Ichthyoses are not curable. Their treatment is therefore based on the individual symptoms and is therefore only symptomatic. Since the skin is too dry overall, it needs water and fat and must be "defatted". Baths with saline and bath oil are considered very useful. Sponges for brushing the skin are essential.
External treatment of ichthyoses
Ointments and creams for external ichthyosis treatment consist of an oil-water mixture in various concentrations, such as Vaseline, Glycerin, Eucerin, wool wax alcohols, etc. In these basics can be incorporated by the pharmacist various active ingredients that promote desquamation: urea, salicylic acid, saline, Lactic acid and vitamin A acid. The ointment base polyethylene glycol also has a scaly effect. Best proven has been according to the dermatologists urea.
Salicylic acid may be used only on small areas of skin and only for a short time, especially in smaller children, as it comes with large-scale highly concentrated long-term treatment to poisoning. The strongest dandruff remover is vitamin A acid. However, it quickly causes skin irritation and skin burning, so you have to be careful with the application.
Some active ingredients can also be combined to enhance the effect. Usual and effective concentrations of these horn releasing substances are:
- Salicylic acid up to 5%
- Vitamin A acid 0.025%
- Urea up to 12%
- Table salt up to 5%
- Lactic acid up to 5%
- Polyethylene glycol 300-400
Further measures for therapy
Steam baths at moderate temperatures with high humidity soften the horns. In addition to the oil or salt baths, the sun or warm and humid climate have a positive effect on the condition of the skin.
Comprehensive treatment also always requires careers advice that takes the sensitive skin into account.
Internal treatment of ichthyoses
In-house treatment is possible with tablets containing the active ingredient acitretin. These tablets belong to the group of retinoids, which are substances related to vitamin A - drugs that are similar in composition and effect to vitamin A (retinol). Retinoids influence the conversion of the genetic information of a cell.
In cornification disorders they regulate the uncontrolled proliferation of skin cells and promote the slow maturation of newly formed cells. They also have a direct corneal dissolving effect, which occurs after a few days. Retinoids affect cells of the immune system in the skin and have an anti-inflammatory effect. Acitretin removes skin keratinization and prevents its regeneration for a certain time.
Caution: Acitretin is not suitable for women of childbearing potential as it causes severe harm to the unborn child during pregnancy. Pregnancy must therefore be safely excluded before, during and for two years after the end of therapy.
Beware of heat accumulation
Very problematic is the inability to sweat. For those affected, this is often worse than the scaling of the skin. For children this means in the summer months that they can not play. But adults are also limited in their capacity despite precautionary measures.
Already at temperatures around 20 ° C it can come to a heat accumulation even with moderate physical stress. At higher temperatures, a massive facial redness and overheating of the body with simultaneous dehydration (dehydration) occur. Only an internal (drinks, ice cream) and extra external cooling as well as hydration can prevent a circulatory collapse and in children a febrile convulsion.
Psychosocial consequences of ichthyosis
The visibility of their skin disease causes the sufferer significant problems. Rejection, irritating and discriminatory remarks and social exclusion begin in infancy and run through life. Always new therapies, new doctors, not infrequently hopelessness and a tiring everlasting skincare are a burden that no one can understand. Psychotherapeutic support can be helpful.
Ways of supporting care
It is already possible for infants to apply for a severely handicapped ID card. The degree of disability (GdB) in congenital ichthyoses is usually between 50 and 70 out of 100, depending on the severity of the condition, but also up to 100.
Treating a child with ichthyosis is not only a lot of mental stress, time and effort involved, but also significant additional costs (such as water, detergents, clothing, non-reimbursable care products). Therefore, the application for care allowance according to SGB XI is justified.