The itch that scratches and leaves behind a thick skin.

Let’s talk about Lichen Simplex chronicus (LSC). A condition in which repeated rubbing/scratching often of areas where the hands can reach easily results in lichenified skin (a thickened area of skin usually hyperpigmented with exaggerated skin markings).

There may be a background condition like atopic dermatitis, contact dermatitis, insect bites anxiety disorders, depression amongst others. In some cases…the individuals have no underlying medical condition.

The cause is not exactly known but there’s a heightened sensitivity of the nervous system to inflammatory mediators that are responsible for itching.

The clinical presentation is that of chronic repeated touching and scratching of a particular area that the hand can reach easily with thickening of that area after some time.

LSC is also called neurodermatitis and can run a very long course. The most important part of management is behavioral, psychological and pharmacological (drug) therapy to help with the itching. Some creams may also be prescribed/injections into the lesions when it has developed.
Bear in mind that the most important part of management is to stop the itching/scratching. Break the itch-scratch cycle…if not, it WILL definitely recur.

I jokingly tell my patients that if you don’t have anything on your skin but you continue to rub and scratch…you will develop LSC. Only a matter of time. LSC can be so bad that it may also cause some behavioral problems on it’s own.

Break the itch-scratch cycle….