Managing Lichen Simplex Chronicus of Scalp at NIS: Understanding the Causes and Treatment Options

Lichen Simplex Chronicus of the scalp, also known as neurodermatitis circumscripta, is a chronic skin condition characterized by dry, thickened skin lesions resulting from repeated scratching of the scalp. While not a primary skin disorder itself, it typically arises following physical trauma to the scalp skin due to persistent rubbing or scratching in response to itching. These lesions often manifest at the top or nape of the scalp and can be effectively managed through skincare routines and behavioral changes. Let’s delve into the causes, symptoms, treatment, and preventive measures for scalp Lichen Simplex Chronicus.

What is Lichen Simplex?

Lichen Simplex Chronicus of the scalp manifests as chronic inflammatory skin lesions characterized by dry, rough patches on the scalp. It occurs due to continuous irritation from intense and uncontrollable itching, often triggered by stress or habit. These thickened, darkened skin lesions are commonly found in areas easily accessible for scratching, such as the scalp, nape of the neck, forearms, elbows, and other body parts.

What Causes Lichen Simplex Chronicus of Scalp?

The primary cause of Lichen Simplex Chronicus of the scalp is excessive scratching, either as a habit or in response to underlying skin conditions like pruritus, eczema, or dermatitis. Environmental factors, psychological stressors, and certain skin disorders can also exacerbate itching and lead to the development of scalp lesions.

Who Gets Lichen Simplex Chronicus of Scalp?

Lichen Simplex Chronicus of the scalp tends to affect individuals in mid-to-late adulthood, with a higher prevalence observed between the ages of 30 and 50. Women are more susceptible to developing these lesions than men, although the condition may be underreported due to social stigma. Factors such as habitual scratching, mental health conditions like anxiety or depression, and obsessive-compulsive disorder increase the risk of developing scalp Lichen Simplex Chronicus.

What are the Clinical Features of Lichen Simplex of Scalp?

The characteristic features of Lichen Simplex Chronicus of the scalp include irregular or polygonal-shaped plaques with elevated red papules, darkened lesions covered by dry scales, and intense itching, especially exacerbated at night. These lesions may present with dusky violaceous or brown hyperpigmentation, indicating chronic inflammation.

How is Lichen Simplex Chronicus of Scalp Diagnosed?

Diagnosis of scalp Lichen Simplex Chronicus is primarily based on clinical examination, although skin scraping for laboratory testing may be performed in some cases to confirm the diagnosis and rule out other skin conditions like psoriasis or eczema.

What is the Treatment for Lichen Simplex Chronicus of Scalp?

Treatment for scalp Lichen Simplex Chronicus involves topical and systemic medications aimed at relieving itching and addressing the underlying causes:

Topical Medications:

• • Steroids, salicylic acid, capsacin, tacrolimus, pimecrolimus, doxepin, and botulinum toxin help alleviate itching and resolve skin lesions.
  • Moisturizing creams prevent dryness of the scalp skin.
  • Cooling creams containing menthol provide soothing relief.

Systemic Medications:

• • Antihistamines reduce inflammation and itching.
  • Antidepressants may be prescribed for itching associated with stress or depression.
  • Antifungals or antibiotics treat underlying infections if present.

Self-Care Guidelines

Preventive measures for scalp Lichen Simplex Chronicus include controlling itching, keeping lesions covered at night, maintaining scalp hydration, using topical antibiotics for cracked lesions, managing stress through relaxation techniques, and seeking professional advice before using hydrocortisone creams or attempting self-removal of hardened skin over lesions.

By understanding the causes and adopting appropriate treatment and preventive measures, individuals with scalp Lichen Simplex Chronicus can effectively manage their condition and improve their quality of life.