Lichen simplex chronicus (LSC) is a skin condition caused by chronic itching and scratching.

LSC; Neurodermatitis circumscripta

LSC may occur in people who have:

• Skin allergies
• Eczema (atopic dermatitis)
• Psoriasis
• Nervousness, anxiety, depression, and other emotional problems

The problem is common in adults but may also be seen in children.

LSC leads to scratching, which then causes more itching. It often follows this pattern:

• It may start when something rubs, irritates, or scratches the skin, such as clothing.
• The person begins to rub or scratch the itchy area. Constant scratching (often during sleep) causes the skin to thicken.
• The thickened skin itches, and this leads to more scratching. This then causes more thickening of the skin.
• The skin may become leathery and brownish in the affected area.

Symptoms include:

• Itching of the skin that may be long-term (chronic), intense, and that increases with stress
• Leathery texture to the skin
• Raw areas of skin
• Scaling
• Skin lesion, patch, or plaque with sharp borders and a leathery texture, located on the ankle, wrist, back of the neck, rectum, anal area, forearms, thighs, lower leg, back of the knee, and inner elbow

The main treatment is to reduce the itch.

You may need to use these medicines on your skin:

• Lotion or steroid cream on the area to calm itching and irritation
• Numbing medicine
• Peeling ointments containing salicylic acid, lactic acid, or urea on patches of thick skin

You may need to use dressings that moisturize, cover, and protect the area. These may be used with or without medicated creams. They are left in place for a week or more at a time. Wearing cotton gloves at night may prevent skin damage from scratching.

To control itching and stress due to it, you may need to take medicines by mouth, such as:

• Antihistamines
• Other oral medicines that control itch or pain

Steroids may be injected directly into the skin lesions to reduce itching and irritation.

You may need to take antidepressants and tranquilizers if the cause of your itching is emotional. Other measures include:

• Counseling to help you realize the importance of not scratching
• Stress management
• Behavior modification

You can control LSC by reducing itch and controlling scratching. While the condition can be treated, it often returns. The condition may return or move to different areas on the skin. Ongoing management can help relieve symptoms.

These complications of LSC can occur:

• Bacterial or fungal skin infection
• Permanent changes in skin color
• Permanent scar

Contact your provider if:

• Symptoms get worse
• You develop new symptoms, especially signs of skin infection such as pain, redness, drainage from the area, or fever

Published Date: October 13, 2024
Published By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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