Lichen Simplex Chronicus – Causes, Symptoms & Treatment

Lichen simplex chronicus

Lichen simplex chronicus is a chronic inflammatory skin disease that manifests itself in adulthood. People between the ages of 20 and 60 are most commonly affected, with women being significantly more susceptible than men. The following article explains in more detail the causes, symptoms, complaints, diagnosis and course of the disease as well as treatment options using various therapies.

What is lichen simplex chronicus?

Lichen simplex chronicus is a chronic, itchy inflammation of the upper layers of the skin that occurs in episodes. It is one of the chronic eczematous skin diseases and often occurs under the name neurodermatitis cirumscripta , lichen chronicus vidal or Vidal disease.


The exact causes have not yet been fully clarified. In most cases, eczematous inflammation of the skin occurs as a result of a drug reaction or allergy . However, studies also point to systemic diseases that cause itching due to diabetes mellitus , liver diseases , gastrointestinal disorders , renal insufficiency or other underlying diseases, as well as environmental factors such as cold, heat, air pollution or non-specific irritants.

Furthermore, psychosomatic factors play an important role as triggers. Until now, it has been assumed that people who are exposed to psychological stress and high levels of stress over a long period of time are particularly susceptible to lichen simplex chronicus.

A clinical study then examined the period of relapses in which the disease and its symptoms were particularly active. Periods of relative relaxation and inactivity also emerged. As a result, it is clear that the involuntary scratching mechanism is also present in aspects that distract from the itch.

Symptoms, Ailments & Signs

Lichen simplex chronicus manifests itself as constant severe itching, which is not alleviated by scratching but instead provokes further attacks of scratching. This causes even more itching. Many sufferers are no longer aware of this vicious circle of itching and scratching. They act as if in a trance, sometimes scratching themselves for no apparent reason.

The disease can occur anywhere on the body. Disorders caused by lichen simplex chronicus primarily appear on the chest and neck area, on the arms, legs, the back of the knees, on the scalp and neck, but also in the genital area. Anxious or depressive situations favor the excessive scratching reaction and the complexion worsens.

In the early stages, the skin still has a normal appearance. It starts to itch and eventually becomes dry and scaly. Rubbing and scratching causes streaky changes on the skin that increase in size. Pea-sized, reddish-brown to grey-brown papules form , which multiply on the extensive leathery thickening of the skin (lichenification) as mostly scratched lichen-like nodules.

Diagnosis & course of disease

In order to be able to diagnose lichen simplex chronicus with certainty, skin diseases that have similar symptoms must be ruled out. These include, for example, allergic contact dermatitis, atopic dermatitis or lichen ruber planus. However, if the itching occurs in the vagina or anal area, fungi , local discharge , warts , psoriasis and contact dermatitis can be responsible. The doctor will initiate the necessary examinations.

Even during the anamnesis, the doctor must be informed of all known details about family circumstances, illnesses or existing mental illnesses. In addition to a differential diagnosis in the medical field, the histological findings usually provide clarity about the actual presence of lichen simplex chronicus.

A biopsy is used to take a tissue sample from the affected area and analyze it histologically. The diagnosis in patients with severe symptoms can be recognized without difficulty from the chronic course and the inflammatory manifestations of the typical lichen nodules.


In most cases, those affected by lichen simplex chronicus suffer from very severe itching. As a rule, this itching only gets worse if the person concerned scratches the area in question. Patients’ quality of life is significantly reduced by lichen simplex chronicus.

This disease can also lead to psychological problems, since the itching occurs permanently. Sometimes redness occurs on the skin. Especially in the area of ​​the head and face, these complaints are very unpleasant and can also lead to inferiority complexes or reduced self-esteem. Depression is also not uncommon.

The skin is clearly damaged by lichen simplex chronicus and appears dry and scaly. Furthermore, this disease leads to the formation of papules and pustules, which can cover the skin in different places. The disease can also negatively affect the patient’s sleep and thus lead to irritability.

The treatment of this disease is carried out with the help of drugs. It usually leads to a positive course of the disease. There are no particular complications. The life expectancy of the patient is usually not reduced or influenced by lichen simplex chronicus.

When should you go to the doctor?

If the affected person suffers from severe persistent itching on the skin, he should consult a doctor. If there is no relief from the symptoms despite scratching the affected parts of the body, this is a peculiarity and an indication of lichen simplex chronicus. A doctor’s visit is necessary before further illnesses or complications occur. Pathogens can enter the organism via the existing wounds and trigger further diseases. A doctor’s visit is therefore necessary as soon as the person concerned cannot ensure adequate wound care. If there are further changes in the usual skin appearance or if the existing symptoms spread, a doctor is required.

If pus forms, the person affected is at risk of blood poisoning. A doctor’s visit is necessary to prevent a life-threatening condition. In case of fever, pain or sweating, a doctor should be consulted immediately. If vague fears arise due to the symptoms or if the affected person experiences mood swings, it is advisable to consult a doctor.

Depressive behavior is considered worrying and must be clarified. A doctor should be consulted as soon as the behavioral problems persist for several weeks or months. If dry or scaly skin gradually develops, you should consult a doctor. If poplars or other swellings form on the skin, it is advisable to have the skin changes clarified by a doctor.

Treatment & Therapy

The therapy of the disease often proves to be very complex, which alone represents an additional and frustrating burden for those affected. However, the goal of treatment is always to minimize the itching and, as a result , eliminate the eczema . General measures such as topical moisturizing cream, corticosteroids or lifestyle changes can help here.

In exceptional cases, light sleeping pills have a supporting effect to curb the annoying itching or an antihistamine , which is taken before going to bed. This prevents impending sleep disorders or lack of sleep, which are often the triggers for mental illness.

In the case of psychological stress as a result of lichen simplex chronicus, it is advisable to consult a psychologist before starting clinical therapy in order to be able to identify possible psychological causes. Itching in the genital area is particularly uncomfortable. Regular use of sitz baths with tanning additives or applications of coal tar-based ointments and pastes containing zinc oxide are helpful here and can achieve considerable relief.

Climatotherapy often achieves beneficial results in the treatment of skin diseases . It is said: The greater the difference in climate, the more favorable are the healing effects for the clinical picture! As a result, a stay in the low mountain range is less successful than carrying out therapy in the high mountains or directly on the North Sea, where the ultraviolet light is particularly intense.

Outlook & Forecast

The prognosis of the skin changes is linked to the causal disorder. In a large number of patients, an unfavorable course of the disease and later freedom from symptoms can be documented. If the inflammation of the skin is triggered by an intolerance, recovery can take place within a short time. The causative agent must be found and should be avoided in the future. Often it is an intolerance caused by the administration of medicines.

Alternative preparations are prescribed so that the underlying disease continues to be treated. If lichen simplex chronicus occurs due to severe emotional stress, the person affected can improve their mental state on their own responsibility or with the support of a therapist. Stressors must be minimized and lifestyle should be optimized. In many cases, a fundamental improvement in the quality of life also leads to an alleviation of skin problems. If the affected person suffers from a chronic disease or organic disorder, the prognosis is usually worse.

The course of this underlying disease is usually characterized by an increase in symptoms or irreversible damage to the organism. Regardless of the cause of the disease, it has been shown that the overall symptoms can be reduced if the zest for life and well-being have increased. Therefore, the emotional aspect seems to be of particular importance in the prognosis.


The chronic and recurring disease lichen simplex chronicus is usually a lifelong companion for those affected. However, the effects of the symptoms can be positively influenced medically. In everyday life, the patient should always be careful not to unnecessarily irritate the affected areas of skin by not using aggressive cosmetic products or wearing scratchy clothing. Spending time in the fresh air and moderate exposure to the sun, on the other hand, are recommended for relief or faster healing.


The follow-up measures usually depend very much on the severity of the disease, so that no general prediction can usually be made. Various symptoms and complications can occur with lichen simplex chronicus. Most patients suffer from severe itching of the skin and significantly reduced aesthetics due to lichen simplex chronicus. Aftercare is aimed at dealing well with the suffering and strives to improve the quality of life. Signs of depression or other mental disorders should be clarified by a psychological expert and, if necessary, cured with therapy. The disease cannot heal itself, so that regular visits to a doctor will always be necessary. Contact with other sick people can sometimes promote an exchange of information and the certainty of not being alone with one’s fate. However, lichen simplex chronicus does not have a negative effect on the life expectancy of the person affected and does not reduce it.

You can do that yourself

Patients with lichen simplex chronicus suffer from severe impairment of their usual quality of life due to itching and skin damage caused by scratching. The most important self-help measure for those affected is therefore to become aware of the disease and to make the decision to initiate medical treatment. Because numerous patients with the disease scratch themselves in a trance-like manner and continue to reinforce the vicious circle of itching and skin injuries.

The dermatologist prescribes medication and ointments to treat the symptoms, which the patient usually has to apply on a daily basis. As long as the treatment of the disease is not yet complete and visible changes appear on the skin, those affected often suffer from shame because of the cosmetic flaw.

In order to accelerate healing, the affected person follows the doctor’s instructions regarding personal hygiene, the use of cosmetics and clothing, which should preferably consist of skin-friendly fibers.

Finding the often psychological trigger for the itching is also central to the success of the treatment of the disease. Here, too, the patients themselves play the most important role, and they must first admit to themselves that they have mental problems. They then turn to a psychologist to work on the relevant problems and restore mental balance.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.