What Is Hyperkeratosis ?

Hyperkeratosis is the localised thickening of the outer layer of your skin, occurring secondary to persistent rubbing, pressure, friction, infection, harmful radiation or irritation. This thickening actually occurs as a part of your skin's defensive mechanism to prevent damage to the deeper skin tissues.

Sometimes hyperkeratosis may just take place on its own, without any apparent cause, involving large areas of the skin. In such instances, hyperkeratosis usually begins soon after birth as a part of a congenital condition.
Depending upon the cause and the site involved, hyperkeratotic skin may be called corns or calluses , which is when the skin thickens on your toes, soles or palms following constant irritation probably secondary to wearing tight shoes in the case of feet; or Warts , which are small bumpy skin thickenings, caused by human papillomavirus (HPV), occurring anywhere on your body but most frequently on your hands, feet, and face (areas of frequent contact).

Hyperkeratosis may appear as itchy, bluish-purple, scaly patches on the skin called Lichen planus . Whitish spots inside the mouth following constant friction may be due to dentures. It may take the form of chronic skin inflammation called eczema stimulated by irritating chemicals, allergies or other factors causing thickened, dry scaly skin with areas of colour change and hair loss.

It can develop as flat, red, coarse skin patches of actinic keratosis secondary to excessive exposure to the sunlight caused by ultraviolet radiation. It may also occur as small harmless brown or black skin growths of unknown cause anywhere on your face, trunk or limbs.

What are the symptoms?

The symptoms depend upon the form of hyperkeratosis. Corns, calluses and plantar warts can be quite painful for you. In other people they may just be because of their unsightliness. Eczematous skin may cause itching. However in most cases, hyperkeratosis is painless.

How is it diagnosed?

Your Doctor usually reaches the diagnosis of hyperkeratosis after taking a detailed history including your family history of skin problems plus your personal history of allergies, sun exposure, wearing dental appliances etc. Then he/she will examine your skin. Sometimes your doctor may also do a skin biopsy to reach the correct diagnosis and to rule out skin cancer.

What is the prevention?

You can prevent some types of hyperkeratosis quite easily. The tip is to remember how hyperkeratosis develops. So you can prevent corns and calluses by wearing comfortable shoes. Avoid direct contact with a person who has warts because you may acquire the infection by direct contact with the wart, like touching or shaking hands or walking barefoot on a contaminated floor like gym or a pool deck. Avoid too much sun exposure. Do not use strong soaps or cosmetics that may aggravate your eczema.

How is it treated?

The exact mode of treatment depends on the type of hyperkeratosis. Warts may be treated with cryosurgery (freezing them with liquid nitrogen), laser therapy, or they can be removed surgically. Chronic eczema and lichen planus may be treated with corticosteroid ointment or creams. Your doctor may use cryosurgery to remove seborrheic keratosis and actinic keratosis. For more advanced cases, skin peels, laser therapy or dermabrasion may also be used. There is no treatment for inherited conditions.

What is the prognosis?

The prognosis is good for most types of hyperkeratosis. However, actinic keratosis and very rarely, seborrheic keratosis can change into skin cancers.