The Effect of Water-Filtered Infrared-A (wIRA) Radiation on Morphea: An Intra-Individual Pilot Split-Study

Water-filtered infrared-A (wIRA) has been proposed to enhance tissue perfusion and modulate fibrosis, but clinical evidence in morphea (localised scleroderma) is limited. We conducted a prospective, intra-individual pilot split-study in 10 adults (six female; mean age 47.6 +/- 19.0 years). One plaque per patient received wIRA using a Hydrosun device (30 min, three times weekly, for 20 weeks; 60 sessions); a clinically comparable contralateral plaque served as untreated control. Blinded assessments at baseline, after 30 and after 60 sessions comprised high-frequency ultrasound (22 MHz; primary endpoint), durometry, Patient Global Impression of Change and a Skin-Change-Perception scale; safety was recorded throughout. Outcome measurements showed substantial inter-individual variability, and irradiated plaques did not significantly improve compared with baseline or with untreated control plaques. However, treatment was well tolerated; two participants reported transient mild burning during early sessions, and no serious adverse events were observed. Larger, adequately powered trials with optimized irradiation parameters and complete follow-up are warranted to clarify the role of wIRA in morphea.