Lichen simplex chronicus

Treatment:

The primary treatment is to stop scratching the skin. This may include counseling to become aware of the importance of not scratching, stress management measures, or behavior modification.

The itching and inflammation may be treated with topical (applied to a localized area of the skin) steroid or antipruritic lotions. (See corticosteroids - topical - low potency, and corticosteroids - topical - medium to very high potency). Peeling ointments, such as those containing salicylic acid, may be used on thickened lesions. Soaps or lotions containing tars (coal tar) may be recommended.

Occlusive dressings that cover and protect the area may be used with or without topical medications. They are left in place for a week or more at a time.

Antihistamines, sedatives, or tranquilizers may be needed to reduce itching and to reduce stress. Steroids may be injected directly into lesions to reduce itching and inflammation.

Antidepressants and tranquilizers may be needed in those patients who have an emotional component to their lichen simplex chronicus.

Expectations (prognosis):

Lichen simplex chronicus may be controlled with reduction of stress and scratching. It may recur or change sites.

Complications:

• secondary bacterial skin infection
• permanent scar formation
• permanent pigmentary changes

Calling your health care provider:

Call your health care provider if symptoms worsen or new symptoms develop, especially signs of skin infection such as pain, redness or drainage from the lesion, or fever.