What is Hyperkeratosis?
Hyperkeratosis is when the outer layer of the skin is thickened. The outer layer of the skin will contain keratin, which is a protective protein. It is a form of keratosis, which is a skin disorder caused by over production of keratin. It occurs most often on skin that has been irritated, has pressure on it, or has rubbed against something. Less frequently, it will occur on skin that has not been irritated. This often occurs due to heredity if no irritation is seen. Hyperkeratosis often occurs on large portions of the skin. There are many forms of hyperkeratosis. These include warts, corns and calluses, chronic eczema, seborrheic keratosis, lichen planus, actinic keratosis, and other inherited conditions. There is a good prognosis for hyperkeratosis, however, do note that actinic keratosis can result in squamous cell skin cancer.
Many times, hyperkeratosis is painless. There may be corns, calluses, and warts that can cause some form of discomfort. There may be itchy, scaly patches of skin that is associated with lichen planus. These patches are often purplish-blue. White spots may appear in the mouth due to friction from dentures. The skin could appear to be scaly and dry and may change colors. Hair loss is commonly seen. Small brown or black growths of skin may appear, but these are harmless and are formed from unknown causes. Red, flat patches that are course are associated with actinic keratosis. There may also be chronic inflammation of the skin (eczema) that is triggered by chemicals, allergies, or other factors.
How to diagnose Hyperkeratosis?
A doctor will be able to diagnose by examining the skin and asking for a family history. Your doctor will want to know if there is a family history of skin problems, if you are in the sun excessively, have dentures, use smokeless tobacco, chew on your tongue or cheeks, or have a history of allergies. A skin examination will be performed, and other tests may be ordered. A biopsy of the skin may be needed to confirm the patient has hyperkeratosis.
Treatment for hyperkeratosis includes the use of salicylic acid. Salicylic acid will break up the keratin. This will shed the thick skin, as well as soften it. Urea topical agents are often prescribed to increase water content in the skin, thus softening it. Urea will also help to break up the keratin. Alpha hydroxy acids can be used on hyperkeratosis to exfoliate the skin, revealing skin that is better able to accept any moisture to keep it soft. Tretinoin can also be used to shed the skin that has become thick.
Many times, depending on where the hyperkeratosis is located on the body, a different treatment will be administered. Corns and calluses may find relief from using padding or moleskin next to the areas that are effected. On lichen planus, it is often helpful to use a corticosteroid cream. Should one have eczema, they could find relief in corticosteroid creams and ointments as well. Seborrheic keratosis can be removed with a scalpel or by using cryosurgery (freezing using liquid nitrogen). Warts are often removed using cryosurgery as well, or they could be cut out or a laser may be used to remove them. Actinic keratosis can be removed with cryosurgery if the area is small, but lasers will be needed if there are multiple areas of keratosis.
How to Prevent Hyperkeratosis?
Prevention methods for hyperkeratosis include wearing shoes that are comfortable to avoid corns and calluses. Never go into public places, such as locker rooms or rest rooms, without shoes on the feet. Should you need to use a public shower, leave thongs or socks on the feet. If you have eczema, avoid using harsh soaps and deodorants on the skin. Do not take bubble baths and avoid dry air. Avoid triggers that cause allergies.