In Ask a Dermatologist

We all get dry skin from time to time. Especially after a harsh winter, your skin may be dry and red. Likewise, after a harsh summer of sun and pool chlorine, your skin may also be dry, which is normal for most. However, there is a difference between dry skin and a condition called ichthyosis. Ichthyosis is a skin condition that results in more than typical dry skin. Studies show that, in the United States alone, at least 200 babies are born with a moderate to severe form of ichthyosis each year. Here, we highlight facts about ichthyosis and when to see a dermatologist.

What is ichthyosis?

Ichthyosis is a skin condition that gets its name from the Greek word for “fish.” The skin becomes dry and flaky, resembling fish scales, hence the name. Rather than being a single disease, ichthyosis makes up about 20 different skin conditions. People with ichthyosis shed old cells slowly and make new skin cells more rapidly than normal, and this leads to a buildup of skin that resembles fish scales. In all 20 conditions, people also lack the protective barrier that locks moisture into the skin, so it becomes very dry.

What are the different types of ichthyosis?

As mentioned, there are approximately 20 different types of ichthyosis. Most forms are rare, and most only cause surface issues, meaning the skin is dry and scaly. Some forms of the disease cause internal problems as well. The two most common types of the disease are ichthyosis vulgaris, which affects one in every 250 people, and X-linked recessive ichthyosis, which affects about one in 6,000 males.

What can irritate or trigger ichthyosis?

Genetics is usually the culprit. The condition can be inherited, meaning a person has inherited the genetic mutation that causes ichthyosis. Genes tell the body how to make proteins, and with ichthyosis, a genetic mutation alters the proteins that create the protective moisture layer on the skin. These proteins also dictate how quickly the skin makes new cells and sheds old ones. Parents pass the genes along to children, and it is possible for a male child to have ichthyosis even though both parents do not. The parents are simply carriers of the gene but don’t exhibit symptoms. Sometimes children get the disease even before birth.

Ichthyosis can also be an acquired condition, meaning the disease can start when a person is an adult. Researchers don’t understand why adults acquire the disease, but people with it often have other conditions like kidney disease, hypothyroidism (a less-than-active thyroid gland), HIV, certain cancers like Hodgkin’s lymphoma or even the rare disease sarcoidosis, which is characterized by inflammatory areas inside the body.

Certain medications are also known to trigger the condition. The high cholesterol treatment nicotinic acid is a trigger, as are some cancer drugs like protease inhibitors and hydroxyurea drugs.

What is the most effective treatment for ichthyosis?

If you have ichthyosis, the best treatment is to keep the skin moisturized with creams or lotions. People with the condition need to moisturize daily. Products with propylene glycol, lanolin, urea or hydroxy acids are best, as are creams that contain cholesterol or ceramides. To truly lock in moisture to the skin, apply the product right after bathing or showering while your skin is still damp.

Saltwater baths are also very soothing. Many patients find the need to remove the dead skin physically by using a pumice stone or chemically by using products with lactic, glycolic or salicylic acids.

When patients have severe scaling and dryness, dermatologists often prescribe oral retinal medications like isotretinoin or acitretin.

When should you seek treatment for ichthyosis?

Most cases of ichthyosis can be managed by proper moisturizing and excess skin removal. However, patients often experience a disruption in the skin’s ability to fight off bacteria and other invaders. Patients with more severe cases have skin scales that fall off, exposing the skin to harmful bacteria.

Seek treatment if your skin is severely dehydrated or if you are developing infections. Sometimes, the skin scales are thick enough to block sweat glands or hair growth, so seek treatment in these cases. In particular, blocked sweat glands are dangerous because it can lead to your body overheating.

Ichthyosis can be unsightly and, as such, can cause a person emotional distress over his or her appearance. If you are feeling depressed about your ichthyosis, visit a doctor.

Ichthyosis treatment in Columbia

Ichthyosis is a problematic issue in which the skin is scaly and dry, but it can be managed fairly easily at home and can also be effectively treated by a dermatologist. If you have more than just normal dry skin, make an appointment at Columbia Skin Clinic today.

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