A.Vogel Talks Ichthyosis

Ichthyosis is an uncommon and thoroughly unpleasant skin condition that is sometimes known as the ‘fish scale disease.’


Felicity Mann
Skin Health Advisor
@AVogelUK
Ask Felicity

An introduction to ichthyosis

Ichthyosis is an extremely visible and uncomfortable skin condition, first described by Robert Wilan during the 19th century.

The affliction is believed to get its name from the Greek word for fish, ichthys, and is often known as the ‘fish scale disease.’ This is in part due to its most prominent symptom, the dry scaling that appears on the sufferers skin, affecting any area of the body.

There is no evidence to suggest that ichthyosis is contagious, although the disease can be divided into two different subtypes – hereditary ichthyosis and acquired ichthyosis.

Of the two, the hereditary form is more common, being present in around 95% of ichthyosis cases.1This can mean that often the condition is chronic and there is no definitive cure, with most treatments being aimed at easing or relieving symptoms such as stress and scaling or reducing the appearance of dry, flaky skin.

It is estimated that there are 20 different forms of ichthyosis with the most common subtype, ichthyosis vulgaris, affecting as many as 1 in every 250.2 

In this hub, we shall be exploring the most common variations and how they can be alleviated through the use of natural and herbal remedies.

1http://emedicine.medscape.com/article/1112753-overview

2http://www.nhs.uk/conditions/ichthyosis/Pages/Introduction.aspx

Genetics

Since 95% of ichthyosis cases are congenital, it seems only natural that we discuss your genes and how they can influence your susceptibility to the condition. Simply put, your genes dictate almost every reaction that takes place in your body – from your eye colour, to your immune function. You inherit your genes from your ancestors – your parents, your grandparents etc. When it comes to ichthyosis, there are two different types of hereditary factors that you have to consider.

  • Autosomal Recessive Inheritance: If neither of your parents suffers from ichthyosis, then why are you plagued by the affliction? Well, broadly speaking, there are two specific types of genes – recessive genes and dominant genes. For example, red hair is considered to be a recessive trait and the odds of a dark haired couple producing a red haired child are slim. However, if both parents carry the red-hair gene, then it can increase their chances of having a red haired child. Your parents might not suffer from ichthyosis, but both of them might carry the recessive gene, increasing your odds of inheriting the condition
  • Autosomal Dominant Inheritance: In keeping with the example of the red hair gene, autosomal dominant inheritance means that at least one of your parents must be carrying the dominant gene that can trigger ichthyosis. If one of parents suffers from ichthyosis, and the other does not then we’re afraid that you have a 50-50 chance of inheriting the condition as well.

However, what gene is it that causes ichthyosis? Research has suggested that the filaggrin gene, also known as FLGG, is the prime suspect.

Keratin and filaggrin

Ichthyosis is identified as a keratinising disorder. This means that the sufferer must be carrying a gene that affects the production of keratin. Keratin is a tough, structural protein that is needed for the formation of skin cells, hair follicles and nails.

Keratin filaments work together to strengthen the skin cells on the epidermal layer of skin. This is where filaggrin comes into the picture. Filaggrin is another protein produced by the FLGG gene and it is responsible for bonding the keratin filaments together.

However, most ichthyosis sufferers are born with a defective FLGG gene that inhibits the production of filaggrin. Without filaggrin, the epidermis can become weakened, lose moisture and essential fatty acids, while your production of keratin is also affected.3 

This can give rise to many of the symptoms found in ichthyosis, including dry, brittle skin that is prone to flaking and scaling.

3http://www.ichthyosis.org.uk/wp-content/uploads/2011/02/Vulgaris-gene-found-information-sheet.pdf

Immune system

However, despite the connection between your genetics and ichthyosis, your immune system still plays a vital role in stimulating the condition, even if you suffer from hereditary ichthyosis.

For example, if you are born with a weak or impaired epidermis, then bacteria, fungi and other pathogens are going to find it easier to permeate your skin and cause a secondary infection. 

Your immune system is responsible for eliminating these invaders, but if it is also sluggish or over-stimulated, it might not be able to kill the pathogens. This can lead to complications such as a fungal skin infection or a secondary bacterial infection, both of which will worsen your existing symptoms and damage your skin even further.

Another thing that you have to consider is ‘acquired ichthyosis.’ Acquired ichthyosis may only account for 5% of ichthyosis cases, but nevertheless, the condition normally emerges in patients that are already suffering from another health condition or an autoimmune disease.

This suggests that in some instances, ichthyosis is linked to the health of your immune system, making it essential that you try to support your immune function during outbreaks of ichthyosis.

The causes of ichthyosis

The link between ichthyosis and your genetics has already been touched upon; however there are a number of secondary triggers that can also stimulate an outbreak.

These are normally linked to lifestyle habits, such as stress and nutrition, which can impact the strength of your immune system. If you want to learn more about the other causes of ichthyosis, please read our causes page for more information.

The symptoms of ichthyosis

The symptoms of ichthyosis can be uncomfortable and difficult to manage, usually revolving around the scaling that is so synonymous with the condition.

However, it can sometimes be a good idea to enhance your understanding of your symptoms as it may give you an idea about what is and is not commonplace for the affliction.

If are interested in furthering your familiarity, please check out our symptoms page , which details the most common symptoms of ichthyosis.

The treatment of ichthyosis

There are a variety of different home, herbal and conventional treatments associated with ichthyosis, which will certainly come as a relief to sufferers.

Natural remedies tend to be more focused on lifestyle habits, such as your diet and your stress levels, in order to boost your immune function, whereas conventional medicines and some herbal solutions are more focused on the external symptoms and look to reduce dry skin and irritation.

Please review our treatments page  for further information.

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