If I may be blunt, ulcers as a result of Secondary Raynaud's (as in secondary to systemic scleroderma) are a chronic problem and require aggressive treatment and trump your dislike of needles and Iloprost.
Now let me just explain my position, I had Iloprost once in 2007, 6 hours a day over 5 days and I NEVER had it again. The side effects were truly awful for me and as my Raynaud's is not bad why suffer needlessly!
I have had the same ulcers for 4 years! I have foot ulcers cause by the breakdown of skin not because of poor blood flow, and have just been discharged from the hospital as there's nothing more they can do for me! Great eh? Skin grafts were bandied about but even I knew they'd never work, after all I still have tight skin all over my feet and ankles so the grafted skin would never take and of course I'd then have fresh wounds elsewhere that may not have healed.
As far as the ulcers are concerned, district nursing will continue and I'll just have to live with great patches of open skin on my feet I guess. Painful? Oh yes!
If Iloprost improves your Raynaud's and therefore the ulcers, maybe you should continue with it? I know of people who have it as regularly as every 3 months. If it would help my ulcers I would have it again believe me!
I am also on Amlodipine, 10 mg once a day, for blood pressure and my migraines also disappeared! Scleroderma and Raynaud's are vascular diseases and migraines are a type of vascular headache, during the first two years of my scleroderma the migraines returned with a vengeance, having previously disappeared for about 5 years. It was not until I added Amlodipine into my drug regime that the migraines again went! Let me tell you that given the choice then I would have had rid of the migraines over the scleroderma because they were that painful, that frequent, that debilitating and unpredictable, of course I was yet to have any internal organ involvement from the scleroderma.