In this section
Ichthyosis (ick-thee-owe-sis) means 'fish scale', and is the name of a group of genetic skin diseases that cause dry, scaly, thickened skin.
The skin has many important functions, including physical protection, providing a barrier to keep the skin hydrated (moisturised), protecting against infection, and helping to regulate body temperature.
In normal skin, new skin cells are formed in the deepest layer of skin at the same time as dead cells are shed from the top layer of the skin. In ichthyosis, either the dead cells are shed too slowly, causing a build-up of the top dry layer, or the production of new cells from the lower
layers is too slow, allowing too much water to be lost from the skin.
There is no known cure for ichthyosis, but there are treatments available that can help to improve the skin's condition.
Symptoms of ichthyosis include thick, scaly, dry and cracked skin. If your child has ichthyosis, their skin may appear normal at birth, but then gradually dry out and become scaly. Symptoms usually appear by the age of five years.
Inherited ichthyosis (passed down from parents to children) is usually present at birth or develops in childhood. As a genetic disorder, ichthyosis is not caused by infection and is not contagious (it cannot be caught by others).
Acquired ichythyosis is more common in adults and can be triggered by various conditions or medications.
If you are worried about your child's skin, see your GP. The doctor will examine your child's skin and may refer you to see a paediatrician or paediatric dermatologist (skin specialist). A skin biopsy (small sample of skin taken, with an anaesthetic) and genetic test (blood or saliva) may be
required for a diagnosis.
If the skin on your child’s feet is causing issues such as thickened skin, pain and cracking, your child may need to see a podiatrist for further management and treatment.
There are two main types of medications used to treat ichthyosis.
Keratolytics help to loosen the scales on the skin and encourage them to come off. They are found in creams that also moisturise the skin. Unfortunately, they can also be irritating, causing redness, stinging, itching or discomfort. The strength of the cream can be changed if
any of these symptoms occur.
Examples of keratolytics include:
In severe cases of ichthyosis, a type of medicine called retinoid (e.g. Neotigason) can be helpful to help get rid of the scale, redness and itch. Retinoids are derived from vitamin A.
Taking high doses of vitamin A can cause dry eyes, lips and nose. Other side effects include nose bleeds, headaches, nausea and high blood cholesterol. If taken during pregnancy, high does of vitamin A can cause birth defects.
Retinoids can only be prescribed by dermatologists and require strict monitoring with regular check-ups and blood tests.
If your child has ichthyosis, you may need to spend time each day caring for their skin.
Ichthyosis can be distressing for children and their families. Children with the condition may suffer from poor self-esteem, teasing or bullying. Meeting with other young people in a similar situation can be helpful (see For more information below).
See your doctor if your child's skin suddenly gets worse with pain, cracking or oozing/weeping/crusting. Your doctor may prescribe antibiotics to treat any skin infections.
If you are worried about any of your child's treatment, talk to your doctor. If your child is taking oral medications, don't forget to have regular blood tests.
Will my child pass their ichthyosis onto his children in the
Depending on the type of ichthyosis, it may be inherited and
therefore passed down to your child's future children. We recommend genetic
counselling when the time comes, to discuss any aspect of the inheritance and
risk to future children.
Is there any cure for ichthyosis?
There is no known cure for ichthyosis, but with
careful management and depending on the severity of the disease, a child with
ichthyosis is usually able to live a full, happy life.
Developed by The Royal Children's Hospital Dermatology department. We acknowledge the input of RCH consumers and carers.
Reviewed June 2018.
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