Ichthyosis Vulgaris

Ichthyosis vulgaris is a condition that happens when the dead skin cells are not eliminated. It is also known as the "fish scale disease" due to the look of the accumulated dead skin. The dead cells, which are completely dry, build up in patches on the skin surface. It is an inherited disease, with a genetic cause.

In most cases, ichthyosis vulgaris is not very severe and only some parts of the body are affected. Rarely, ichthyosis vulgaris extends over a large surface and covers the back, abdomen, legs and arms, with a significant effect.

What are the signs and symptoms of ichthyosis vulgaris?

When someone suffers from ichthyosis vulgaris, the skin continues to produce new cells as normal. The dysfunction appears on the corneum stratum, or the exterior layer of the skin, where dead cells don't separate properly from the rest and are not shed at a normal rate. As a result, dead cells build up and look like scales. For some reason, the effect is most common and visible on the lower part of the legs, even if other zones of the body can be affected. It rarely happens on the face, while the effect on the torso is usually mild. In the rare situations when it does appear on the face, the scales are found only on the cheeks and forehead. The scales normally have a white color and tend to be small. Ichthyosis vulgaris looks different on the palms and feet soles, where instead of scales the skin becomes very thick and its lines can be deeper than normal.

As an inherited disease, ichthyosis vulgaris is present since birth but not always visible immediately. However, the symptoms usually develop during a baby's first year of life. Warm climates or hot summer weather can have a positive effect on the condition, which also improves as a person ages.

What causes ichthyosis vulgaris?

Ichthyosis vulgaris is sometimes visible since birth or appears early in life but in most cases it disappears completely in childhood. Some people are healed for good, but there are cases when the condition comes back in adult life.

It is an inherited disease, like many other skin problems, so the root cause has a genetic nature. It is one of the most widespread of the genetic skin problems because only one of the parents with a faulty gene is enough to transmit it. In medical terms, this is known as an autosomal dominant pattern.

However, it is possible for ichthyosis vulgaris to affect adults who don't have the mutated gene at all. The cause in this situation is another disease, usually very serious ones such as kidney failure, thyroid dysfunctions or cancer.

Ichthyosis vulgaris is sometimes combined with other skin problems, such as eczema (atopic dermatitis) or keratosis pilaris. Eczema is a rather common issue that causes very itchy rashes on the skin. It can also cause an effect that resembles ichthyosis vulgaris, with thick skin and patches covered in scales. Keratosis pilaris appears on the arms, legs and buttocks and causes red or white skin bumps that look similar to acne. It contributes to making the skin rougher in the affected areas.

Treatment options

Since the disease is inherited, ichthyosis vulgaris can't be directly cured. However, the symptoms can be treated and there are several methods available to make them less severe as part of a treatment plan.

An easy remedy is to take baths very often. The soaked skin becomes softer, while the scales are more likely to detach. Open sores must be protected before entering the water, with petroleum jelly or a similar skin care product, otherwise the bath can be very unpleasant, with a burning or stinging sensation. Adding bath salts or sea salt can reduce these problems, as well as itching. Common table salt is also effective, if the other types are not available.

The scales become hydrated and soften up during a bath, so it is possible to remove them. While the skin is still soft, use an abrasive item to eliminate scales, such as a buff puff, pumice stone or sponge. You have to do it gently, without applying too much pressure.

When the skin is damp in the first two minutes after exiting the bath, apply a moisturizing product. Moisturizers basically keep the water on your skin and maintain it hydrated. Normal cosmetic products are effective but your doctor can prescribe you a stronger one, with alpha hydroxyl acid, lactic acid, urea or other active ingredients. These can reduce the scales even further. Deep cracks should be coated in petroleum jelly, which is a cheap but effective product.

Normal skin infections must be treated, ask for an advice from your dermatologists. Either oral or topical medicine can be used to treat them. If skin infections happen often after bathing, put a small quality of bleach in your water. Bleach is an antiseptic and can kill some of the bacteria in the water, reducing their number on the skin. However, only use bleach if told by a doctor. Another useful treatment against ichthyosis vulgaris is vitamin D supplements, especially in very serious cases.

Several more powerful drugs are also available. However, these are only prescribed by doctors if the simpler methods fail, such as the baths and moisturizers.

Mild cases of ichthyosis vulgaris disappear during the summer and only require treatment in the winter season. Ichthyosis vulgaris is a lot less severe in wet climates, which make the skin moist. Only when the air becomes dry during the winter, some of the scales can return.

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