How is ichthyosis treated?

Acquired ichthyosis usually improves with treatment of the underlying condition. Congenital ichthyosis is difficult to treat, especially in its severe forms.

Topical emollients containing glycolic acid, lactic acid, urea, or glycerin may partially improve dryness and scaling. Topical tretinoin (Retin-A) is effective but poorly tolerated due to irritation. Oral retinoids, including isotretinoin, etretinate, and acitretin, are very effective, but relapses after treatment cessation are common. The use of oral retinoids is limited by major side effects (including teratogenic effects), and chronic use, which is often required in congenital disorders, is associated with hyperostoses. Blistering may indicate bacterial infection and should be cultured and managed with oral antibiotics. The foul odor present in epidermolytic hyperkeratosis may be due to bacterial colonization and can be improved by the use of an antibacterial soap.

Oji V, Traupe H: Ichthyosis: clinical manifestations and practical treatment options, Am J Clin Dermatol 10(6):351–364, 2009.