Ichthyosis: see the types and causes. Find out if there is a cure and how to treat it

Ichthyosis is among the conditions that can affect the skin. There are different types, which can be of hereditary origin or be acquired due to the use of some medications, infections and some diseases.

The condition has no cure, but there is treatment. That way, it is possible to control the symptoms with a few simple measures in most cases.

What is ichthyosis?

Ichthyosis can be defined as a set of skin diseases in which dead cells accumulate in thick, dry scales. Therefore, this health condition provides extremely dry skin, which resembles fish scales.

The condition can be hereditary or acquired. In the first case, it occurs due to a genetic mutation that encodes the filaggrin protein, one of the molecules responsible for the impermeability of the skin and for its hydration.

When it is an acquired (or secondary) ichthyosis, when it appears during life, it can occur due to various health conditions such as HIV , for example. And this type occurs more often in adults.

It is known that the disease affects both men and women in the same proportion.

The problem may be present from birth, but signs usually appear in the early years of childhood. In the mildest cases, it can be mistaken for extremely dry skin, which makes diagnosis difficult.

Is ichthyosis the same thing as psoriasis?

No, they are different health conditions. The psoriasis is a chronic autoimmune disease that causes rapid buildup of skin cells. Because of this, there is a peeling on the surface of the skin.

This health problem is the result of an accelerated skin production process. Whitish or red scales appear, in addition to dry skin that can bleed, itch or burn in the affected regions.

Experts believe that psoriasis occurs because of an immune system problem. And among the triggers for its emergence are infections, stress and cold.

What are the types of ichthyosis?

Ichthyosis can have several types with different symptoms. It is believed that there are more than 20 types. See some details below.

Vulgar ichthyosis

It is the most common type and usually appears during the child’s first year. It is estimated to reach one in 250 people. Dead skin accumulates in a pattern similar to the scales of a fish.

It can also occur with other skin diseases, such as atopic dermatitis . Although rare, some adults may have a health problem.

Most cases are mild and appear in specific areas of the body. However, some people present in different areas like abdomen, back, arms and legs.

Bullous ichthyosis

In addition to extremely dry skin, this type of ichthyosis causes blisters that can be very painful. In some cases, they also have a strong and unpleasant odor.

Harlequin ichthyosis

Quite serious, this type of ichthyosis is congenital, that is, the baby is already born with very dry skin, covered by thick diamond-shaped plates that resemble fish scales. The excess skin can turn the lips and eyelids inside out, turning a bright red color.

This can make it difficult for your baby to breathe and feed. Therefore, these children generally need intensive care right after birth to avoid complications or even death.

X chromosome-linked ichthyosis

The condition affects only boys after birth. And the disease brings symptoms such as scales in the regions of the hands, feet, neck, buttocks and trunk.

Acquired ichthyosis

It appears in adults who have other health conditions such as HIV, kidney disease, Hodgkin’s lymphoma , for example. They can also arise due to the use of some medications.

What are the causes?

The causes of ichthyosis vary according to the type. But most are due to a genetic mutation inherited from one or both parents.

Thus, children who inherit a defective gene from only one parent have a milder form of the disease. Those who inherit two defective genes have a more severe form.

This mutation is responsible for encoding philagrin, a protein that helps create the skin’s natural barrier. Without an effective barrier, the skin has difficulty retaining moisture. And the dehydrated cells in the dermis start to thicken and harden as they age.

The condition can also be caused due to the use of certain medications and because of health conditions that affect the whole body like cancer , thyroid problems or HIV. If genetic abnormalities are not responsible for ichthyosis, it is known as acquired ichthyosis.

What are the symptoms of ichthyosis?

The main symptom of ichthyosis is extremely dry skin, which can worsen in dry and cold climates, in addition to fine skin peeling.

In severe cases, there is an intense peeling of the skin, scalp, palms and soles. It can also appear an intense itch, in addition to deep and painful cracks in the skin.

The limbs may develop gray scales. And the skin on the palms of the hands and the soles of the feet may have more lines than normal and become thicker.

Ichthyosis affects the joints?

Not always. When ichthyosis is very intense, it can cause symptoms that disrupt body movements and cause pain when moving.

There are reports of rarer cases that link harlequin ichthyosis to inflammatory arthritis . In these situations, arthritis can affect the joints of the hands and feet, causing pain and swelling.

In addition, in severe cases, excess skin causes joint deformity. Some people experience skin infections due to cracking and others experience overheating, as they have a reduced ability to sweat.

How is the diagnosis made?

This skin disorder is usually diagnosed by pediatricians, even in childhood. Adults, on the other hand, can be referred to a dermatologist, who is responsible for treating skin problems.

In addition to analyzing the symptoms, the doctor may order blood and imaging tests to rule out other health conditions such as cancer, leprosy (infectious disease caused by bacteria) or cutaneous xerosis (excess dry skin).

Is there a cure?

To date, there is no known cure for ichthyosis. However, there are several treatment options that aim to reduce symptoms, such as the discomforts caused by excessive skin dryness.

It is worth noting that people with mild ichthyosis have a normal life expectancy. And those with acquired ichthyosis can improve as soon as the underlying cause is identified and treated appropriately.

How is the treatment?

Treatment varies according to the severity of the ichthyosis. Usually, the specialist indicates a cream with specific components to help hydrate the skin. It may be necessary to use more than three times a day.

It may also be necessary to use specific creams with acids to aid in the peeling of the skin.

In more severe cases, oral medications may be indicated to contain ichthyosis. Generally, the dermatologist is able to determine which treatment is to minimize the symptoms, as well as the most suitable products for each case and how medical monitoring should be performed.

Your symptoms can be controlled with a few changes on a daily basis.

Among the nominations of the Brazilian Society of Dermatology are:

  • Avoid long and hot baths;
  • Do not use excessive soap and always choose neutral ones;
  • Use moisturizers after bathing;
  • Use sunscreen when exposed to the outdoors;
  • Exfoliate the skin with the indicated creams;
  • Comb the damp hair to remove the scales from the scalp;
  • Avoid brushes, sandpaper and bath plugs, as they can worsen symptoms.

Remedies to control ichthyosis: what to take?

The specialist may recommend some oral medications to control the symptoms of ichthyosis. Among them are corticosteroids or drugs with vitamin A to reduce the risk of skin infections.

It is worth mentioning that creams or remedies that contain acitretin , a substance derived from vitamin A in severe cases. The Hereditary Ichthyosis Treatment Protocol, from the Ministry of Health, guides the use of a daily starting dose of 25mg / 30mg for 2-4 weeks.

The maintenance dose should be used according to the effects and results of the treatment, the maximum dose being 75mg / day.

The salicylic acid 5% can be applied once a day to the lesions, according to medical advice.

But these drugs cannot be used on their own, without prescription and medical evaluation. It is very important to seek specialized help to control this skin disorder and its complications.

In general, ichthyosis is treated with intense and frequent skin hydration. Often, it is necessary to use manipulated or specific moisturizers, guided by dermatologists.

How to prevent ichthyosis?

As it is a condition, most of the time, of a genetic character, ichthyosis cannot be prevented. Prevention, however, involves measures aimed at reducing the manifestation of symptoms – that is, for patients who already have the condition.

Based on medical guidelines, it is possible to reduce and control the incidence of symptomatic episodes.


Several conditions can affect the skin and cause discomfort. Ichthyosis is one of them, but if it is well controlled, through correct treatment, it does not harm the well-being of patients.

Find out more about treatments and causes of different dermatological conditions at Minute Healthy!

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