Hyperkeratosis

Medically reviewed by Sarah Taylor, MD on June 15, 2017Written by James Roland on June 15, 2017

What is hyperkeratosis?

Hyperkeratosis refers to thickening of your skin’s outer layer. This layer is made of a protein called keratin. Keratin can start to overgrow in many different conditions.

Some types of hyperkeratosis are inherited conditions. They may be present at birth. Other kinds of hyperkeratosis may be early signs of skin cancer. They tend to develop later in life.

What are the different types of hyperkeratosis?

In some cases, hyperkeratosis is the skin’s response to rubbing or irritation. A corn or callus on your hands or feet is a form of hyperkeratosis. Keratin is a tough type of protein and is meant to help protect your skin. A bump or patch of thickened skin is known as a hyperkeratotic lesion.

Other types of hyperkeratosis include:

Chronic eczema: Eczema is a condition in which patches of dry, scaly skin develop. Often the cause is unknown. Eczema is believed to be the result of genetic or environmental causes.

Actinic keratosis: These are usually small, reddish, scaly bumps that emerge after exposure to too much ultraviolet light. Sun exposure is the most common culprit. Actinic keratosis means you have precancerous growths. A dermatologist should inspect them.

Seborrheic keratosis: These small brown or black patches usually appear on the face, neck, shoulders, and back. They’re noncancerous, but often look suspicious. This is one of the most common benign skin growths that develop on adults.

Epidermolytic hyperkeratosis: This condition can be seen at birth. Newborns have reddish skin and sometimes blisters too. There are two main types of this form of hyperkeratosis: PS-type epidermolytic hyperkeratosis features thickened skin patches on the hands and feet. If you have NPS-type epidermolytic hyperkeratosis, your hands and feet may not be affected, but tough skin patches may develop elsewhere on your body.

Keratosis pilaris: Often described as “goose flesh,” keratosis pilaris is a harmless condition. It tends to develop on the upper arms, but may also appear on the legs and buttocks. Too much protein in the skin leads to tiny bumps on the skin that are more of a nuisance than a health concern.

Follicular hyperkeratosis: Also known as inverted follicular hyperkeratosis, this condition presents as a single bump, often on the face, of middle-aged or older adults. These growths are benign (noncancerous), but they often look like cancerous lesions.

Psoriasis: This inflammatory disease commonly causes hyperkeratotic, scaly silver plaques, or scales, on the skin.

When should you see a doctor?

Some types of harmless hyperkeratosis resemble cancerous growths, while others can actually be precancerous. To be sure you’re safe, you should have the suspicious lesions evaluated by a doctor. Corns, calluses, and eczema should be treated if they’re making you uncomfortable.

When you do see a doctor, you’ll be asked about your:

  • personal medical history of skin problems, allergies, and autoimmune diseases, if any
  • family history of skin conditions
  • sun exposure and use of sunscreen
  • use of smokeless tobacco or smoking products

If you have chronic eczema, you may be advised to use mild soaps, thicker creams, and perhaps topical steroids. Growths suspected of being cancerous or precancerous, such as actinic keratosis, may be treated with liquid nitrogen or other methods, or biopsied. A biopsy involves taking a bit of tissue and having it tested for cancer in a lab.

How is hyperkeratosis treated?

Treatments for hyperkeratosis depend greatly on the type of disease you have.

Corns and calluses

Corns and calluses usually disappear over time once the source of skin irritation is removed. You should stop wearing ill-fitting shoes to deal with foot problems. Padding to protect the affected areas is helpful. Moisturizing the areas helps also.

In some cases, the thickened patch of skin can be filed down. This should be done at a doctor’s office. Don’t try to cut away or scrape off a corn or callus by yourself.

Eczema

Topical treatment with corticosteroids can often help an eczema flare-up. Consistently following good bathing habits, such as moisturizing areas that are prone to flare-ups, may also help prevent future episodes.

Actinic keratosis

Procedures to treat this precancer include freezing the lesion (cryosurgery), using special creams, or even having chemical peels. The precancer should get a scab, or sometimes a blister, flake off, and disappear.

Seborrheic keratosis

Treatment with liquid nitrogen is effective. Sometimes the patches can also be removed by curette or with a shave removal technique.

Epidermolytic keratosis

This and other inherited forms of hyperkeratosis can’t be cured. Medications that include a form of vitamin A can sometimes improve symptoms. There is also research being done to use gene therapy to help treat this condition.

Keratosis pilaris

This condition usually clears up on its own in time. However, a dermatologist may be able to suggest treatment options to improve the appearance of your skin.

Follicular keratosis

Scalpel surgery or laser treatment can remove these lesions, though treatment isn’t necessary.

Psoriasis

Treatments for this disease depend on how severe it is. They can range from topical ointments for mild to moderate cases, to light therapy and oral or injected medications for more severe cases.

What is the outlook for hyperkeratosis?

The type of hyperkeratosis you have will determine how much or how little the skin condition affects your quality of life.

Talk with a dermatologist about your concerns and discuss your treatment options. You may find that with some home treatments or in-office procedures, your hyperkeratosis may resolve or at least become manageable.

CMS Id: 123234