A common health condition in which the skin becomes scaly and dry is called ichthyosis vulgaris. It is caused by a genetic change (mutation), but in some cases, it is associated with other health conditions and certain medicines. Mild forms of ichthyosis vulgaris are often mistaken for dry skin. Unfortunately, there is no way to cure this condition, but you can manage the symptoms and prevent infections. Doctors usually recommend exfoliating, soaking, and moisturizing the skin regularly.
Generally, there are more than 20 types of this disease, and ichthyosis vulgaris is the most common of them. It affects about 1 in 250 people.
What Are The Symptoms of Ichthyosis Vulgaris?
Usually, the symptoms of this condition worsen during winter and improve during summer. Moreover, it is common for people with ichthyosis vulgaris to have white, gray, or brown scales on the front of the legs, back, arms, scalp, or stomach. Sometimes, they may appear on the face (mostly on the forehead and cheeks). You may also notice multiple deep lines on the palms of the hands and soles of the feet. Check below some ways the skin feels and looks in people with ichthyosis vulgaris:
- Cracked or split
- Rough
- Thick
- Scaly
- Itchy
- Dry
- Chapped
- Bumpy (keratosis pilaris)
If you notice any of the previous symptoms, do not hesitate to see a doctor for a diagnosis and prompt treatment.
Causes and Risk Factors
Typically, this condition happens due to a genetic mutation that can be inherited from the biological parents during pregnancy, or it may happen randomly (spontaneously) during fetal development. This gene is responsible for filaggrin production. This is a specific protein that binds cells together and forms the skin barrier. When this protein is in reduced amounts or even missing, the skin separates, causing scales. Sometimes, people may develop ichthyosis vulgaris from certain medicines. For example, Clofazimine, Cimetidine, or nicotinic acid (a type of vitamin B). However, this disease may happen along with the following medical illnesses. Examples include:
- Sarcoidosis
- Lupus
- Human immunodeficiency virus (HIV)
- Kidney failure
- Cancer
While anyone can develop this condition, there are some factors that may significantly increase the risk. Check some of them below:
- Age – While most people develop ichthyosis vulgaris between 2 months of age and 5 years old, it may also occur during the teen years. In rare cases, it may start even during adulthood.
- Hay fever (also known as allergic rhinitis)
- Asthma
- Eczema (also called atopic dermatitis)
- Food allergies
Nowadays, researchers continue to study the link between ichthyosis vulgaris and the previous risk factors.
Is Ichthyosis Vulgaris Contagious?
No, this condition is not contagious, which means it cannot spread from one person to another through skin-to-skin contact.
What Happens if Ichthyosis Vulgaris is Left Untreated?
People who leave this condition untreated may also experience some complications. Check some examples below:
- Pruritus (severe itching) – This complication may cause continuous rubbing, which may lead to thickened and leathery skin.
- Painful skin cracks – It often occurs due to deep splits and fissures. Mostly, it appears on the palms of the hands and soles of the feet, especially during dry weather.
- Secondary infections – Continuous cracks or split skin allow bacteria and fungi to enter the body and cause skin infections.
- Overheating – This complication occurs because thick scales on the skin block sweat glands. As a result, it becomes challenging for the body to cool itself in hot weather.
- Keratosis pilaris – In this case, you may notice small, rough bumps on the skin. They often appear on the thighs and upper arms.
- Eczema – There are a lot of people with this condition who also experience eczema, asthma, or seasonal allergies. All of them are caused by a skin-barrier protein defect.
This document does not contain a complete list of ichthyosis vulgaris complications. In any case, you can talk with your doctor about ways to reduce the risk or even prevent them. Unfortunately, it is not possible to prevent ichthyosis vulgaris. However, you can moisturize the skin to prevent flare-ups.
Diagnosis
Commonly, it is challenging to diagnose this condition because a lot of people who have mild symptoms think they just have dry skin. However, if skin moisturizers do not help, it may indicate ichthyosis vulgaris.
Typically, when doctors suspect ichthyosis vulgaris, you may be referred to a dermatologist for further testing. He/she may ask some questions about your symptoms and medical history to get more clues about your disease. In some cases, they may also perform a skin biopsy. During this procedure, doctors will take a sample of the affected skin to examine it under a microscope. Physicians may also perform additional tests to check for a filaggrin mutation, which is common in people with ichthyosis vulgaris.
Treatment
This condition cannot be cured. That’s why the treatment goal is to relieve the symptoms, prevent serious complications, and improve your quality of life. Usually, doctors recommend soaking, exfoliating, and moisturizing the skin regularly. When this skin condition happens due to another condition, doctors may prescribe additional treatment. However, if a medicine causes this condition, your physician may reduce the dose or even change the medicine. If you develop a severe form of ichthyosis vulgaris, doctors may prescribe oral retinoids (such as Acitretin or Isotretinoin) to reduce the symptoms.
Frequently Asked Questions
Can ichthyosis vulgaris go away on its own?
Ichthyosis vulgaris is usually a lifelong condition, although symptoms may become less noticeable with age. Regular skin care can help control dryness, scaling, and itching.
Is ichthyosis vulgaris hereditary?
Yes. The most common form is often inherited because of changes in the FLG gene, which provides instructions for making Filaggrin, an important protein in the skin barrier. However, not everyone with ichthyosis vulgaris has an identifiable FLG mutation.
Can ichthyosis vulgaris get worse with age?
Symptoms often begin in early childhood and may become less noticeable during adulthood. However, dryness and scaling can continue throughout life and may worsen when the weather is cold or dry.
What makes ichthyosis vulgaris worse?
Cold, dry weather and low humidity commonly worsen symptoms. Long, hot showers or baths and harsh soaps can also dry out the skin and increase scaling and irritation.
How often should I moisturize if I have ichthyosis vulgaris?
Moisturizers are generally most effective when applied frequently, especially immediately after bathing while the skin is still slightly damp. Your dermatologist can recommend how often to apply them based on the severity of your symptoms.
What ingredients are helpful for ichthyosis vulgaris?
Moisturizers containing ingredients such as urea, lactic acid, alpha-hydroxy acids, or salicylic acid may help soften and remove excess scales. However, some products can irritate sensitive or cracked skin, so it is best to follow your healthcare provider’s recommendations.
Can ichthyosis vulgaris cause skin infections?
It can increase the risk of secondary skin infections because severe dryness and cracking can damage the skin barrier. Seek medical attention if you develop increasing redness, warmth, swelling, pain, pus, or fever.
Can people with ichthyosis vulgaris swim?
Yes. Most people with ichthyosis vulgaris can swim. However, chlorine and prolonged exposure to water may dry or irritate the skin. Applying a moisturizer after swimming and showering can help reduce dryness.
Does ichthyosis vulgaris affect sweating?
Severe scaling may interfere with sweating and the body’s ability to cool itself, potentially increasing the risk of overheating. People with significant symptoms should take precautions during hot weather and seek medical advice if they have difficulty regulating their body temperature.
When should someone with ichthyosis vulgaris see a dermatologist?
You should consider seeing a dermatologist if persistent dry, scaly skin does not improve with regular moisturizing, if symptoms interfere with daily activities or sleep, or if you develop painful cracks, signs of infection, or difficulty tolerating heat. A dermatologist can confirm the diagnosis and recommend an appropriate skin-care regimen. Ask your healthcare provider if you have additional questions.
