The following medical article is about hyperkeratosis and its causes. It also highlights treatment options and preventive measures for the disease.
What is hyperkeratosis?
Schematic diagram showing the anatomy and structure of the skin. The skin is a sensitive organ. Daily care and medical precautions help against skin aging and skin diseases. Click to enlarge. Hyperkeratosis is a thickening of the skin areas caused by an overproduction of keratin. Thickening of the skin also occurs due to friction, pressure, or strength exercises. Hyperkeratosis is also caused by stress on the skin, eczema, warts and UV radiation. However, in very many cases it is very easy to treat. A sensitive reaction of the skin can also be caused by chronic inflammations, or infections, or by sunlight or chemicals. Hyperkeratosis can also be caused by a foreign influence, e.g. by a congenital disorder. The horny layer normally takes on a protective role. However, it can be disturbed by various causes and the cornea proliferates as a result. Too narrow footwear or by physical work hyperkeratosis is caused besides In addition, movements at body places, which can cause calluses, are not healthy for the body. The thickenings on the skin can vary in size.
Causes
Hyperkeratosis is often referred to as a form of keratosis. There is an overproduction of keratin. This is associated with an abnormality of the keratin structure, and the corneal layer thickens very noticeably. The thickening develops due to a constant pressure, as well as other impacts on the skin. Then the skin reacts by the increased creatine to compensate this pressure. The thickenings in this case are also called calluses and are usually only an external problem. Warts, which are caused by infections, also accumulate individual thickenings under the skin. A similar reaction occurs with eczema. However, these then usually cause inflammation. There is then also often a discoloration of the skin. In the case of keratosis, small dots are formed, which are a reaction to UV light. These carry the risk that skin cancer can develop further.
Symptoms, complaints and signs
In hyperkeratosis, painful calluses develop on various parts of the body. The excessive keratinization of the skin can be very painful and lead to limited movement. Occasionally, additional nodules or warts develop during the course of the disease. Severe thickening of the skin makes the affected area appear almost paralyzed and insensitive to touch. If the symptoms occur on the feet, pressure sores and bruising may develop. If the affected leg continues to bear weight, there is a risk that the skin areas will crack and scar, which is associated with severe pain and further thickening of the skin. Externally, hyperkeratosis can be recognized primarily by the visible skin changes. Affected individuals initially notice a slight thickening that rapidly increases and often spreads to surrounding areas of the body. The affected areas of skin may redden or become very warm. Circulatory disorders are also possible. In extreme cases, hyperkeratosis can degenerate and cause ulcers or malignant skin changes. In a positive course, the skin thickening persists for years without causing any great distress to the affected person. Other symptoms usually do not occur. However, if the symptoms are based on eczema, a painful infection may occur in the area of keratinization.
Diagnosis and course
Hyperkeratosis is diagnosed depending on the cause. Warts and calluses in particular can be very painful for the affected person. Meanwhile, other people only see a distinction from the rest of the skin. If hyperkeratosis develops without a significant reason, then it is already present at birth, so it is a congenital disorder. This is usually accompanied by other symptoms. Depending on the nature of the symptoms, the doctor will ask further questions during the examination in order to make an accurate diagnosis. This will include questions about family history or even questions about allergies. If the patient is exposed to sunlight for a longer period of time, the question arises what happens then.In many cases, the doctor can already tell which diagnosis to make based on the symptoms and questions about the hyperkeratosis. If eczema is associated with an allergy, then an appropriate test is performed. Often it is necessary to perform a biopsy. In this case, a small sample is taken from the skin, which is then examined in detail in the laboratory. In children, it is usually a congenital hyperkeratosis.
Complications
Hyperkeratosis primarily causes thickening of the skin. Although this represents an unpleasant symptom, it can be treated relatively well and easily so that there are no further complications for the patient. Warts and calluses appear, which can be associated with pain. Likewise, skin thickening can lead to inferiority complexes or lowered self-esteem, so that those affected feel ashamed of the discomfort and no longer feel comfortable with their own bodies. It is not uncommon for the symptoms to occur in the feet as well, which can lead to pain when walking. In many cases, ordinary activities are also restricted. Treatment of hyperkeratosis always depends on its cause and usually proceeds without complications. Creams and ointments are mainly used. Infections or inflammations can be treated with antibiotics. In severe cases, surgical intervention may be necessary to treat hyperkeratosis. After treatment, the symptoms disappear completely and no further complications occur. Life expectancy is not limited by the disease.
When should you go to the doctor?
If excessive keratinization of the skin is noticed, hyperkeratosis may be the cause. A visit to the doctor is indicated if further complaints occur or the symptoms persist over a longer period of time. Calluses, warts and other skin changes that are not due to any identifiable cause always require medical clarification. If bleeding, pain or pressure points occur as a result of the skin thickening, a doctor must be consulted. The affected person should also speak to a medical professional if there are restrictions in everyday life. If hyperkeratosis remains untreated, pigmentary disorders can occur, which in turn can cause skin cancer. Any skin changes should therefore be clarified in any case. If the keratosis causes psychological discomfort, a therapist must be consulted. Even after successful treatment, skin changes can remain and, in extreme cases, degenerate. For this reason, patients should regularly visit their family doctor or a dermatologist after completion of therapy. If a recurrence is suspected, it is best to inform the appropriate physician immediately.
Treatment and therapy
Of course, the treatment methodology depends on the type and cause of the keratosis. If the affected person has calluses on the feet, attention should be paid to suitable footwear, insoles or plasters also help in this case. The thickened skin areas should be relieved in the first place. Under no circumstances should you treat them yourself, an expert should always look at this and decide what to do. Warts also need to be treated by a doctor. There are different methods for this. By icing with a special liquid, or destruction with a laser or removal of the calluses or warts would be different treatment options. If the treatment does not bring anything, then new warts form. It requires then a repetition. These can also be treated by guidance, but this procedure is very lengthy. A combination of medical and self-treatment is most useful, e.g. using patches or creams. For chronic eczema, one usually uses cortisone ointments.
Outlook and prognosis
Hyperkeratosis can be treated in many ways. There is a prospect of cure, but it is not achieved in every patient. In some cases, a few steps taken by the patient on his or her own initiative are sufficient to achieve relief or freedom from symptoms for a favorable prognosis. Patients with thickened epidermis will have a good prognosis if they see a doctor early and pursue various approaches to therapy on their own. These include intensive care of the feet, adequate hydration, and selection of the right footwear and reduced stress on the feet.Periods of rest and protection are necessary so that the skin has a chance to regenerate. In addition, drug treatment can be used to alleviate the symptoms. In some patients, healing occurs with the administration of medications and ointments. If hyperkeratosis is severe and living conditions are not optimized according to the organism’s needs, the prognosis worsens. Skin blemishes or warts are treated or removed in a surgical procedure. Nevertheless, the skin lesions may reappear at any time if the cause has not been changed. Especially in the case of warts, there is an increased incidence of re-emergence. The process of permanent healing is lengthy, but would still be possible.
Prevention
There are forms of hyperkeratosis that can be prevented very easily. These include calluses on the feet. The affected person can ensure that these do not form again by a specific choice of shoes. To prevent warts from appearing, one should never be barefoot in baths or showers. Targeted contact with allergens should be avoided. The actinic keratosis prevents the affected person also with a sufficient UV- protection.
Aftercare
In the case of hyperkeratosis, the first priority must be a rapid diagnosis with subsequent treatment, so that there are no further complications or complaints with this disease. An independent healing can also not occur with hyperkeratosis, so that the affected person is always dependent on medical treatment by a doctor in this case. In most cases, however, the disease can be treated relatively easily and also by self-help measures. Simple plasters or wearing the right shoes can significantly alleviate the symptoms of hyperkeratosis and even make them disappear completely. However, professional orthotics may also be necessary to alleviate the discomfort of hyperkeratosis. Warts can also be removed relatively easily, with no further follow-up care required. In rare cases, sufferers rely on the application of creams. Care must be taken to ensure correct dosage and regular application so that the discomfort to the skin disappears completely. Since this disease can also cause psychological upsets or depression, psychological treatment is also necessary in some cases. However, the life expectancy of the affected person is not negatively affected by hyperkeratosis.
What you can do yourself
Some forms of hyperkeratosis can be directly avoided and equally limited with self-help measures. However, this does not generally apply to the disease. As a rule, wearing comfortable footwear can have a positive effect on the disease and directly avoid the appearance of calluses on the feet. Likewise, the affected person should always ensure proper hygiene and thus not step barefoot on the floor in public areas of bathrooms or showers. Simple slippers can prevent the transmission of the infection. If the symptoms occur due to an allergy, contact with the allergen should be avoided. Furthermore, sufficient sun protection should always be applied in case of direct contact with the sun. The disease significantly increases the risk of skin cancer. Those affected should therefore undergo regular examinations by a dermatologist in order to detect and remove possible tumors at an early stage. This can prevent further complications. In the case of psychological complaints, self-confidence can be significantly increased by talking to friends or relatives. As a rule, however, infections can always be treated with the help of medication.