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Morphea

Medically reviewed on Oct 1, 2018

Overview

Morphea (mor-FEE-uh) is a rare skin condition that causes painless, discolored patches on your skin.

Typically, the skin changes appear on the abdomen, chest or back. But they might also appear on your face, arms or legs. Over time the patches may become hard, dry and smooth. Morphea tends to affect only the outer layers of your skin. But some forms of the condition also affect deeper tissues and may restrict movement in the joints.

Morphea usually subsides on its own over time, though recurrences are common. In the meantime, medications and therapies are available to help treat the skin discoloration and other effects.

Morphea

Morphea is a rare skin condition characterized by small red or purple patches that develop firm white or ivory centers. The affected skin becomes tight and less flexible.

Symptoms

Signs and symptoms of morphea vary, depending on the type and stage of the condition. They include:

  • Reddish or purplish oval patches of skin, often on the abdomen, chest or back
  • Patches that gradually develop a lighter or whitish center
  • Linear patches, especially on the arms or legs
  • A gradual change in the affected skin, which becomes hard, thickened, dry and shiny
  • Loss of hair and sweat glands in the affected area over time

Morphea usually affects only the skin and underlying tissue but sometimes involves bone as well. The condition generally lasts several years and then disappears by itself. It may leave scars or areas of darkened or discolored skin.

When to see a doctor

If you notice reddish patches of hardening or thickening skin, see your doctor. Early diagnosis and treatment may help slow the development of new patches and allow your doctor to identify and treat complications before they worsen.

Causes

The cause of morphea is unknown. Some experts think it is caused by an infection, but that theory has not been proved. The condition isn't contagious.

Risk factors

Certain factors may affect your risk of developing morphea, including:

  • Female sex. Females are more likely to develop morphea than are males.
  • Age. The condition can affect people at any age. It usually appears between the ages of 2 and 14 or in the mid-40s.

Complications

Morphea can cause a number of complications, including:

  • Self-esteem issues. Morphea can have a negative effect on your self-esteem and body image, particularly if discolored patches of skin appear on your arms, legs or face.
  • Movement problems. Morphea that affects the arms or legs can impair joint mobility.
  • Widespread areas of hardened, discolored skin. Numerous new patches of hard, discolored skin may seem to join together, a condition known as generalized morphea.
  • Eye damage. Children with head and neck morphea may experience unnoticeable but permanent eye damage.

Diagnosis

Your doctor may diagnose morphea by examining the affected skin and asking you about your signs and symptoms. He or she may take a small sample of the affected skin (skin biopsy) for examination in the laboratory. This may reveal changes in your skin, such as thickening of a protein (collagen) in the second layer of skin (dermis). Collagen makes up your connective tissues, including your skin. It helps make your skin elastic and resilient.

It's important to distinguish morphea from systemic scleroderma and other conditions. So your doctor may refer you to a specialist in skin disorders (dermatologist) or diseases of the joints, bones and muscles (rheumatologist).

If your child has head and neck morphea, take him or her for regular comprehensive eye exams, as morphea may cause unnoticeable yet irreversible eye damage.

Ultrasound and magnetic resonance imaging may be useful in monitoring disease progression and response to treatment.

Treatment

Morphea usually goes away without treatment, though it may leave scars or areas of discolored skin. Until your condition clears up, you may want to pursue treatment that helps control your signs and symptoms.

Treatment options include:

  • Medicated creams. Your doctor may prescribe a vitamin D cream, such as calcipotriene (Calcipotriene, Dovonex, Taclonex), to help soften the skin patches. Skin generally begins to improve during the first months of treatment. Possible side effects include burning, stinging and a rash.

    Or your doctor may prescribe a corticosteroid cream to reduce inflammation. When used for a long time, these creams may thin the skin.

  • Light therapy. For severe or widespread morphea, treatment may include the use of ultraviolet light (phototherapy).
  • Oral medications. For severe or widespread morphea, your doctor may prescribe an immunosuppressive medication, such as oral methotrexate (Trexall), corticosteroid pills or both. Or your doctor may suggest hydroxychloroquine (Plaquenil). Each of these drugs has potentially serious side effects.

Lifestyle and home remedies

Because morphea dries the affected skin, moisturizers may help soften and improve the feel of your skin. It's a good idea to avoid long, hot showers or baths, as these can dry your skin.

Coping and support

Because morphea affects your appearance, it can be an especially difficult condition to live with. You may also be concerned that it will get worse before it goes away.

If you want counseling or support, ask your doctor for a referral to a mental health professional or contact information for a support group in your area or online.

Preparing for an appointment

You may start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in skin disorders (dermatologist) or a specialist in diseases of the joints, bones and muscles (rheumatologist).

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment make a list of:

  • Symptoms you've been having and for how long
  • All medications, vitamins and supplements you take, including the doses
  • Questions to ask your doctor

For morphea, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Are there other possible causes?
  • Do I need any tests?
  • How long will these skin changes last?
  • If the skin discoloration and hardening clears up, will it ever come back?
  • What treatments are available, and which do you recommend?
  • What side effects can I expect from treatment?
  • I have other health conditions. How can I best manage them together?
  • What can I do to improve my appearance?
  • Do you have any brochures or other printed materials I can take with me? What websites do you recommend?

What to expect from your doctor

Examples of questions your doctor may ask, include:

  • When did you first notice changes in your skin?
  • Has this ever happened before?
  • Do the changes come and go or are they constant?
  • What steps have you taken to treat this condition yourself?
  • Have any of these measures helped?
  • Have you ever been treated by a doctor for this condition?
  • If so, what were the treatments? Did they help?
  • Have you had any difficulty chewing food or swallowing?
  • Have you experienced extreme cold sensitivity in your fingers or toes?
  • Have you noticed any other changes in your general health?

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