have encountered many people who has also had both high and low blood pressure. A few of the hypertension, or high blood pressure, cases reported that their blood pressure was lowered while using Nattokinase, but none said it was made too low. Remember, Dupuytren’s contracture can be complicated because the fibrous lumps and cords of DC is difficult to remove naturally. It takes a serious effort and good management. Let me know if I can help in any way. TRH

  25. Dr.Herazy says:

    Greetings BJ,

    I have never had anyone tell me that they have had an adverse response or side effect to taking any of the Dupuytren’s contracture therapies, other than diarrhea when increasing dosages too rapidly. This temporary diarrhea is controllable by simply slowing down the rate of increase of the dosages, especially the enzyme group (Neprinol, Inflamazyme, Nattokinase, Bromelain, etc.).

  26. Dr.Herazy says:

    Greetings Eric,

    Surgical repair of Dupuytren’s contracture is always limited because the problem always returns, and it will always be worse when it returns, as you have seen with your mother. The only question is how fast does the Dupuytren’s contracture recur, one year, two years, seven years? It sounds like your mother has had a lot of intervention, causing a lot of recurrence and additional scar development. Eventually she will be come to the point where there will be nothing more for the hand surgeons to do but to offer her the option for amputation.

    At this point I think she can consider using Alt Med to try to slow the Dupuytren’s contracture development down a bit, and perhaps reduce some of the pain she is having. There is no way for me to predict or offer an opinion about how much, if at all, she can be helped. It is possible the DCI concepts of using Alt Med can help her, but I cannot say for certain given her extension surgical history. I can only suggest she gives it a very good try to see what and if she can do to get some relief for herself. Who knows, we might all be surprised and she will find a lot of relief.

    Please read at least the first few pages of the DCI website to get an idea of what is involved in Dupuytren’s contracture treatment using Alt Med. If you have questions please contact me directly.

    She must have been a great Mom because she raised a pretty good son. You are doing a wonderful thing to work so hard for her. TRH

  27. Dr.Herazy says:

    Greetigns David,

    Fibrozym is a great therapy for treating Dupuytren’s contracture as part of a larger comprehensive treatment plan, but by itself it does not do much good. It must be combined with several other internal and external therapies in order to assist the healing process of the body. That is why we have these therapy plans developed that offer a balanced approach to treatment.

    Since Fibrozym is never used by itself according to the DCI treatment concepts, I cannot say what kind of dosage you might take if you used it by itself. When it is used as part of a larger treatment plan it is often used in dosages of 6-8 tablets daily.

    Remember, Dupuytren’s contracture is a tough problem to treat so it will typically not respond to small and half-hearted efforts. Read more about how our readers get the job done using these ideas, to see how you might work to get rid of your hand lumps also. TRH

  28. Dr.Herazy says:

    Greetings Dr. Foster,

    I do not have a good answer for you about SSKI treatment for Dupuytren’s contracture.

    Like you, I have read Dr. Wright’s few comments about using SSKI with DMSO but that is about all I know about it. I have looked around the internet many times for additional information and confirmation of results of reduction or elimination of Dupuytren’s contraction nodules and cords as a result of SSKI usage, but have found none. The only references to SSKI — other than people like you asking about it — are the one or two comments from Dr. Wright himself. Additionally, I have had several personal communications with people over the years telling me that they tried SSKI as Dr. Wright suggests and it did not help them; of course, this usage was as a very limited application of just DMSO, SSKI and vitamin E, so it was used in a limited application that does not subscribe to the broader use of multiple therapies that DCI advocates. For this reason I have not suggested that anyone use the DMSO, SSKI and vitamin E approach for their Dupuytren’s contracture treatment. TRH

  29. Dr.Herazy says:

    Greetings Mike,

    Yes, they are entirely different external therapy approaches for Dupuytren’s contracture.

    The 3MhZ ultrasound machine is a very effective portable and affordable physiotherapy device that is used medically for all types of soft tissue problems. As a result of a DCI research project a few years ago we observed that people who were already on a large DCI treatment plan of various multiple internal therapies and not getting good treatment results with their DC did see an improvement when the 3MhZ ultrasound was added into their plans. Of course, this was not correct scientific research protocol to test the effectiveness of 3MhZ ultrasound against Dupuytren’s contracture. We do not care about isolated research testing of any solo therapies, so we did not test it that way. We care about what works to help the body eliminate DC. We found that adding 3MhZ ultrasound treatment increased effectiveness of already existing treatment. The Genesen Acutouch instruments are a very different and unique kind of external therapy that is best described in detail on the DCI website. It would take me hours to explain it again in this space. Suffice it to say it is a professional acupuncture instrument that is so simple to operate that a layperson can use it for self-treatment at home following instructions that I have written specifically for Dupuytren’s contracture treatment. I suggest that people start with the 3MhZ ultrasound only because it is much less expensive to purchase and a bit easier to apply. Either one of these two machines can be used for either problem, and both can be used for Dupuytren’s contracture and Peyronie’s disease self-treatment. TRH

  30. Dr.Herazy says:

    Greetings Susan,

    Congratulations on making improvement with your Dupuytren’s contracture while you are still relatively early in self-treatment.

    Concerning the timing for taking Bromelain 5000: You are incorrect. The label says to take Bromelain 5000 between meals, not with food. The instructions you received with your initial order from DCI and subsequent orders clearly state to take all enzyme products (Neprinol, Nattokinase, Fibrozym, Inflamazyme, etc.) between meals or at least 1-2 hours before or after you eat.

    I appreciate you are trying to use and apply all your internal and external therapies in the right way, and I appreciate that you checked this point out. You are working hard at your recovery, so it is no wonder you are seeing improvement of your Dupuytren’s contracture. Again, congratulations and keep up the good work. TRH

  31. Dr.Herazy says:

    Greetings Denise,

    There are many of similar silica gel products on the internet, but most promote their use for scar tissue treatment. None directly say they can or should be used for Dupuytren’s contracture treatment. Considering how many of these products there are fiercely promoting themselves, one time I contacted a few of these companies directly by phone. I asked each one if their product had any beneficial effect on Dupuytren’s contracture. In every case no company representative had ever heard of Dupuytren’s contracture or knew what it was. This tells me there is no feed-back or experience these companies have with people who have Dupuytren’s contracture. For this reason I have not included these silica gel products in the DCI treatment lineup. TRH

  32. Dr.Herazy says:

    Greetings Simon,

    Any PABA ban is limited to the dosage of each individual pill; how large the dose of PABA per capsule. The DCI suggestion for using PABA are safe because the total dosage is still within recommended PABA daily usage, and we advise people who are on a heavy PABA dosage to take periodic breaks or vacations from treatment every 6-8 weeks of use.

    So sorry to hear that you did not see any change after one month of Dupuytren’s contracture treatment. However, in many places on the Dupuytren’s Contracture Institute website we advise people to make up their minds that they will use their DCI treatment plan for at least 3-4 months to be fair to themselves. Dupuytren’s contracture is a very difficult and tenacious condition to treat and will seldom respond within one month.

    I have been doing this work with Dupuytren’s contracture since 2002 using these dosages of PABA. During this time no one has reported any adverse reaction or side effect from PABA, other than mild temporary diarrhea that is eliminated by slowing down the rate of usage. TRH

  33. Linda Wojciechowski says:

    My first Dupuytren’s contracture nodule appeared 2 years ago in my left hand.I was told it was a fibroma and to remove it surgically. I now have a row of them in the left palm and nodules are forming in the right hand along the thumb tendon as well as at the base of the palm. No contractures yet. A second hand specialist diagnosed Dupuytren’s contracture last summer. My concern is that I am allergic to sulfa drugs. Am I still a candidate for the DCI treatment? If so, which level should I begin with? I am in the Chicago area, can I come in for a consultation?

  34. Dr.Herazy says:

    Greetings Linda,

    Sorry to hear of your Dupuytren’s contracture problem.

    First, a question please: Did you have the initial fibroma surgically removed when it was first diagnosed, and after the hand surgery did the row of nodules develop on the left hand? Or did you not have the hand surgery and the nodules progressed across the palm? I am curious because of the nature of Dupuytren’s contracture nodules to recur post-surgically when they are removed, and to also recur in a more vigorous or aggressive way than the initial occurrence.

    Sulfa drugs (sulfonamides) and the organic sulfur found in foods (sulfites) and nutritional supplements (sulfonyls) are not chemically related. Therefore, someone with a sulfa drug allergy does not have to avoid sulfur in the diet or in the vitamin portion of a Dupuytren’s contracture treatment plan. You are apparently allergic to sulfonamides, not the sulfonyl that is in our MSM. As you probably know, if you have a sulfa allergy you don’t have to avoid any particular foods. The body metabolizes (chemical breakdown, absorption and distribution) of sulfites, sulfates and sulfonyl differently than sulfa drugs. Further, someone with a sulfa drug allergy is not necessarily predisposed to other sulfur-related allergies.

    Sulfa drugs are known to cause allergic reactions such as hives, tissue swelling especially the mucous membranes, difficulty breathing which includes aggravation of asthma especially if it pre-exists, unrelated to Dupuytren’s contracture. If you’ve ever had a severe sulfa drug reaction it would be wise to wear a bracelet that informs emergency personnel of your sulfa allergy.

    Since 2003 I have worked with DCI involved in Dupuytren’s contracture treatment questions. During this time I have dealt with perhaps 100 people who were concerned about their sulfa drug allergy in relation to the various therapy products in the various treatment plans, most notably the MSM (methyl-sulfonyl-methane) which is a sulfur containing supplement. No one with Dupuytren’s contracture has ever reported back any adverse response, side effect or allergic reaction as a result of taking any of our nutritional supplements, most notably the MSM supplement.

    Lastly, I have been retired since 2012 from active practice and do not maintain an office to see patients. All of the help I can give you for your Dupuytren’s contracture is on the website. TRH

  35. Elizabeth Pullen says:

    I have received the Dupuytren’s contracture medium plan and met with my Functional Medicine Nurse Practitioner. We have a question about getting started. Should I start taking all of the items at the lowest dose at the same time (on the first day), or should I start with one item and then add the 2nd, 3rd, etc. every few days? I understand once I’ve gotten started with all 8 items that I should slowly increase dosage of 1 or 2 items every 7-10 days after reassessing my hand.
    Thank you.

  36. Dr.Herazy says:

    Greetings Elizabeth,

    Glad to know you are checking in and working with your medical practitioner about your Dupuytren’s contracture treatment.

    You can certainly use either option because neither are wrong. However, the first option of “taking all of the items at the lowest dose at the same time (on the first day)” is a faster way to work up eventually to where good tissue changes typically occur and where you want to be; it will save you time and expense. This approach is by far the most common, and is used by all except those with extremely sensitive digestive tracts. The second option of starting “with one item and then add the 2nd, 3rd, etc. every few days” offers no advantage I can determine except to be most cautious if you have a history of gastric or intestinal dysfunction.

    Thanks for the question, and if you have any other concern with your Dupuytren’s contracture plan please let me know. TRH

  37. John Berry says:

    Hello I have just purchased and started a large Dupuytren’s contracture plan this is more about my brother who is recovering from surgery on digit 3,4 and 5 on his left hand has Dupuytren’s contracture very early stages in 3 & 4 of his right hand I’m ordering plan for him to treat his right hand my question is would the ultrasound and external treatment be beneficial to healing his recent surgery surgeon/therapist have said his body has reacted to the operation it is now 4 months since the op. and recovery seem slow thank you in advance for any info.
    Cheers John

  38. Dr.Herazy says:

    Greetings John,

    Well, aren’t you a very good brother to share your Dupuytren’s contracture treatment plan with him like that? Nice guy.

    Your full and appropriate use of all elements of the many aspects of this Alt Med plan should increase and support your body’s ability to reduce and perhaps eliminate your own Dupuytren’s contracture. Your brother’s use of the different external elements of the large plan four months post-surgery, especially the ultrasound, should, in my opinion, be helpful for a speedier recovery from his surgery. However, I insist he first talk to his surgeon before using these therapies in his case.

    Further, I speculate that the slow recovery your brother is experiencing might be related to the tendency of Dupuytren’s contracture to recur after surgery. Usually the recurrence might take a few years to appear, but I have encountered many people whose DC returned within less than a year post-surgery. This is the problem with all Dupuytren’s contracture hand surgery: A person undergoes considerable risk and pain engaging in surgical excision of the Dupuytren’s contracture fibrous tissue, only to have almost no reward since the recurrence is usually just a few years and in some cases even less than that. To make matters worse, the recurrence of Dupuytren’s contracture is always worse than the original case of DC, and the surgeon will have less normal and healthy tissue to work with, since the first surgery consumes normal tissue, when the recurrence problem eventually has to be dealt with surgically. This becomes a vicious DC cycle: surgery, recurrence, surgery, recurrence, etc., until eventually no more surgery can be done. At this time the options become very ugly. It is far better to avoid, or delay as much as possible, having that first Dupuytren’s contracture surgery. This is where the DCI Alt Med self-treatment approach is valuable since many people are able to avoid having any hand surgery for their Dupuytren’s contracture.

    Good luck to you and your brother, John. Let me know if I can help you in any way. TRH

  39. Lilia says:

    I am a female aged 65 y.o. My GP recently diagnosed me with Dupuytren’s Contracture. I have CFS + several Autoinmune Disorders + severe food sensitives/intolerances. I am very sensitive to salicylates, amines, casein, gluten, soy. I am already taking several supplements. I frequently react to new supplements/medicines. I definitely would like to treat my Dupuytren’s contracture. Money is not an issue. What would be your advice regarding which suplemments to buy I definitely have to avoid any herbals re: salycilate and soy.

  40. Dr.Herazy says:

    Greetings Lilia,

    None of the supplements, homeopathic products or topical agents used in our Dupuytren’s contracture therapy lineup contains any ingredient on your list of sensitivities.

    Since you currently take several supplements there is ample room for optimism you can successfully take our supplements; it is do-able. In view of your multiple sensitivities I suggest that you do two things as you start your Dupuytren’s contracture program: Read the label of each bottle to satisfy yourself that you are secure. Also, take a 1/2 tablet or single capsule dosage of each supplement in your program to evaluate your response. If you do these things you should have a clear mind that all is well with you and the DCI program.

    You ask for advice about which supplements to buy. I suggest that you get the largest plan you can afford to use for 3-4 months while you aggressively pursue your Dupuytren’s contracture plan. The more broad and diversified treatment is, and the more faithfully the plan is followed, the better the response tends to be. I will be available to answers questions as you advance your Dupuytren’s contracture treatment protocol. TRH

  41. I was recently diagnosed with Dupuytren’s contracture in my left pinky finger. I am not 100% convinced that it is DC.

    I cut the flexor and extensor tendons while carving a pumpkin in 2015. I had surgery to repair the tendons, and the repair was successful. After a short time I was unable to move the finger, I was told I had extensive scar tissue build up. 6 months later I had tenolysis to remove the scar tissue. The surgery was deemed a success, but within a few weeks my finger started contracting. I showed the contracture to my hand therapist and hand surgeon. I was told I would need tenolysis once again. I tried explaining to the surgeon that I was having problems flattening my hand, my PIP joint seemed hot & swollen and everything felt tight inside. He stated that was due to the scar tissue once again, and on the 1 year mark of my original injury I went under the knife again. This time in less than 2 weeks I was not able to move the DIP joint and the PIP joint appeared to be more deformed. It is now 5 months since the 3rd surgery, and my pinky finger is nearly touching my palm. My hand therapist had me ‘pop in’ to see her. The surgeon stopped in the room for 1 minute, said it was Dupuytren’s contracture and I should have a 4th surgery.

    My question after this long email is this: I do not have a lump in my palm, could it still be Dupuytren’s contracture?

    Thank you,


  42. Dr.Herazy says:

    Greetings Coleen,

    Yes, you could still have Dupuytren’s contracture even if you do not have the typical palm lump or nodule.

    Dupuytren’s contracture (hand), Peyronie’s disease (penis) and Ledderhose disease (foot) are all conditions of excessive collagen and fibrotic tissue deposition which are notorious for widely variable presentations; it seems sometimes that no two people have the same history, symptoms and description of their problem. Accordingly, some palm lumps are huge while some are relatively minor; the absence of yours is still consistent with a Dupuytren’s contracture diagnosis. In addition, it is Dupuytren’s contracture that is most easily started by not only trauma or cutting of the hand, but many cases of Dupuytren’s contracture are triggered after trauma or cutting of other parts of the body.

    You report a series of very fast recurrences after each hand surgery; this is also consistent with Dupuytren’s contracture and cause for concern. Your surgeon is quick to suggest more surgery in spite of your rapid recurrences, which should concern you. Please be aware that it is not possible to continue this rate of hand surgery without some eventual horrific consequences. As best I understand, you report three Dupuytren’s contracture surgeries in 18 months. Since DC recurrence tends to accelerate with each successive surgery, you are on a fast course to not being able have any more hand surgery. I say this because with each hand surgery normal tissue is “used up” making each subsequent surgery more difficult, as well as leaving the hand less functional as more hand tissue is removed each time. Eventually a person has so little normal tissue remaining that amputation is the only recourse. Even Xiaflex injections have a limited number of uses for the same reason.

    I suggest you review the information on the Dupuytren’s Contracture Institute website to learn how Alt Med can be used to support your body’s ability to reduce and normalize some of this contracted hand tissue. I have worked with many people who have found themselves in trouble after having multiple Dupuytren’s contracture surgeries and used our protocol to slow this recurrence process down. The results after multiple surgery are not as good as if none are done, but sometimes the outcome can be surprising. It seems to me that you should at least explore this more conservative approach. Please let me know if I can help you in any way. TRH

  43. Lowell says:

    I am a 78 yr old male who has a (2 to 3 year) developing Dupuytren’s contracture on my left-hand pinky. I am interested in trying DCI treatment, but concerned about an interaction with other drugs, mainly Coumadin and Sotalol.

    In particular, I have seen cautions on using DMSO to treat Dupuytren’s contracture while on coumadin, which I take for preventing recurrent strokes. Can I be assured that none of the components of the DCI treatment would seriously interfere with the regulation of these two drugs?

    I would appreciate your comments, please.


  44. Dr.Herazy says:

    Greetings Lowell,

    No one has ever reported a drug interaction or adverse reaction from using any of the DCI Dupuytren’s contracture therapy items (including DMSO) in over 16 years of doing this work. That having been noted, I suggest you contact the doctor who prescribed your Coumadin and Sotalol and ask him/her that same question about interference or interaction with your prescription drugs.

    Good luck with your Dupuytren’s contracture. TRH

  45. Gary says:

    Dr. Herazy,

    Just started the moderate Dupuytren’s contracture plan yesterday after receiving shipment, reading instructions, and taking baseline measurements. So have only been taking pills and applying creams for less than a day but initial observation is that DMSO doesn’t cause any warming of treatment areas and nodules on fingers of both ring fingers seem to be getting harder. Anything to be concerned about or just to keep on with initial program?

    (I’m almost 64 with somewhat advanced Dupuytren’s contracture – ring fingers 60 and 45 deg curvature, cords on little fingers and palms for ring and thumb fingers, nodules on ring and little fingers.)

    Thanks for any assistance. I’m trying this before going back to hand doctor for Xiaflex injection.


  46. Dr.Herazy says:

    Greetings Gary,

    Thanks for your questions about treatment of your advanced Dupuytren’s contracture. I am concerned you could be one of those folks who has unreasonable expectations about treatment and could be setting yourself up for failure only because you will demand more from yourself than is possible.

    You have an advanced case of Dupuytren’s contracture with significant flexion and cords on two fingers of both hands and you have given yourself basically one self-treatment, and you think things are not going well perhaps because of that single treatment? You concern me because it appears you are going to “try” to make some changes before Xiaflex injections that have already been scheduled. Well, that sounds like you are giving yourself almost no time to do a lot of healing and repair on an advanced case of Dupuytren’s contracture. It sure seems like you are anticipating so deeply into this protocol, and having expectations no one can fulfil, that you are setting yourself up for failure without cause. Please rethink your mind set.

    Throughout the DCI website we suggest that folks allow at least 3-4 months of an intense Dupuytren’s contracture treatment strategy to allow enough time and opportunity for their immune system and fibrous tissue to respond. Anything less than that is unfair to you. Dupuytren’s contracture is a nasty and difficult problem to treat; that is why most MDs are not excited when a case walks in their office.

    It is not common for a warm sensation to develop where DMSO is applied so that is not an issue. But then again, you have treated your Dupuytren’s contracture only one or two times, so that might happen at a later time. Any heating of the tissue could be the result of using a 99% DMSO product; our DMSO two products (Dusa Sal and PMD) are formulated by Stanley Jacobs, MD, the discoverer and developer of the medical use of DMSO, to be at 60% dilution. This diluted state is used to avoid skin reactions that occur at 99% concentrations, and to allow for the addition of other ingredients to be included in our formulations that would not otherwise be possible. For these reasons a person can use our DMSO products more safely, more often and with greater therapeutic effect than a 99% DMSO. It is far more common that someone applying DMSO for Dupuytren’s contracture treatment will experience an brief mild itching or tingling sensation; most people most of the time feel absolutely nothing.

    Any actual hardening of your nodules or cords are more likely the result of the usual progression of Dupuytren’s contracture or the fact that you are just paying more attention to your hands than usual because you applied the DMSO one time.

    If you are serious about promoting actual changes in your Dupuytren’s contracture in a few weeks, like it sounds you are, then I trust you are ready to be very aggressive and faithful to your protocol. If so, I will be happy to offer whatever ideas I can that might make a difference to you. But in the meantime, please do not put so much pressure on yourself that you can only be disappointed. TRH

  47. Kirsty says:

    Hi. I live in Cape Town, South Africa I was diagnosed with Dupuytren’s contracture in March 2016, now I am booked for surgery in December (2017). Reading this I may postpone my Dupuytren’s contracture surgery for a few months. In both hands, my little and ring fingers are more than 90 degrees contracted. All other fingers also affected and both palms are swollen and hard. My feet are also starting to be painful.

    I have 3 questions:

    1. I would like to be as aggressive as possible. You said that a doctor must agree to me using the ultrasound machine, but I don`t think he`d be at all interested. Is it dangerous to use? would the sticks work even better?

    2. I have been given a hydrolysed collagen type 2 supplement (high quality from France). I haven`t used it because I`ve seen that Dupuytren’s contracture is somehow related to the ratio between type 1 and type 3 collagen? Am I right to leave it alone or could it help?

    3. I know you said that raw juices won`t help the Dupuytren’s contracture, but have you noticed any relationship between diet and disease process?

    Many thanks

  48. Dr.Herazy says:

    Greetings Kirsty,

    Sorry to hear about your Dupuytren’s contracture. You might have a genetic predisposition to fibrosis since you have Dupuytren’s contracture and what sounds like Ledderhose disease developing in your feet. South Africans (colonizing from the UK) have such a genetic tendency to DC; for this reason we ship to your country several times a week.

    Many people use the strategy of first attempting to jump-start a natural healing process by aggressively and faithfully using the DCI treatment protocol for several months before attempting surgery for their Dupuytren’s contracture. All Dupuytren’s contracture surgery carries with it the promise of recurrence that will be a worse DC than the condition before the surgery; disturbing the tissue triggers a more intense fibrous tissue outpouring. For this reason I suggest that everyone try a more conservative treatment approach that has, in the time we have been doing this work since 2002, not once resulted in recurrence. Our success rate is that we get 8-10 reports of improvement (from moderate to marked) for every one report of failure.

    Your questions:
    1. Ultrasound is not dangerous as a Dupuytren’s contracture treatment when used as instructed. It is a good therapy for DC because it can be easily and safely self-administered.
    2. I have not heard much success reported from use of hydrolysed type 2 collagen supplements for Dupuytren’s contracture, and cannot comment much about it.
    3. Diet is an important component of treatment in relation to keeping the blood pH in the most favorable alkaline range. This is done by emphasizing the intake of fresh fruits and vegetables, and avoiding intake of sugar, refined wheat and meat. This is an over-simplification of the dietary restrictions, but you get the idea. Please do a Google search for “alkaline diet” or “diet to reduce blood pH” for more details.

    Please let me know if I can help you in any way. TRH

  49. Andrea says:

    Dear Dr. Herazy,
    I was diagnosed with Dupuytren’s contracture. I have been using Serrapeptase and eating a whole foods plant-based diet (promotes blood alkaline pH). I was wondering if there are any scientific studies that you could point me to that support this approach that might assist me. I would greatly appreciate that. Thank you!
    Sincerely, Andrea

  50. Dr.Herazy says:

    Greetings Andrea,

    Your use of serrapeptase and a diet that promotes tissue alkalinity are a good start to treat Dupuytren’s contracture. Greater variety of treatment, especially with the addition of enzymes and several external therapies, should be helpful to reduce your Dupuytren’s contracture.

    There are currently no scientific studies that investigate this Alternative Medicine approach that is used by DCI. The scientific method is all about the isolation of variables and the study of specific single treatments; this is why it is used in drug research. However, the scientific method cannot be used to evaluate the multi-therapy treatment of Dupuytren’s contracture used by DCI. You will read something like, “A scientific study has shown that vitamin E is ineffective against Dupuytren’s contracture,” or “University research has shown that an alkaline diet does not mitigate the course of Dupuytren’s contracture.” These are both examples of evaluations of isolated treatments that are ineffective by themselves to help the body eliminate Dupuytren’s contracture, yet are extremely useful when used in combination with other Dupuytren’s contracture therapies. We agree that small and isolated efforts of natural remedies do not help these resistant and complex fibrous tissue problems like Dupuytren’s contracture; this is why DCI favors the use of large and multilayered combinations of natural internal and external therapies that assist the natural healing process.

    Many cases of Dupuytren’s contracture self-heal in the early stages. We seldom hear about these cases, but it does happen often. Since 2002 the Dupuytren’s Contracture Institute has studied how that process of self-healing works and how we can assist that process so that people who do not spontaneously heal when they should can be helped to do a better job of healing their own hand nodules and lumps later. DCI is simply trying to help that process in any way that makes sense. Over time we are slowly putting ideas together that increase our success rate. Sometimes it works and sometimes it does not help. We do not have all the answers to help people do a better job of eliminating their hand nodules and cords, but what we do is often significant. Our success rate with Dupuytren’s contracture is that we get 8-10 reports of improvement (from moderate to marked) for every one report of failure. As we learn how to use the natural vitamins, minerals, enzymes and other therapies better perhaps the reports of improvement will increase. Please look over the information on the DCI website to determine how this is done.

    Please let me know if you would like more information about Dupuytren’s contracture. TRH

  51. Martha Miners says:

    Greetings Dr. Herazy,

    I started with the Dupuytren’s contracture large plan, and found I could not tolerate the Quercitin/Bromelain supplement even with food. Is it okay to continue with the other supplements without a substitution for this one?

  52. Dr.Herazy says:

    Greetings Martha,

    Sorry to hear of your gastric sensitivity with the Quercetin/Bromelain. This is rather unusual in that the few people who notice stomach queasiness or discomfort while taking it on an empty stomach find complete relief if they take Q/B with food. Did you try reducing your dosage of Q/B down to just one pill at a time with food? Did this also cause gastric distress? Do you have a prior history of a sensitive gastric tract?

    To answer your question, yes, you can easily substitute the Q/B out of your Dupuytren’s contracture treatment plan by taking L-arginine or coenzyme Q10 (Ubiquinol) instead. You might also consider using a straight bromelain product like our Bromelain 5000 since this is a very good enzyme that breaks down foreign protein nicely.

    Please keep me posted with how you progress. Good luck with your care. TRH

  53. Martha Miners says:

    Dear Dr. Herazy

    Thank you very much for your suggestions for my Dupuytren’s contracture plan. I did try taking one Q/B a day with food and still had excessive flatulence. I kept it up with occasional breaks until I finished the bottle, and that reaction never went away. I do not have digestive sensitivity in general except that I am celiac, and would have symptoms if I did consume gluten grains, but have not done that for many years.

    Since you are suggesting substituting the Bromelain 5000, you must be confident that it is the Quercitin that is causing the problem. I already take Ubiquinol at 50 mg a day and another supplement that contains CoQ10 at 75 mg a day. Is that enough?

  54. Martha Miners says:

    Dear Dr. Herazy

    I looked up your recommended ubiquinol supplement and see that it’s 100 mg once a day to start, so I will do that.

    Thank you very much,


  55. Dr.Herazy says:

    Greetings Martha,

    Yes, that should be enough Ubiquinol to add to you Dupuytren’s contracture program. TRH

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