What is it?

As complicated as the name may sound, lichen simplex chronicus is not as scary as it may seem!

The condition is characterised by thickened or leathery patches of skin. These patches may also show features of scaling, weeping, redness, hyperpigmentation and excessive creasing.  

The condition is the result of the following:

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1. Areas of skin spontaneously becomes itchy

2. Chronic rubbing of the skin leads to skin thickening (hyperkeratosis)

3. Skin thickening causes further itchiness

4. Process continues through the itch-scratch cycle.

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The areas most commonly affected are the neck, scalp, pubic area, wrists, ankles, outer arm and thighs.  As lichen simplex chronicus is often recurring, it is important to manage the itch-scratch cycle and treat any underlying causes.  

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Disease process

Although the exact cause is still unknown there are many known associated conditions.

Skin conditions: dermatitis, infections, viral warts, and insect bites.

Psychiatric conditions: anxiety, depression, OCD.

Environmental conditions: heat, sweating, rubbing of clothes and harsh skincare products.

Other medical conditions: renal failure, asthma, allergic rhinitis, obstructive biliary disease, Hodgkin's lymphoma

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All of the above may contribute to the development of spontaneous itch leading to the condition.

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What treatments are available?

Using Emollient correctly is vital: ideally twice a day after having a shower.

Underlying causes if any may need to be treated with anti-histamines, corticosteroids, topical antipruritics as appropriate. 

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Lifestyle changes that can be made

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1. Take measures to reduce stress

2. Physical barriers such as bandaging to break the itch-scratch cycle

3. Keep nails short to reduce capability to inflict damage to the skin.

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