This image displays thickening of the skin typical of lichen simplex chronicus. This image displays thickening of the skin with pronounced skin lines and some scaling on the neck typical of lichen simplex chronicus. Lichen simplex chronicus is caused by rubbing and scratching an area of skin. This child has been rubbing or scratching the area between the heel and the ankle, leading to dark, rough areas of thickened skin known as lichen simplex chronicus.
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Lichen Simplex Chronicus:
A parent's guide to condition and treatment information

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Picture of Lichen Simplex Chronicus: This image displays thickening of the skin typical of lichen simplex chronicus. Divider line
This image displays thickening of the skin typical of lichen simplex chronicus.
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Treatments Your Physician May Prescribe
If it is not certain that your child has lichen simplex chronicus, the doctor may 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 stitch (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 your child has lichen simplex chronicus, it is important to break the scratch-itch cycle. In addition to the above self-care measures, your child's doctor may recommend one or more of the following treatments to reduce itching and scratching:
  • Aggressive moisturizing
  • 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
  • Doxepin or capsaicin cream
  • Topical or oral antibiotics if infection is present
Last Modified: 29 Jan 2008

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