How can I effectively manage a patient with ichthyosis in primary care, including topical treatments and lifestyle advice?

Effective management of ichthyosis in primary care involves regular use of emollients to maintain skin hydration and reduce scaling. Emollients should be applied liberally and frequently to the whole body, even when the skin appears clear, to prevent dryness and flares.

Choose unperfumed, leave-on emollients suitable for sensitive skin, and consider prescribing large quantities to ensure adequate use. Patients should be shown how to apply emollients by smoothing rather than rubbing them in to avoid skin irritation.

Advise patients to avoid soaps and detergent-based wash products, recommending instead the use of emollient soap substitutes or emollients added to bath water to reduce skin dryness.

For areas of inflammation or flares, topical corticosteroids may be used cautiously, tailoring potency to severity and body site, and applying only to active affected areas. Mild potency corticosteroids are preferred for sensitive areas such as the face and neck, and potent corticosteroids should be reserved for severe flares and used for short durations.

Lifestyle advice should include gentle skin care routines, avoiding irritants, and maintaining skin hydration. Patients should be educated on recognising flares early and starting treatment promptly.

Referral to dermatology specialists is appropriate if the condition is severe, complicated, or unresponsive to primary care management.