Symptoms, Causes, Treatment, and More

Repeatedly scratching an space may cause lichenification, which is thickened, tough, and darkish pores and skin. The identify comes from its resemblance to lichen, a plant-like development discovered on rocks and bushes.

Lichenification just isn’t a situation by itself; it is how your pores and skin reacts to long-term irritation or scratching, usually from eczema or psoriasis.

There are two sorts of lichenification: main and secondary.

Major lichenification, or lichen simplex chronicus, happens when there is no such thing as a pores and skin situation inflicting your itch. Stress, nervousness, obsessive-compulsive disorder (OCD), bug bites, tight clothes, dry pores and skin, or nerve irritation can set off it.

Secondary lichenification develops when a pores and skin situation makes you itch, inflicting you to scratch extra.

When you might have lichenification, chances are you’ll discover signs on the pores and skin in areas similar to your head, neck, scrotum or vulva, arms, scalp, or thighs. Signs embody:

• Deep strains or crisscross patterns
• Dry, leathery, or bumpy patches
• Areas that seem grey, reddish-brown, yellow, or darker than ordinary
• Thicker, rougher patches that really feel totally different from the encircling space

How It Seems to be on Completely different Pores and skin Tones

Lichenification would not all the time look the identical on everybody. Your pores and skin tone can have an effect on the way it seems.

In folks of Asian descent, lichenification could seem as thick, scaly plaques with sharp edges and clear borders. On darker pores and skin, it might seem as shades of purple, grey, or darkish brown, particularly across the elbows, knees, or knuckles the place the pores and skin bends and stretches.

Something that causes you to scratch or rub your pores and skin usually may cause lichenification. The extra you scratch, the thicker and itchier your pores and skin could grow to be. This could create an itch-scratch cycle that is laborious to interrupt, inflicting lasting modifications in your pores and skin’s texture and shade. 

Threat Elements

You are extra more likely to develop secondary lichenification when you have a pores and skin situation similar to:

• Eczema
• Pityriasis rubra pilaris (crimson, scaly patches)
• Porokeratosis (thick, tough patches)
• Psoriasis (crimson, scaly patches)
• Pores and skin infections
• Dry pores and skin

You are extra more likely to develop main lichenification in the event you:

• Are feminine
• Are 30-50 years previous
• Have nervousness, stress, or obsessive-compulsive dysfunction (OCD)

Lichenification is extra prevalent amongst folks with darker pores and skin as a result of eczema signs could also be much less obvious at first, which might delay prognosis and early remedy. This will increase the probability of extreme itching and widespread eczema, making it tougher to stop lichenification.

To make a prognosis, a healthcare supplier will possible study your pores and skin and ask about your signs, triggers, and household historical past. They could additionally order assessments similar to:

• Blood assessments: Testing a blood pattern will help your supplier decide the reason for your itchy pores and skin. A blood check could embody an immunoglobulin E (IgE) check to detect allergic reactions.
• Patch testing: The sort of allergy testing will help decide when you have allergic reactions contributing to your itching. It includes making use of totally different allergens to your pores and skin to see when you have an allergic response.
• Potassium hydroxide examination: For this check, your supplier collects a small pores and skin pattern, applies a chemical resolution, and examines it underneath a microscope to detect or rule out a fungal an infection.
• Pores and skin biopsy: For a pores and skin biopsy, your healthcare supplier will study a small pores and skin pattern for irritation or illness.
• Pores and skin tradition: This swab or biopsy check helps detect micro organism, fungi, and different germs.

Lichenification remedy focuses on breaking the itch-scratch cycle so your pores and skin can heal. Therapy could contain skincare, topical therapies, and different drugs. If in case you have darker pores and skin, chances are you’ll want early and aggressive remedy to handle extreme signs.

Skincare and Prevention Ideas

Skincare tips to prevent scratching which will result in lichenification embody: 

• Apply thick lotions or ointments inside three minutes of bathing
• Restrict showers to 10 minutes or much less with heat (not sizzling) water
• Observe deep respiration, journaling, or mindfulness to scale back stress
• Use gentle, fragrance-free soaps and skincare merchandise
• Put on smooth, breathable materials
• Use cool cloths, aloe vera, or colloidal oatmeal baths and lotions to appease itching

Moist wrap remedy could assist with extreme pores and skin irritation. For this, you apply moisturizer or medicine, cowl it with a moist gauze wrap, and depart it on for 2 hours or in a single day. Chances are you’ll do that for a number of days.

Topical Remedies

If at-home care would not work, your supplier could suggest you apply topical therapies on to the pores and skin to assist scale back signs. Topical drugs embody:

• Aspirin (acetylsalicylic acid) with dichloromethane (methylene chloride): This compounded combination could relieve ache and swelling by lowering irritation. 
• Calcineurin inhibitors: Nonsteroidal drugs like Elidel (pimecrolimus) and Protopic (tacrolimus) scale back irritation and itching by blocking particular immune system responses.
• Capsagel (capsaicin): This medicine, produced from chili peppers, helps scale back itching by desensitizing nerve endings over time.
• Corticosteroids: Anti-inflammatory steroid drugs like Clobex (clobetasol), Cortizone-10 (hydrocortisone), and Diprolene (betamethasone) could assist scale back redness, swelling, and itching.
• Phosphodiesterase-4 (PDE4) inhibitors: Eucrisa (crisaborole) helps decrease swelling and itching by blocking enzymes that trigger irritation.
• Zonalon (doxepin): This topical anti-itch medicine helps relieve itching by blocking histamine receptors within the pores and skin.

Oral and Injectable Remedies

Oral and injectable drugs work all through your physique to assist calm your immune system, scale back irritation, or relieve itching. Choices embody:

• Anti-anxiety drugs: Xanax (alprazolam) and Ativan (lorazepam) could assist scale back stress-related scratching.
• Antibiotics: These assist deal with pores and skin infections which will trigger itching.
• Antihistamines: Benadryl (diphenhydramine), Claritin (loratadine), and Zyrtec (cetirizine) assist cease itching from allergic reactions.
• Biologics: Dupixent (dupilumab) helps calm your immune system to scale back swelling, redness, and an infection danger.
• Immunosuppressants: CellCept (mycophenolate mofetil), Imuran (azathioprine), Neoral (cyclosporine), and Rheumatrex (methotrexate) assist scale back irritation by calming your immune system.
• Janus kinase (JAK) inhibitors: Cibinqo (abrocitinib), Rinvoq (upadacitinib), and Xeljanz (tofacitinib) block immune pathways to assist scale back swelling and itching.

Extra Remedies

If drugs do not work, your supplier could counsel:

Lichenification usually happens with different persistent pores and skin circumstances, together with:

Residing with lichenification could be irritating, particularly if the pores and skin modifications have an effect on your confidence. Following a correct skincare routine and any medicine plan really helpful by your healthcare supplier will help calm itching and promote therapeutic.

Thick areas could take time to melt, and discoloration can take some time to fade, particularly when you have darker pores and skin. That is regular and a part of the therapeutic course of.

In case your signs aren’t bettering otherwise you’re not sure what’s inflicting them, it is essential to speak to a healthcare supplier. They will help you create or regulate your care plan.