Ichthyosis Vulgaris Treatment

Overview
Ichthyosis vulgaris, also known as common ichthyosis or fish scale disease, is a skin condition resulting in scaly skin, especially on the arms and legs, in overgrowth (hyperkeratosis) of the skin on the palms and soles (sometimes the skin creases may crack during dry weather) It also results in keratosis pilaris (follicular hyperkeratosis) on the side of the neck, back of the upper arms, buttocks and/or thighs.

Its name is derived from the Greek word meaning "fish."

Ichthyosis vulgaris can be a trait passed on in families (hereditary), or it may develop later in life as a result of certain exposures (acquired). Hereditary ichthyosis vulgaris is an autosomal dominant genetic disorder first evident in early childhood. Hereditary ichthyosis vulgaris is also called congenital ichthyosis vulgaris. It first appears in early childhood and accounts for more than 95% of cases of ichthyosis vulgaris. It is caused by altered profilaggrin expression leading to scaling and desquamation. Visible scales are retained for longer periods and sloughed off in clumps. Hereditary ichthyosis is also associated with atopy.

The protein filaggrin is important in maintaining effective skin barrier function. Loss-of-function mutations in the profilaggrin gene (FLG) are evident in up to 10% of the population, causing ichthyosis vulgaris and representing a major risk factor for the development of atopic dermatitis.

The acquired type usually develops in adulthood and results from an internal disease or the use of certain medications, such as niacinamide, Tagamet (cimetidine) and Lamprene (clofazimine). Acquired ichthyosis is rare and must be viewed as a marker of systemic disease, including malignancy.

Acquired ichthyosis is also associated with various types of cancers:
* Hodgkin's disease, non-Hodgkin lymphoma (including mycosis fungoides), lung cancer, breast cancer, ovarian cancer and cervical cancer, among others
* sarcoidosis, leprosy, thyroid disease, hyperparathyroidism, nutritional disorders, chronic kidney failure, HIV infection
* may occur after bone marrow transplantation
* autoimmune disorders, such as systemic lupus erythematosus, dermatomyositis

Ichthyosis vulgaris is found in people of all races and of both sexes. Hereditary ichthyosis vulgaris is fairly common. As many as 1 in 250 children may have hereditary ichthyosis vulgaris. On the other hand, acquired ichthyosis vulgaris is rare and is found almost exclusively in adults.

In hereditary ichthyosis, usually at least one of the affected person's parents had the same dry, scaly skin as a child. It is inherited in an autosomal dominant fashion, meaning that each child of an affected parent has a 50-50 chance of having hereditary ichthyosis vulgaris.

Signs and Symptoms

The most common locations for ichthyosis vulgaris include:

Fronts (extensor surfaces) of the legs

Backs (extensor surfaces) of the arms

Scalp

Back

Forehead and cheeks, especially in younger children

The scales of ichthyosis vulgaris range in size from 1–10 mm and in color from white to gray to brown, with darker-skinned people often having darker scales. The legs are usually affected more than the arms. The creases on the palms of the hands and the soles of the feet are prominent and often crack during dry or cold weather. However, the scaling tends to improve in more humid or warmer weather.

The following areas tend to NOT be affected:

Face

Front of the neck

Abdomen

Folds in front of the elbows (flexural surfaces of the arms)

Folds behind the knees (flexural surfaces of the legs)

Hereditary ichthyosis and acquired ichthyosis look similar, and both are usually itchy. However, the acquired form occurs in people with many internal conditions, including:

Poor nutrition

Infections, such as leprosy or HIV/AIDS

Glandular diseases, such as thyroid or parathyroid problems

Sarcoidosis

Cancer, such as lymphoma or multiple myeloma

Use of certain medications, such as nicotinic acid, cimetidine, and clofazimine

Self-Care Guidelines
Hereditary ichthyosis vulgaris tends to improve after puberty, while acquired ichthyosis vulgaris requires treatment of the medical condition before it will improve.

However, both conditions should improve by restoring moisture (hydration) to the skin. Creams and ointments are better moisturizers than lotions, and they work best when applied just after bathing, while the skin is still moist. The following over-the-counter products may be helpful:

* Preparations containing alpha-hydroxy acids such as glycolic acid or lactic acid
* Creams containing urea
* Over-the-counter cortisone cream (if the areas are itchy)

Any cracks in the skin should be treated immediately with an over-the-counter topical antibiotic ointment (eg, Neosporin®) in order to prevent an infection.
When to Seek Medical Care
If your child continues to have very dry, scaly skin despite twice daily application of an over-the-counter moisturizer, be sure to tell his/her pediatrician.

Any adult who develops dry, scaly skin that is not improved by twice daily application of an over-the-counter moisturizer should see a physician for evaluation.

Treatment Options

To treat the dry, scaly skin of ichthyosis vulgaris the focus should be on exfoliating or softening the skin to reduce keratin clogged pores.

An important first treatment step is to use a gentle cleansing agent with light abrasive properties, often termed scrub, but one that keeps moisture (for sensitive skin). The goal is to clean and open the pores of the skin without over drying. Other measures to avoid excessive dryness include taking lukewarm, brief showers and using a humidifier, particularly during the winter months when low humidity dries out the skin.

A physician may recommend a topical cream or lotion containing the following:

* Prescription-strength alpha- or beta-hydroxy acids (glycolic acid, lactic acid, salicylic acid)
* Prescription-strength urea
* A retinoid medication such as tretinoin or tazarotene
* High concentrations of propylene glycol

For more severe, stubborn ichthyosis vulgaris, oral treatments may include:

* Isotretinoin, a very strong medication with many potential side effects, usually used in the treatment of severe, scarring acne

The chance for recovery (prognosis) for a child with hereditary ichthyosis vulgaris is excellent, as most individuals improve after puberty.

If acquired ichthyosis vulgaris is suspected, the doctor will likely attempt to determine the underlying medical condition or the medication that triggered its development. The prognosis for an adult with acquired ichthyosis vulgaris depends upon treating the underlying medical condition or discontinuing the triggering medication.

Hereditary ichthyosis vulgaris is a chronic disorder that may improve with age but often requires continuous therapy. The severity of acquired ichthyosis usually depends on the status of the underlying systemic condition. The main approach to treatment of both conditions includes hydration of the skin and application of an ointment to prevent evaporation. Hydration promotes desquamation by increasing hydrolytic enzyme activity and the susceptibility to mechanical forces. Pliability of the stratum corneum is also improved.

Topical retinoids are helpful for some patients.

Alpha-hydroxy acids (eg, lactic, glycolic, or pyruvic acids) are effective for hydrating the skin. They work by causing disaggregation of corneocytes in the lower levels of the newly forming stratum corneum.

Lactic acid is available as a 12% ammonium lactate lotion, or it can be compounded by prescription in a concentration of 5-10% in a suitable vehicle. Twice-daily applications have shown to be superior to petrolatum-based creams for controlling of ichthyosis vulgaris.

Removal of scales can be aided by keratolytics (eg, salicylic acid), which induce corneocyte disaggregation in the upper stratum corneum. A commercially available 6% salicylic acid gel can be used on limited areas.

Over-the-counter products often contain urea or propylene glycol. Moisturizers containing urea in lower strengths (10-20%) produce a more pliable stratum corneum by acting as a humectant. Propylene glycol draws water through the stratum corneum by establishing a water gradient. Thick skin is then shed following hydration. Propylene glycol is a common vehicle in both prescription and over-the-counter preparations.

Topical retinoids (eg, tretinoin) may be beneficial. They reduce cohesiveness of epithelial cells, stimulate mitosis and turnover, and suppress keratin synthesis. Tazarotene, a topical receptor-selective retinoid, has also been effective in one small trial.

Ichthyosis vulgaris is not responsive to steroids, but a mild topical steroid may be useful for pruritus.

Acquired ichthyosis vulgaris generally tends to improve with treatment of the underlying systemic condition.

Many people find ichthyosis vulgaris aesthetically unappealing and therefore look for treatment. Occasionally, they may happen to get infected because of scratchy tight-fitting clothing or abrasive self-therapy, in which case treatment of the disease is necessary.

A significant inflammatory constituent may be present and may be relieved with topical steroid therapy. Treatment of the tiny horny papules can be tricky because they are resistant to most therapeutic treatments.

Biological Skin Treatment Lotion

The only natural skin care lotion that actually works for ichthyosis vulgaris is BIOSKINTREATMENT.

BIOSKINTREATMENT softens coarse and dry skin, gets rid of excessive keratin and thus unclogs pores. It is also anti-inflammatory, controls the production of keratin while it helps to moisturize the skin by attracting water molecules when first applied.

It also restores the skin's capacity to hold in water by speeding up the production of collagen, elastin and glycosaminoglycans from inside the deep layers of the skin.

BIOSKINTREATMENT LOTION leaves your skin smooth, refreshed, soft, and healthy

BIOSKINTREATMENT ™ is a 100% natural skin care product that yields a two fold effect on skin blemishes:

(1) Purifies the cells & decongests the hair follicles as it helps to eliminate keratin plugs, debris, toxins, and all damaged skin tissues.

(2) Favors regeneration of skin cells and all the structures of healthy skin: collagen, elastin and the molecules that retain several times their weight in water in the skin (true moisturizing).

Those effects clear ichthyosis vulgaris as well as keratosis pilaris bumps, redness, rashes, acne and all skin blemishes – even scars that you have lived with for years will become softer and less noticeable.

Ultra exfoliate rough scars and dull skin with BIOSKINEXFOL

Home microdermabrasion cream. Contains the same natural ingredients in BIOSKINTREATMENT but infused with micro-crystals so that you may rub it with your finger tips to remove old, hard, and tough scars or stretch marks by a physical breakdown of the scar tissues. Best also for oily skin and aged skin, actinic keratosis scales and pitted acne scars. Not for keloids and not if your skin is still fragile (use BIOSKINTREATMENT for a few months first to strengthen your skin). The compounded action of the physical abrasion and the enzymes in the cream liquefy damaged proteins more thoroughly helping to release amino-acids to aid in rebuilding damaged tissues quickly. Results are not only immediate, but compound over time and do not trigger inflamm-aging of delicate skin tissues.

Microdermabrasion Benefits

Made in the USA. Two to Three Month's supply 120 grams = 4.23 oz

120 Gram Bottle: $89