The diagnosis is primarily based on the appearance of the skin and a history of chronic itching and scratching. A skin lesion biopsy may be needed to confirm the diagnosis.
The primary treatment is to stop scratching the skin. This may include counseling to become aware of the importance of not scratching, stress management, or behavior modification.
The itching and inflammation may be treated with a lotion or steroid cream applied to the affected area of the skin. Peeling ointments, such as those containing salicylic acid, may be used on thickened lesions. Soaps or lotions containing coal tar may be recommended.
Dressings that moisturize, cover, and protect the area may be used with or without medication creams. They are left in place for a week or more at a time.
Antihistamines, sedatives, or tranquilizers may be needed to reduce itching and stress. Steroids may be injected directly into lesions to reduce itching and inflammation.
Patients who have an emotional component to their lichen simplex chronicus may need antidepressants and tranquilizers.
You can control lichen simplex chronicus by reducing stress and scratching less. The condition may return or change sites.
Bacterial skin infection
Permanent changes in skin color
Calling your health care provider
Call your health care provider if:
Symptoms get worse
You develop new symptoms, especially signs of skin infection such as pain, redness or drainage from the lesion, or fever
Habif TP. Ezcema and hand dermatitis. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 3.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.