Lichen Simplex Chronicus

Lichen simplex chronicus likely begins with a minor irritation of the skin, causing the person to rub or scratch the area. This causes thickening of the skin. The thickened skin itches, causing more scratching and more thickening. This is called the "itch-scratch-itch" cycle.

Lichen simplex chronicus can occur anywhere on the body but is most common on the back of the neck, lower legs, and genital region. In the early stages, the skin looks normal, but it itches. Later, dryness, scaling, and thick dark patches develop as a result of the scratching and rubbing.

Lichen simplex chronicus is most often seen in adults. It may begin with a minor skin irritation, causing the person to scratch the area. Dryness of the skin makes the itching worse.

Psychological factors, such as anxiety and depression, may play a role. The condition is not allergic. Scratching the skin raw can result in secondary infection..

To prevent lichen simplex chronicus, one must prevent the "itch-scratch-itch" cycle from beginning by not scratching and rubbing the skin..If the skin is dry, moisturize it to reduce itch. Keep fingernails short to avoid trauma to the skin. Control of stress and other emotional conditions may be helpful in the prevention of this condition.

The diagnosis of lichen simplex chronicus is based on the appearance of the skin, and a history of chronic itching and scratching.

The skin lesions of lichen simplex chronicus may persist for years and are prone to secondary infection and scarring.

There are no risks to others, as lichen simplex chronicus is not contagious.

Treatment of lichen simplex chronicus may include:

• a skin emollient to moisten skin and reduce itching
• topical corticosteroid cream or ointment to reduce itching and inflammation
• corticosteroid injections into the affected area of skin to reduce itching and inflammation
• antibiotics if secondary skin infection is present
• keeping fingernails short to prevent trauma to the skin from inadvertent scratching
• occlusive dressing, which covers the involved skin completely, to completely prevent the person from scratching
• antihistamines to relieve the itching
• sedatives and tranquilizers to reduce stress
• antidepressants, if there is an emotional component to the condition
• counseling, stress management, or behavior modification

Side effects of treatment depend on the medication used. They may include drowsiness, dry mouth, and allergic reactions.

Lichen simplex chronicus skin lesions generally clear up completely with treatment. However, they may recur later.

Any new or worsening symptoms should be reported to the healthcare professional.