Ichthyosis Vulgaris Treatment

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Ichthyosis Vulgaris Treatment

What is ichthyosis vulgaris?

Ichthyosis is a group of more than 20 different common skin disorders that are inherited. They cause extremely dry, thick, scaly skin that’s caused when skin cells accumulate, forming scales on the skin. It’s treated with heavy duty moisturizers. The condition can be annoying but rarely affects overall health. In fact, many people never realize they have ichthyosis because the moisturizer they use keeps their skin free of scales and dryness. There is no cure for ichthyosis and it is not contagious. 

The most common type is ichthyosis vulgaris (ik-thee-O-sis vul-GAY-ris). About 95% of ichthyosis patients have this type. Usually beginning in early childhood, (between 3 months to 5 years of age) ichthyosis vulgaris often disappears in adulthood, although it can later return. Ichthyosis vulgaris is the mildest form. Other types of ichthyoses include harlequin ichthyosis, lamellar type, x-linked ichthyosis, and acquired ichthyosis vulgaris.

Causes

What causes ichthyosis vulgaris?

Most people never notice the normal process of growing, dying and shedding skin. People with ichthyosis vulgaris either produce new skin cells faster than they can shed them or produce skin at a normal rate but shed it much slower than normal. Either way, the result is a buildup of dry scaly skin that can look like fish scales.

If a child inherits the defective gene for ichthyosis vulgaris from one parent, they usually have a milder form of the disease. If the defective gene is inherited from both parents, the child will have a more severe form. 

Although very rare, adults can develop acquired ichthyosis vulgaris when a disease or medication causes it. Triggering diseases include kidney failure, thyroid disease, sarcoidosis, some cancers, and infections such as human immunodeficiency virus (HIV) AIDS or leprosy. 

Ichthyosis can also be triggered by medications or vitamins, although this is very rare. Triggering medications include Cimetidine (used to treat ulcers and acid reflux), Clofazimine (treats leprosy) or nicotinic acid, one of the B vitamins.

Acquired ichthyosis can develop before there are symptoms of the triggering disease. The person should have a complete physical exam to find the cause if this happens.

With Insurance

Dermatology

Your copay
Depending on insurance

Without Insurance

Dermatology

$89

Initial Visit

$75

Follow Up

Symptoms

What are the symptoms of ichthyosis vulgaris?

Symptoms vary from person to person and not everyone with the disease have all these symptoms:

  • Dry, rough, itchy, scaly skin that can resemble fish scales is the main symptom. Scales are white, gray or brown. The edges of each scale curl leaving the skin very rough. The legs are more commonly affected. The skin on arms, hands, torso, and scalp can also be involved. This symptom is worse in winter when the air is cold and dry. Some people find that during hot and humid weather, their symptoms go away or are barely noticeable.
  • Thickened skin, especially on the palms and soles of the feet. The skin can appear dirty.
  • Lines on the palms and soles can range from many fine lines to deep cracks in the skin in severe cases. 
  • Infection can develop when the skin splits or develops deep cracks.
  • Rough bumps on the skin that can resemble acne, usually develop on the arms, thighs and buttocks. This condition is called keratosis pilaris, and it’s common even in people who do not have ichthyosis vulgaris.
  • Inability to sweat normally in very severe cases can cause overheating. Some people develop excessive sweating (hyperhidrosis).
  • Asthma and atopic dermatitis (eczema) are present in up to 80% of people affected by ichthyosis vulgaris.
  • Hay fever and hives can develop in children with ichthyosis vulgaris.

Diagnosis

How is ichthyosis vulgaris diagnosed?

Diagnosing a rare or genetic disease can be challenging. A dermatologist can diagnose ichthyosis vulgaris by looking at the skin. A small amount of skin may be removed so it can be analyzed to rule out other skin conditions. He/she may ask some questions about the patient’s health history, such as:

  • Do you have blood relatives with similar skin problems?
  • At what age did this develop?
  • Do you have other skin problems?
  • Do you have other medical conditions?
  • What medicines, vitamins and supplements do you take?
  • What improves/worsens your symptoms?
  • Do symptoms come and go or are they constant?

Treatment

How do you treat ichthyosis vulgaris?

Treatment focuses on managing the symptoms. Treatment medications can include:

  • Creams and ointments that contain alpha hydroxy acids (lactic or glycolic acids) to increase the skin’s moisture level, control skin scaling and help the skin to shed normally
  • Retinoids (vitamin A) to reduce skin cell production
  • Antibiotics may be needed if a secondary infection develops from deep skin cracks

Stronger medications may be needed if symptoms worsen, or there’s no improvement with self-care measures.

Self-care includes:

  • Frequent baths with mild soap can add moisture to the skin and soften the scale.
  • Open sores should be coated with petroleum jelly or something similar before bathing to reduce the stinging of water on open sores.
  • Some patients add salt to the water to reduce the stinging and the itch.
  • Soaking softens the scale and makes it easier to remove with an abrasive sponge, buff puff or pumice stone.
  • Apply moisturizer immediately after bathing to seal in water; apply petroleum jelly to the deep cracks.
  • If you get a lot of skin infections, adding a small amount of chlorine bleach to the bath water can reduce the bacteria on your skin.
  • Use a portable humidifier, or have one installed on your furnace system, to add moisture to the air -- especially helpful during winter months.

Inherited ichthyosis vulgaris often improves with age, however, some people have to keep treating it for life. Acquired ichthyosis vulgaris is treated by first identifying the disease that triggered it, and then treating that disease. Reducing the dose of medicine that caused it is also usually successful.

References

Mayo Clinic (Sept. 2021). Ichthyosis Vulgaris. Retrieved 9-20-21, {https://www.mayoclinic.org/diseases-conditions/ichthyosis-vulgaris/symptoms-causes/syc-20373754}
American Academy of Dermatology. (N.d.). Ichthyosis Vulgaris: Overview. Retrieved 9-20-21, {https://www.aad.org/public/diseases/a-z/ichthyosis-vulgaris-overview}
American Academy of Dermatology. (N.d.). Ichthyosis Vulgaris: Symptoms. Retrieved 9-20-21, {https://www.aad.org/public/diseases/a-z/ichthyosis-vulgaris-symptoms}
American Academy of Dermatology. (N.d.). Ichthyosis Vulgaris: Treatment. Retrieved 9-20-21, {https://www.aad.org/public/diseases/a-z/ichthyosis-vulgaris-treatment}
American Academy of Dermatology. (N.d.). Ichthyosis Vulgaris: Causes. Retrieved 9-20-21, {https://www.aad.org/public/diseases/a-z/ichthyosis-vulgaris-causes}
National Center for Advancing Translational Sciences. (n.d.). Ichthyosis Vulgaris. Genetic and Rare Diseases Information Center. Retrieved 9-20-21, {https://rarediseases.info.nih.gov/diseases/6752/ichthyosis-vulgaris}

Information

Medically reviewed by:

Dr. Javeed Siddiqui, MD, MPH

Dr. Siddiqui is the Chief Medical Officer at TeleMed2U responsible for clinical and technical program development as well as maintaining a thriving telemedicine practice in infectious diseases which includes specialized care of Hepatitis and HIV.

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Affordable –
with or without insurance

With Insurance

Dermatology

Your copay
Depending on insurance

Without Insurance

Dermatology

$89

Initial Visit

$75

Follow Up