EXPERT’S NOTEBOOK Hyperkeratosis

Hyperkeratosis is first of all an adaptive physiological phenomenon that aims, through the accelerated production of strongly keratinised cells, to strengthen the resistance of the epidermis. Walking barefoot or intense manual work generates a “ reflex ” –a thickening of the soles of the feet and palms of the hands. This phenomenon has a beneficial protective effect but creates discomfort on the surface of the skin, which becomes rough, course and prone to cracking.

If the physical stress is localised (repeated rubbing, permanent pressure on a very particular area), the hyperkeratosis takes on the appearance of a callus. The most common example is a plantar callus, caused by high stress on a small area of skin, causing a painful phenomenon similar to when a foreign body comes into contact with the foot.

Out of all dermatological conditions, it is psoriasis which almost constantly induces hyperkeratotic areas. The typical plaques of the condition, originally red, are surrounded by thick, very dense skin flakes, creating a scaly appearance. A kind of armour forms, causing significant aesthetic damage, skin discomfort and preventing psoriasis medications from penetrating.

When there is a physical cause (friction, irregular support), first of all, try to remove this pressure.
To remove hyperkeratosis, hydrating and emollient products, enriched with active ingredients that break up the blocks of keratin are required. Urea and salicylic acid are the main keratolytic active ingredients. Depending on the thickness, location and cause of hyperkeratosis, these substances are used to varying concentrations by incorporating them into very rich textures.
When used to treat psoriasis, these keratolytics help to remove the lesions. Once the hyperkeratosis has been removed, follow up with topical corticosteroids or vitamin D analogues.

A consultation with a dermatologist should be considered. Diagnosing scalp conditions is sometimes difficult, even for a specialist. The two most common conditions that fit this description are psoriasis and seborrhoeic dermatitis. In both cases, targeted application of care products containing urea and/or salicylic acid will improve symptoms. They tend to come and go, with chronic and recurrent flare-ups: it’s important to seek the advice of a dermatologist.

This description can be an indication of many conditions, but the first guess is keratosis pilaris. This damage is manifested by hyperkeratosis in the hair. It is particularly common and can be found in a third of the population. Its only damage is aesthetic and many patients are keen to find out how they can deal with it. Aside from hydration, one remedy that can help improve it is the use of the keratolytics, as described above.