All about ichthyosis: Use retinoids, humidifiers, moisturisers to manage this skin disorder

Painful cracks or fissures in the skin, particularly on the palms and soles are initial symptoms of ichthyoses. (Image: Canva)

Ichthyosis is a group of genetic skin disorders characterised by dry, scaly skin. The name comes from the Greek word for fish, as the condition often causes the skin to resemble fish scales. There are several types of Ichthyoses, with varying degrees of severity, but they all share the common feature of abnormal skin shedding and scaling. Here’s a detailed look at ichthyosis, including how to spot the initial symptoms.

Types of ichthyoses

Ichthyosis vulgaris: The most common form, often appearing in early childhood, says Mumbai-based skin specialist Anuket Makand.

X-linked ichthyosis: Affects males and is usually noticeable at birth or within the first year.

Lamellar ichthyosis: Present at birth with large, dark scales covering much of the body, says Makand.

Congenital ichthyosiform erythroderma (CIE): Present at birth with red, scaly skin.

Harlequin ichthyosis: A severe form present at birth with thick, plate-like scales.

Initial symptoms

The symptoms of ichthyosis can vary depending on the type, says Makand. However, he says that common early signs include:

Dry skin: Persistent dryness that doesn't improve with standard moisturisers.

Scaly skin: Fine, white scales, especially on the lower legs, but can spread to other areas.

Thickened skin: Skin may appear thick and leathery in certain areas.

Flaky scalp: Dandruff or flaking of the scalp that is resistant to treatment.

Cracked skin: Painful cracks or fissures in the skin, particularly on the palms and soles.

Itching: Persistent itching that can be severe and uncomfortable.

Redness: Red or inflamed skin, especially in more severe forms of ichthyosis

Specific symptoms by type

Ichthyosis vulgaris:

Fine scales on the extensor surfaces of the limbs.
Mild itching.
More noticeable in the winter months.

X-linked ichthyosis:

Large, dark scales, particularly on the neck, trunk, and extremities.
Eyelids may have small, corneal opacities.

Lamellar ichthyosis:

Thick, dark scales covering large areas of the body.
Possible development of ectropion (outward turning of the eyelids).

Congenital ichthyosiform erythroderma (CIE):

Red skin with fine white scales.
Erythroderma (red, inflamed skin).

Harlequin ichthyosis:

Thick, plate-like scales covering the body.
Severe complications due to tight, cracked skin.

Treatment

While there is no cure for ichthyosis, treatments focus on managing symptoms:

Moisturisers: Regular use of thick, oil-based moisturisers to keep the skin hydrated.

Keratolytic agents: Products containing urea, lactic acid, or salicylic acid to help shed dead skin cells.

Retinoids: Oral or topical retinoids can help reduce scaling in severe cases.

Baths: Regular baths with added oils or salts can help soften the skin.

Humidifiers: Using humidifiers in the home to add moisture to the air.

Lifestyle tips

Avoid harsh soaps: Use gentle, fragrance-free cleansers.

Stay hydrated: Drink plenty of water to keep the skin hydrated from the inside.

Wear soft clothing: Choose soft fabrics to avoid irritating the skin.