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. Morphea tends to affect only the outermost layers of your skin. But some forms of the condition also 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.
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 when 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 and, rarely, bone. The condition generally lasts several years and then disappears on its own. But it usually leaves some patches 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.
The causes of morphea are unknown. It may be due in part to an unusual reaction of the immune system. Or it may be triggered by:
- Radiation therapy
- Repeated trauma to the affected area
- A recent infection, such as measles or chickenpox
The condition isn't contagious.
Certain factors may affect your risk of developing morphea, including:
- Your sex and age. Females are more likely to develop morphea than are males. The condition can affect people at any age. It usually appears between the ages of 2 and 14 or in the mid-40s.
- Your race. Morphea is more prevalent among Caucasians.
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, permanent eye damage.
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 these 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
Your doctor is likely to ask you a number of questions, such as:
- 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?
Your doctor may diagnosis 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 the collagen in the second layer of skin (dermis). Collagen is a protein that 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, so if you have morphea, your doctor will likely 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 in for regular comprehensive eye exams, as morphea may cause unnoticeable yet irreversible eye damage.
Ultrasound and magnetic resonance imaging (MRI) may be useful in monitoring disease progression and how it is responding to 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:
- Light therapy. A special treatment that uses ultraviolet light (phototherapy) may improve your skin's appearance, especially when used soon after skin changes appear.
- Drugs that fight inflammation. Your doctor may prescribe an immunosuppressive medication, such as oral methotrexate (Rheumatrex, Trexall). This may be used in combination with corticosteroid pills for the first few months. Each of these drugs has potentially serious side effects.
- A form of vitamin D. The prescription cream calcipotriene is a synthetic form of vitamin D. It may help soften the skin patches caused by morphea. Skin generally begins to improve during the first months of treatment. Possible side effects include burning, stinging and a rash.
- Physical therapy. This type of treatment uses exercise to prevent joint deformity and maintain movement.
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.
Para-aminobenzoic acid (PABA) is an oral medication that has been used to treat morphea. But it hasn't been proved to reduce skin symptoms in clinical trials. If you're interested in trying PABA, discuss its proper use with your doctor.
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.