Thick, scaly, slightly elevated lesions with pronounced skin lines occur when the skin is repeatedly rubbed. This image displays thickening of the skin typical of lichen simplex chronicus. Chronic rubbing leads to thick, scaly skin lesions, as displayed here. This image displays very thick skin from being chronically rubbed. This image displays thick areas of skin on the forearms typical of lichen simplex chronicus. As displayed in this image, chronic rubbing and scratching can lead to darkening of the skin as well as skin thickening. This image displays an early, mild lesion of lichen simplex chronicus. In lichen simplex chronicus, the skin lines or markings are more pronounced than in normal skin. As displayed in this image, the top of the hand is a typical location for lichen simplex chronicus. This image displays scaly skin due to lichen simplex chronicus. This image displays a thickened, cobblestone-like area of lichen simplex, due to repeated rubbing of the area. Chronic rubbing or scratching of the same area leads to lichen simplex chronicus, with thickened, rough, and sometimes red, broken skin areas.
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Lichen Simplex Chronicus:
Information for adults

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Picture of Lichen Simplex Chronicus: Thick, scaly, slightly elevated lesions with pronounced skin lines occur when the skin is repeatedly rubbed. Divider line
Thick, scaly, slightly elevated lesions with pronounced skin lines occur when the skin is repeatedly rubbed.
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Treatments Your Physician May Prescribe
If your doctor is not sure if you have lichen simplex chronicus, he/she may wish to perform a skin biopsy to confirm the diagnosis. The procedure involves:
  1. Numbing the skin with an injectable anesthetic.
  2. Sampling a small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a "punch biopsy"). If a punch biopsy is taken, a suture or two may be placed and will need to be removed 6–14 days later.
  3. Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).
Once you are sure you have lichen simplex chronicus, it is important to break the scratch-itch cycle. In addition to the above self-care measures, your doctor may recommend one or more of the following treatments to reduce itching and scratching:
  • Aggressive moisturizing techniques
  • Corticosteroid (cortisone) creams or ointments
  • Creams containing salicylic acid or urea, to improve penetration of the topical corticosteroid
  • Oral anti-histamines, especially for use at bedtime
  • Injection of corticosteroid solution directly into the lichen simplex chronicus lesions
  • Ultraviolet light therapy
  • Sedatives or anti-depressants for people with lichen simplex chronicus strongly related to psychological stress
  • Doxepin or capsaicin cream
  • Topical or oral antibiotics if infection is present
Last Modified: 29 Jan 2008

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