Can ichthyosis vulgaris be cured?

            Having healthy skin can be a great way to feel confident and attractive. However, not everyone is lucky enough to be born and have healthy skin. Some may need extra care or treatment to help them achieve this. No matter what your skin condition is, it is important to get regular health screening as some skin issues might be giving clues on an underlying disease you may have not been aware of. In this article, we will be learning about one of the many skin disorders known as ichthyosis vulgaris.

            Ichthyosis vulgaris is a group of skin diseases that is characterised by extremely dry, thick and scaly skin. It often resembles fish scales. If you have heard that a baby being born as if it were like a fish, this could be the reason behind the skin changes that causes a baby to have fish scale-like skin. There are more than 20 different types of ichthyoses but the most common one is ichthyosis vulgaris. 95% people have ichthyosis vulgaris compared to other types of ichthyosis. Other types of ichthyoses include harlequin ichthyosis, lamellar type, and x-linked ichthyosis.

            Ichthyosis vulgaris is the mildest form. It often begins in childhood. Ichthyosis affects 1 in every 250 people. This skin disorder is due to the gene mutation of the gene encoding the protein filaggrin (FLG). Mutation of the gene causes defective filaggrin. Filaggrin is a filament-associated epidermal required for the binding of keratin fibres in epidermal cells to form skin barrier. This substance helps maintain the skin pH, retain skin moisture and reduce water loss from skin. Children usually develop this skin disorder when they inherit the defective gene from one or both parents. Parents may not have the disease but the gene is still passed down to their child. It is rare for adults to get ichthyosis vulgaris but once an adult has it, it is known as acquired ichthyosis vulgaris, mainly due to other medical conditions such as kidney failure and cancer or from taking medicine.

            Ichthyosis vulgaris may be seen so mild that it is mistaken as extremely dry skin. Some may not even realise they have these skin conditions as so often they keep on applying moisturiser to keep the skin free from scale. As mentioned, ichthyosis vulgaris often begins in childhood. Most children have normal skin at birth but the skin may show changes between 3 months to 5 years of age of the child. These changes may begin at a younger age or when the child gets older. The skin changes that are common to be seen is dry skin, scales of white, grey or brown with edges curl making the skin feel rough, thickened skin, itchy skin and feeling overheating. Scales can be seen in one or more of these areas: fronts of the leg, back of the arm, scalp, back or belly. The overheating feeling can be from the very severe ichthyosis that causes the child unable to sweet normally. Rough bumps on the skin can be mistaken for acne but it is possible for a child with ichthyosis to have this (keratosis pilaris). In severe ichthyosis vulgaris, many lines on the palms and soles can be seen with deep cracks. At times, infection may occur in these deep cracks. In adults, the symptoms can be seen similar to a child but it may begin years after the person is diagnosed with certain medical conditions and often be caused by medicine or the underlying medical condition itself.

            Treatments available help to restore the skin and reduce the symptoms. Common treatment is to apply emollients with high lipid content such as lanolin cream. In severe cases that are not able to be improved with cream or lotions alone, doctors may prescribe oral retinoids. Treatments aim to reduce dry scaly skin and to reduce splitting or thickening of the skin. Hence, moisturiser and exfoliator are recommended by doctors to be used on a regular and daily basis.

            Unfortunately, there is no cure for ichthyosis vulgaris. A person diagnosed with one may have to live with this condition for a long time. Treatment can help ease symptoms. Beside applying cream or lotions, taking extra steps of emollient containing exfoliator such as salicylic acid, glycolic acid, lactic acid or urea can help remove the scaly skin and moisturise the skin. It is best for patients to apply lotion and cream within 3 minutes after showering or taking a bath as the damp skin will trap in moisture. Lotion and creams can be kept under occlusion for 1 to 2 hours with cling-film wrap to maximise skin hydration. Ichthyosis on the scalp can be removed with a brush but make sure to wash the hair first. Taking a bath in salt water can help soothe the symptoms, especially the dry itchy one. Doctors recommend reducing the scale when taking bath as the skin is softer and makes it easier to remove the scale simply by gently rubbing with buff puff or pumice stone.

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