Ichthyosis Vulgaris or Fish Skin Disease or Fish Scale Disease: Causes, Symptoms, Treatment

Ichthyosis Vulgaris is a skin condition, which is commonly inherited, and is characterized by accumulation of dead skin cells resulting in thick and dry scales on the skin. Ichthyosis vulgaris slows down the natural shedding of the skin cells. This results in accumulation of the keratin in the topmost layer of the skin. Due to the presence of the scales in ichthyosis vulgaris, it is sometimes called as fish skin disease or fish scale disease. The scales can be present at birth; however, they initially appear in early childhood. In some cases, ichthyosis vulgaris is not diagnosed at all, as people mistake them for extremely dry skin. There are very rare cases of severe ichthyosis vulgaris with the majority of them being mild. Sometimes ichthyosis vulgaris is associated with other skin conditions, such as eczema.

As of now, there is no cure for Ichthyosis Vulgaris or Fish Skin Disease or Fish Scale Disease. The aim of treatment is controlling and managing condition.

Ichthyosis Vulgaris or Fish Skin Disease or Fish Scale Disease is an inherited condition occurring due to a genetic mutation, which is passed on by one or both the parents. Children who have inherited the defective gene from only one parent will have ichthyosis vulgaris, which is milder; whereas children who have inherited defective genes from both the parents will have a severe type of ichthyosis vulgaris. Children who have inherited this condition commonly will have normal skin at the time of birth; however, later on, in the initial years of their life, their skin will develop roughness and scaling.

If this condition is not inherited or is not the result of gene mutations, then it is known as acquired ichthyosis. This is a rare type and commonly starts during adulthood; and it also is associated with other medical conditions, such as thyroid disease, HIV/AIDS or cancer.

Symptoms are worse in cold and dry atmosphere and may improve in warm and humid environment and they include:

• The skin is dry with small scales resembling tiles.
• The color of the scales can be dirty gray, white or brown.
• Scales which are dark in color usually appear on darker skin.
• The scales commonly appear on the elbows and lower legs.
• They are particularly dark and thick if present over the shins.
• Patient develops painful and deep cracks in the skin.
• Patient’s scalp is flaky.

Due to the characteristic scales of Ichthyosis Vulgaris or Fish Skin Disease or Fish Scale Disease, diagnosis can be easily made by examining the skin. A skin biopsy can be done to confirm the diagnosis and to exclude other causes for dry/scaly skin.

As of now, there is no known cure for this condition. Treatment is done to manage and control the symptoms.

• Alpha hydroxy acids (lactic acid, glycolic acid) in prescription ointments /creams help in controlling the scaling and increasing the moisture in the skin.
• Retinoids are vitamin A-derived drugs and are given in severe Ichthyosis Vulgaris. They work by cutting down the skin cells production. Side effects include: Inflammation of the eyes and lips, hair loss and bone spurs. Retinoids are contraindicated in pregnancy, as they can cause birth defects.

• A nice soaking bath will help in softening the skin. After this, gently rub the skin with a rough-textured loofa or sponge to remove the thick scales.
• Always pat your skin gently after a bath/shower, so that some moisture is left on the skin.
• Always use mild soaps with added fats/oils.
• Do not use perfumes/scented and antibacterial soaps, as they worsen a dry skin.
• After a bath, apply moisturizer/lubricating cream, such as petroleum jelly, while the skin is still damp, this will help you seal in the moisture.
• Using a humidifier will help in adding moisture to air.