What should you know about facial morphea?

Morphea, also called localised scleroderma, is inflammation and hardening in defined areas of skin and underlying tissue. On the face it may begin as a lighter, darker, pink or purplish patch, then become firm, shiny, tight or depressed. Hair may thin within the area, and a line on the forehead or scalp can affect deeper tissues.

The condition is not the same as systemic scleroderma. A dermatologist may examine the skin, ask whether the area is changing, photograph it for comparison and sometimes arrange a biopsy or other assessment. Activity matters because treatment decisions differ between an enlarging inflammatory patch and an old, stable mark.

Arrange a dermatology review for a new firm or changing facial patch, especially near the eye, mouth or scalp. Bring photographs showing when it started and how it has changed. Treatment may include prescribed anti-inflammatory medicines; topical calcineurin inhibitors can be discussed for selected areas. Narrowband UVB phototherapy may be considered for suitable superficial disease.

Use a bland moisturiser and protect the area from sun, which can make colour differences more noticeable. Do not massage, inject, peel or apply potent steroid products without guidance. If the condition affects deeper tissue, the care team may involve other specialists and monitor movement, growth and function.

Contact a dermatologist promptly if the patch is enlarging, becoming darker or more inflamed, developing a new groove, or causing tightness. Seek urgent care for eye pain, vision change, difficulty opening the eye, trouble speaking or swallowing, or sudden weakness. A painful ulcer, infection or rapidly changing area also needs timely assessment.

Ask whether the morphea appears active, whether deeper tissue is involved, if a biopsy is useful, which treatment fits the location, how progress will be measured, and whether eye, dental or other specialist review is needed.