Diagnosis

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.

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.

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.

Alternative medicine

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.

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.

Preparing for your 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 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?
Sept. 29, 2015
References
  1. AskMayoExpert. Morphea. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  2. Goldsmith LA, et al., eds. Morphea. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012.
  3. Ravelli NF, et al. Interventions for morphea. Cochrane Database of Systematic Reviews. http://ovidsp.tx.ovid.com/sp-3.16.0b/ovidweb.cgi. Accessed Aug. 6, 2015.
  4. Tolkachjov SN, et al. Progressive hemifacial atrophy: A review. Orphanet Journal of Rare Diseases. 2015;10:39.
  5. Sartori-Valinoitt JC, et al. Updates on morphea: Role of vascular injury and advances in treatment. Autoimmune Diseases. 2013;2013:467808.
  6. Para-aminobenzoic acid (PABA). Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/nd/PrintVersion.aspx?cs=MAYO&s=ND. Accessed Aug. 6, 2015.
  7. Valanclene G, et al. Pathogenesis and treatment modalities of localized scleroderma. Medicina (Kaunas). 2010;46:649.