Hyperkeratosis — the excessive keratinization of the skin. What to do with it
Keratosis (photo below) is the process of keratinization of epithelial cells and epidermis. Normally, this process occurs only in skin cells, because the mucous membranes of the body can’t be affected by such disease. The appearance of keratoid scales in skin cells is called keratosis, and the excess keratinization of the epidermis is called hyperkeratosis. These diseases have a similar nature, but their causes and symptoms can vary greatly.
Causes of hyperkeratosis
The process of keratinization is peculiar to the epidermis (stratified keratinized epithelium). Normally, the skin cells gradually move from the lower layer to the upper one, accumulating keratin in the process. This substance makes cells more durable and resistant to external influences. The top layer of the skin includes fully keratoid cells. They lose their vitality but protect the living cells under them from temperature extremes, mechanical damage, ultraviolet radiation, and other adverse factors.
Violation of this process is called hyperkeratosis. Hyperkeratosis of the feet is quite common for healthy people. Less often this illness may affect elbows or knees. The reason is simple: uncomfortable shoes, long walking and other types of pressure cause a defensive reaction, and the skin thickens in those places. Another example of this process is the formation of calluses on the guitarists’ fingers. This is considered as a normal process if the calluses are not painful and do not disturb the function of the limb.
Pathological causes of hyperkeratosis:
- violation of metabolic processes in the skin (diabetes mellitus, thyroid, and adrenal gland disorders);
- hereditary skin diseases (ichthyosis, keratoderma);
- inflammatory diseases (various types of lichen);
- disruption of the regeneration process after the injury;
- neoplasms (benign and malignant tumors).
Hyperkeratosis is not an independent disease — it is a sign of another, more serious pathology.
Сlassification of hyperkeratosis
There are three common types of hyperkeratosis: follicular, lenticular and disseminated.
- Follicular type is a lesion of the hair follicles. It occurs on areas with dry skin more often. Causes: hereditary factors, vitamin deficiency, neglect of personal hygiene, inflammatory diseases of skin and hair.
- Lenticular type is also known as Flegel’s disease. It could be described as the formation of small corks on the hair follicles, which have the form of rough spots. The causes are unknown, most commonly affects older men.
- Disseminated keratosis is not tied to a specific area of the body and can occur in many areas.
- Seborrheic keratosis occurs on oily skin with metabolic disorders.
- Warty type, also known as a cutaneous horn. It looks like a wart, but without the papillomavirus. It can degenerate into a tumor, including malignant.
- Senile hyperkeratosis of the face affects older people of both genders.
Plantar hyperkeratosis (hyperkeratosis of the feet) is connected with overweight, flatfoot, poor posture and limping. This is due to increased or uneven load distribution on the epidermis. Pathological hyperkeratosis is inherent for people with serious pathologies of the endocrine system’s organs. There is no direct connection with personal hygiene features — clean and unkempt people suffer from hyperkeratosis at about the same frequency. Lenticular hyperkeratosis has a definite connection with excessive exposure to the sun.
The main symptom is the thickening of the skin in areas where there is a strong pressure. The affected areas look like hardenings, their sensitivity is reduced, the skin color can change. At an early stage, the damaged skin simply appears coarser than the neighboring tissues. Then the thickening can be observed. Severe hyperkeratosis of the feet may affect the gait.
Follicular keratosis can be determined by the appearance of epidermal flakes on dry skin in the area of hair follicles (“goose-skin”). It is rather difficult to see areas of damage if they are solitary. These are small white or brown spots. If they are removed, normal skin could be found beneath them. Also, they do not affect hair growth. But multiple follicular keratosis can highly damage the human appearance.
In the case of children, this pathology usually accompanies other skin problems, most often atopic dermatitis. The mechanism of development is quite simple — inflamed skin is much more sensitive to external influences, especially if the child constantly scratches it. That is why skin lesions are emerged on scratching spots. After puberty and hormonal adjustment of the body, this pathology can go away on its own.
There are several ways to get rid of keratosis: cosmetic, medical, and surgical. Cosmetic treatment is suitable for the early stages when the skin is just beginning to harden. It includes the use of nourishing, moisturizing, emollient creams, pumice, foot baths, feet steaming. Be sure to select comfortable shoes that will not rub. There are some well-proven folk remedies: trays with chamomile, calendula, pine bark, and needles. They not only soften the skin but also eliminate bacteria that sustain the inflammatory process.
Pharmaceutical drug treatment requires an integrated approach. The first thing to do is to find out the causes of skin keratinization and cure the underlying disease or to reach remission. It is usually advised to choose a balanced diet, normalize weight, and take vitamin complexes. To ease the disease effects, it is recommended to use lavender, pine or lemon balm essential oils.
Keratolytic ointments are used to fight directly with keratosis. These products contain components that break down the horny layer and have an antiseptic effect. An antifungal or anti-inflammatory component may be added as well. The composition of the ointment contains enzymes, caustic substances (sulfur, urea, phenol), weak acids or alkalis.
For effective use of this ointments, follow the next steps:
- wash the affected part of the body. Also, you can pre-steam the skin;
- apply the ointment to clean, dry or slightly damp skin;
- wait about 10 minutes (this term is more precisely indicated in the instructions for each ointment);
- wash off ointment, remove damaged skin with cutting tools.
Seborrheic keratosis can be treated with several types of ointments. Keratolytics are used (callosin for example), as well as agents with a drying effect (salicylic acid), antiseptics and agents that normalize oily skin. Be sure to choose the right care and follow the rules of personal hygiene. This is the only way for the skin to return to its original appearance.
Severe hyperkeratosis is treated surgically. Among the main indications, there are large areas of keratinization, which cause pain, interfere with walking or disrupt the appearance of the skin, while not amenable to medical treatment. Liquid nitrogen, laser or radiosurgery is used to remove the affected areas. Large parts are removed with a scalpel.
To cure follicular keratosis on different parts of the body, medium depth or deep peelings are used. In this case, it is not cosmetic, but a medical procedure, which completely removes the upper layer of the epidermis. After this, it can be restored anew. Skin after peeling requires special care.
Complications and prognosis
Commonly, hyperkeratosis (photo below) does not pose a threat to the life and health of the patient. It’s only an aesthetic problem. It does not cause complications, and the prognosis is favorable. Getting rid of standard hyperkeratosis is relatively easy with proper skin care.
The most common complication of hyperkeratosis is callus. This is the formation of the horny layer, which is ejected from the skin. Also, an inflammatory reaction and the formation of a bubble with a liquid inside the callus is observed. Everyone encountered such things, and the treatment is quite simple. It is necessary to pierce the bubble, remove the liquid from it and seal it with a bactericidal or keratolytic plaster. There is no life or health danger from calluses.
Follicular keratosis can affect a specific area of the body. It can create problems with appearance, especially if it is on the face. This is fixable with peels, so the prognosis for health can be called favorable. However, if the disease recurs constantly, it reduces the patient’s quality of life.
Seborrheic keratosis doesn’t count as a separate disease. More often, it’s connected with some more complex pathology. It can expand the affected area and degrade the quality of life due to the deterioration of appearance. However, the prognosis for this type of keratosis is favorable.
The only type of keratosis that has to be feared is warty. Especially if the tumor on the skin becomes covered with cracks, is constantly exposed to traumatic effects, or suddenly changes its appearance. Warty keratosis can transform into benign and malignant tumors.
In general, keratosis is relatively easy to prevent. To do this, you have to carefully consider the shoes’ selection. They should be comfortable, do not rub, do not create an excessive load on the legs. People who have risk factors, like walking a lot or working on their feet, have excess weight, foot and posture pathologies should pay attention to foot care. Baths and cream should be used every day, and the horny layer should also be scraped daily. This will help to avoid its thickening. The keratolytic ointment will help to beat large calluses.
To prevent seborrheic keratosis, attention should be paid to skincare in general, as well as the state of the immune and endocrine systems. Regular shower, the use of creams and gels for the body, normalizing the production of sebum, as well as a healthy diet with sufficient intake of vitamins, will help to avoid this kind of illness. If skin exfoliation appears, you should consult a doctor to be examined. Perhaps, the cause is a serious illness.
If warty hyperkeratosis appears, treatment should be started immediately cause of its great danger for health. It’s difficult to avoid this pathology because its causes are unknown so far. This could be said about other types of hyperkeratosis (follicular, senile, lenticular). They are difficult to prevent because of the lack of accurate data on their causes.