What is Lichenification?

Lichenification is a skin lesion which occurs in an area of chronic irritation. In this condition, the skin thickens in response to the irritation and can develop a flaky, bark-like appearance. Sometimes the skin becomes shiny and oozes, and in other cases, it may be dry and scabby. While lichenification is usually not dangerous, it can be painful and may attract unwanted attention if it is in a visible location. With treatment, the itching and burning associated with such lesions can usually relieved, and the unpleasant appearance improved.

One common reason this condition occurs is due to eczema, although it can also arise in response to other chronic skin conditions or even as a result of chronic chafing and rubbing. Lichenification usually becomes part of an itch-scratch cycle: the patient's skin is irritated, so the patient scratches or picks at it, which causes the skin to thicken defensively, leading to more itching and more scratching. Breaking this cycle is often key to resolving the problem.

When this condition is identified, there are several measures which can be taken to address it. Medications to relieve the itching sensation and sedatives can help the patient scratch less. Steroids can reduce the body's inflammatory response and allow the skin to return to normal. Sometimes, the site may be bandaged to make it harder for the patient to scratch or pick at it without realizing, and to promote the absorption of any topical medications.

Chronic lichenification can lead to permanent changes in the skin. The area may acquire a leathery or flaky texture which will not go away, even with treatment. Patients may also find that they are chronically itchy or that they lose sensation in the area of damaged skin. Treatment is designed to prevent permanent damage and to resolve the irritation in the skin so the patient will feel more comfortable.

Consultation with a dermatologist may be required to treat lichenification. The doctor can check skin scrapings to check for presence of infectious agents or other problems which might be complicating the skin lesion. After determining the cause, an appropriate course of treatment can be recommended. In addition to oral and topical medications, lifestyle modifications that are designed to promote healthier skin, such as changes to the diet, may be suggested. People with autoimmune conditions can be at increased risk of skin reactions which may develop into lichenification and other skin changes which occur in response to chronic inflammation and irritation.