Ichthyosis Vulgaris

Written by Brian Krans
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

Ichthyosis Vulgaris

What Is Ichthyosis Vulgaris?

Ichthyosis vulgaris is a skin condition that causes dry, dead skin cells to accumulate in patches on the surface of your skin. It’s also known as “fish scale disease” because the dead skin accumulates in a similar pattern to a fish’s scales.

The majority of cases are mild and confined to specific areas of the body. However, some cases are severe and can cover large areas of the body, including the abdomen, back, arms, and legs.

What Causes Ichthyosis Vulgaris?

As with many other skin conditions, genetics play a role in the transmission of ichthyosis vulgaris. The condition follows an autosomal dominant pattern, meaning that only one parent needs to possess the mutated gene in order to pass it onto his or her child. It is one of the most common of all inherited skin disorders.

Ichthyosis vulgaris may be present at birth or can appear in the first few years of a child’s life, but it typically disappears during early childhood. Some people may never have symptoms again, but for others, it can return during adulthood.

Adults can develop ichthyosis vulgaris even if they don’t carry the defective gene. Though this is rare, it is most often associated with other conditions, including cancer, chronic renal (kidney) failure, or thyroid disease (Mayo).

Ichthyosis vulgaris may also occur along with other skin disorders, such as atopic dermatitis (eczema) or keratosis pilaris. Atopic dermatitis, more commonly known as eczema, is known for causing extremely itchy skin rashes. The affected skin may also be thick and covered in scales. The white or red skin bumps caused by keratosis pilaris can look similar to acne, but they usually appear on the arms, thighs, or buttocks. This condition can also cause rough patches of skin.

Symptoms of Ichthyosis Vulgaris

Symptoms of ichthyosis vulgaris are typically worse in winter, when the air is colder and dryer.

Symptoms of ichthyosis vulgaris include:

  • a flaky scalp
  • itchy skin
  • polygon-shaped scales on the skin
  • scales that are brown, gray, or white
  • severely dry skin
  • thickened skin

The patches of dry skin typically appear on the elbows and lower legs, most often affecting the shins in thick, dark segments. In severe cases, ichthyosis vulgaris may also cause deep, painful cracks to develop on the soles of your feet or palms of your hands.

How Is Ichthyosis Vulgaris Diagnosed?

A dermatologist—a doctor specializing in skin disorders—can typically diagnose ichthyosis vulgaris by sight.

Your doctor will ask you about any family history of skin diseases, the age you first experienced symptoms, and whether you suffer from any other skin disorders.

Your doctor will also record where the patches of dry skin appear. This will help your doctor track the effectiveness of your treatment.

Your doctor may also perform other tests, such as a blood test or skin biopsy, to rule out other skin conditions, such as psoriasis, that cause similar symptoms. A skin biopsy involves removing a small section of the affected skin for examination under a microscope.

Treating Ichthyosis Vulgaris

Researchers have yet to find a cure for ichthyosis vulgaris, so the key to controlling your symptoms is receiving ongoing treatment.

The first line of defense against scaly, dry skin is using thick moisturizers on the affected area on a regular basis. This may include applying thick creams and ointments several times a day. The experts at the Mayo Clinic suggest using moisturizers with urea or propylene glycol—even simple petroleum jelly. For best results, apply directly after bathing or swimming (Mayo). Using moisturizing, fragrance- and dye-free soaps can also help.

Your doctor may also prescribe specialized creams or ointments to help moisturize the skin, get rid of dead skin and help control inflammation and itching. These may include topical treatments containing the following ingredients:

  • lactic acid or other alpha hydroxy acids: these compounds, also used in anti-aging cosmetics, help the skin retain moisture, and reduce scaling.
  • retinoids: these substances, derived from Vitamin A, may have some adverse side effects, such as lip swelling, hair loss, or birth defects if taken during pregnancy, retinoid may be used in difficult cases to slow your body’s production of skin cells. (Mayo)

Living with Ichthyosis Vulgaris

Living with ichthyosis vulgaris and similar skin conditions is difficult at times, especially for children. If the cosmetic impact of the condition becomes too much, you may want to attend a support group or see a mental health professional. These therapies can help you to regain your confidence and deal with any emotional difficulties you may encounter.

The key to living with this condition is learning to make management of this disease part of your daily routine.

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