Date: 03/12/2020

In general, people with ichthyosis do not face greater risks of complications when dealing with viral infections like flu, and that is likely to be true with COVID-19.

Recommended safety precautions are the same as for flu, such as frequent hand washing and covering coughs and sneezes with a tissue or your elbow.  The CDC does not recommend the use of face masks by people who are not infected.

We encourage people with ichthyosis to follow the guidance of the CDC: 

• Reduce hand-to-mouth and hand-to-eye contact as much as possible. Take good care of skin to reduce extra touching.
• Wash hands frequently with soap and water, for at least 20 seconds.
• Hand sanitizers are often painful and drying for people with ichthyosis. If necessary, use moisturizing hand sanitizers with 60% alcohol and layer cream over it.

Who is at Higher Risk?

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

• Older adults

• People who have serious chronic medical conditions like heart disease, diabetes, and lung disease

Are People with Ichthyosis at Higher Risk?

There is no evidence that individuals with ichthyosis are more susceptible to this type of virus or would be more severely affected than the general population.

Some people with ichthyosis have other potential risk factors for COVID-19. If you have any of the following, follow the CDC’s higher risk precautions

• Temperature regulation issues

• Respiratory issues

• Immune compromising issues

Some behaviors that spread this type of virus are common in people with ichthyosis. These behaviors should be discontinued as much as possible:

• Face-touching, including hand-to-mouth contact and rubbing eyes

• Avoiding handwashing because it is drying and no lotion is available

• Avoiding hand sanitizer because it is drying and no lotion is available

• Misusing hand sanitizer by applying it to greasy hands

How is COVID-19 Transmitted?

• Mucous Membranes: This virus, and many like it, do not go through the skin; they go through the mucous membranes.  As far as we know, mucous membranes have normal barrier function in most types of ichthyosis.  Darier disease and some very rare cases may be exceptions.
• Not the skin: In the instance of fissures or impaired skin barrier function common in ichthyosis, this is not thought to present a pathway for the infection.

People with ichthyosis are thought to contract the disease the same way as unaffected individuals: the virus enters through mucus membranes, not cracked, scaling, or broken skin.

Person-to-Person Spread

The virus is thought to spread mainly from person-to-person.

• Between people who are in close contact with one another (within about 6 feet).

• Through respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Spread from Contact with Contaminated Surfaces or Objects

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Precautions for Higher Risk Groups

If you are at higher risk of getting very sick from COVID-19, you should:

• Stock up on supplies.

• Take everyday precautions to keep space between yourself and others.

• When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.

• Avoid crowds as much as possible.

• Avoid cruise travel and non-essential air travel.

• During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.

The complete recording of the FIRST to Know Zoom Call held on March 18, 2020, with Dr. Leonard Milstone and Dr. Amy Paller.