Keratin is a tough, fibrous protein found in fingernails, hair, and skin. The body may produce extra keratin as a result of inflammation, as a protective response to pressure, or as a result of a genetic condition.
Most forms of hyperkeratosis are treatable with preventive measures and medication.
Causes and types
Forms of hyperkeratosis may include warts, corns, and calluses.
Pressure-related hyperkeratosis occurs as a result of excessive pressure, inflammation or irritation to the skin.
When this happens, the skin responds by producing extra layers of keratin to protect the damaged areas of skin.
Non-pressure related keratosis occurs on skin that has not been irritated. Experts think that this form of hyperkeratosis may be the result of genetics.
Forms of hyperkeratosis include:
- actinic keratosis, which causes rough, sandpaper-like patches of skin to develop as a result of excess skin exposure
- epidermolytic hyperkeratosis, an inherited skin disorder present at birth
- lichen planus, a condition that causes white patches to grow on the inside of the mouth
- plantar warts
If a person has a potential area of hyperkeratosis on their skin that they are uncertain of, they should see their doctor.
Hyperkeratosis can have a range of symptoms. However, all symptoms will involve an area of rough or patchy skin that feels different from the surrounding skin.
Some symptoms of the more common causes of hyperkeratosis include:
- Calluses: A callus is an area of thickened skin that usually occurs on the feet, but can also grow on the fingers. Unlike a corn (see below), a callus is usually of even thickness.
- Corns: A lesion that typically develops on or between the toes. A corn usually has a center lesion of very hard keratin with an outer ring of hard tissue that is slightly softer.
- Eczema: This condition causes red, itching skin that may appear in patches or as small bumps
- Epidermolytic hyperkeratosis: This condition causes very red skin and severe blistering of the skin at birth. As the baby ages, they will develop areas of thickened skin (hyperkeratosis), particularly over their joints.
- Leukoplakia: This condition causes thick, white patches to build up inside the mouth.
- Plaque psoriasis: This condition can cause an excess buildup of skin cells that are often silvery and scaled.
With the exceptions of corns and calluses, most forms of hyperkeratosis are not painful.
What are the treatment options?
It is recommended to avoid being barefoot in gyms and locker rooms to help prevent hyperkeratosis lesions.
Treatments for hyperkeratosis depend upon what form a person has. Both at-home and medical treatments exist for hyperkeratosis.
Some of the ways to avoid hyperkeratosis lesions, such as corns or calluses include:
- Wearing comfortable, well-fitting shoes. Wearing padding over corns or calluses can also offer further protection.
- Avoiding going barefoot in areas that are prone to fungi, such as in locker rooms, gyms, or pools.
- Avoiding environmental conditions known to contribute to eczema, such as dry air, highly fragranced or perfumed soaps, harsh chemicals, or extremely hot or cold temperatures.
- Avoiding allergy triggers, such as pet dander and pollen that can cause skin inflammation.
- Wearing sunscreen with a sun protection factor of at least 30 every time you go outside. Wearing protective clothing, such as a hat or long sleeves, can also protect against actinic keratosis.
If a person has a condition that causes lesions that are removable, such as warts, they should see their doctor, nurse practitioner, or physician assistant who can "freeze" a wart or use a laser to vaporize it.
These healthcare professionals can also prescribe medication to treat areas of hyperkeratosis, such as corticosteroid creams for eczema or lichen planus.
When to see a doctor
A person should see a doctor when their hyperkeratosis causes pain or discomfort. If an area of the skin appears infected, such as reddened, swollen, or pus-filled, they should also seek medical attention.
Sometimes hyperkeratosis plaques can closely resemble cancerous lesions. For this reason, many people choose to have thickened areas of skin evaluated.
A doctor will take a medical history to determine if there is an underlying cause for the hyperkeratosis. For example, if a person has leukoplakia, a history of smoking or using chewing tobacco, then they may be at higher risk of developing hyperkeratosis.
A doctor may also order imaging tests to determine if there are underlying problems with a person's bone structure or the presence of tumors on or around the hyperkeratosis areas.
Another diagnostic tool is a biopsy, which involves taking a sample of skin and examining it under a microscope for the presence of cancerous cells or other cell abnormalities. In most instances, a doctor can diagnose the underlying cause via a physical examination.
There are many forms of hyperkeratosis, most of which are not painful. Some types of hyperkeratosis, such as warts and calluses are removable, while other forms can be treated or managed with a variety of medications.
Anyone who develops patches of thickened skin on their body should consult a doctor or dermatologist for a diagnosis.