Travel with ichthyosis can pose unique challenges for both packing and skin care.

Preparation is key. Approaching your travel with a sense of anticipation – rather than anxiety – is the goal.

OVERVIEW

Ichthyosis is highly variable among individuals. For the purposes of this resource, we will address common symptoms and refer to “flare ups” in general. “Flare up” is a worsening of symptoms, caused by a trigger. Different triggers can cause different kinds of flares.

Remember ichthyosis is a disorder of inflammation. Stress, change in climate, dry air, food allergies. different skincare…all of these can impact the inflammation already present in the body.

Anticipating these stressors can help minimize their impact and allow you to focus on your trip.

Before You Go
Try to be stricter with your skin care routine prior to the trip. Implementing more bathing and moisturizers will help prevent an occurrence of a flare up. Also, don’t go overboard with exfoliation which can decrease your skin’s ability to protect itself in the changing environment.

Travel Anxiety
Travel stress happens to everyone. For people with ichthyosis, emotional stress can trigger skin flare ups.  Follow your own most effective protocols for stress management and relaxation, Think: deep breathing, quality sleep, yoga, journaling.

Climate Adaptation
Your skin gets used to your home climate. People with ichthyosis have a compromised barrier, so changes in air quality and temperature at a destination could trigger a response and cause a flare up. To prevent this, be aware of the activities planned and resources needed for your comfort and skin health. Before and during your travel, check the UV Index, Air Quality Index, and humidity at your destination. For a dryer environment, you might need to apply more lotion daily or change to a stronger barrier cream. At times of day with high UV Index, take extra care for sun protection it might be much higher than you have at home. Air Quality Index measures the pollutants in the air, large and small. Due to the compromised skin barrier, people with ichthyosis might find themselves triggered by something in the air in the new environment.

Air Travel
Recirculated air in the plane cabin will have an impact on skin—the longer the flight, the bigger the impact. Cabin air is famously dry, and the Covid pandemic and it’s hand sanitizers, masks, and antibacterials are hard on skin.

Travel outfits should include socks and options to layer. Most cabin temperatures are cold, and long sleeves and pants will not only keep you warm, but provide an extra layer of protection against cabin air.

Your carryon bag should contain hand lotion, lip balm, and face lotion at a minimum. Some people like to bring wet wipes (look for low or no alcohol) and water sprays on board for skin hydration. Consider bringing prescriptions and full-body lotion in case you need it or get separated from your checked bag.

Doctor’s Letter
Your doctor’s letter is a pass for several things:

1. Medical exemption for carryon luggage liquids.
2. Some airports will allow you to preboard or use a disability placard that allows use of faster handicapped security lanes. 
3. In the unfortunate event your symptoms of ichthyosis are questioned as a communicable disease, the doctor’s letter can clear up the situation. See details below in Air Carrier Access Act.

Allergies
For those prone to contact allergies and skin breakouts, it’s recommended to bring your own pillow and sheets. Depending on the hotel, the option to stay in a feather free room may be available. For hotels and rentals, be aware that cleaning supplies might be used that don’t agree with your skin.
If you struggle with food allergies, pack a carry-on with essential safe snacks. Calling ahead to restaurants or looking at their online menu may save time. Food Allergy Research & Education (FARE)  allows you to print a card that has foods you need to avoid in different languages.

Bathing
Maintaining your home bathing protocol will help your skin ease into the new environment. Consider choosing lodging that has confirmed bathtubs, rather than just showers.

Products
Given the other unknowns you face, travel is not a good time to experiment with new products. That said, if you forget or lose your cream, you can likely find a petroleum jelly at most drugstores around the globe. Sunscreen is also widely available around the globe. If you want to bring your full-size creams with you, and you worry about the weight limit of checked bags, you can carry them on provided you have your doctor’s note (see above).

International Travel
Throughout the world, product formulations differ for lotions and other household products. To ensure your skin doesn’t break out, check ingredient labels starting with your favorite brands from home. As a last resort, you can ship necessary items to your destinations before you leave.

YOUR RIGHTS- Air Carrier Access Act

The Air Carrier Access Act (ACAA) is a law that makes it illegal for airlines to discriminate against passengers because of their disability. The Department of Transportation is responsible for enforcing the ACAA, which applies to all flights to, from, or within the United States.

The Air Carrier Access Act prohibits discrimination on the basis of disability in air travel.   The Department of Transportation has a rule defining the rights of passengers and the obligations of airlines under this law. This rule applies to all flights of U.S. airlines, and to flights to or from the United States by foreign airlines.  The following is a summary of the main points of the DOT rule (Title 14 CFR Part 382).

According to the U.S. Department of Transportation, airlines must do the following:

Prohibition of Discriminatory Practices

  • Airlines may not refuse transportation to people on the basis of disability. Airlines may exclude anyone from a flight if carrying the person would be inimical to the safety of the flight. If a carrier excludes a person with a disability on safety grounds, the carrier must provide a written explanation of the decision.
  • Airlines may not require advance notice that a person with a disability is traveling. Air carriers may require up to 48 hours’ advance notice for certain accommodations that require preparation time (e.g., respirator hook-up, transportation of an electric wheelchair on an aircraft with less than 60 seats).
  • Airlines may not limit the number of persons with disabilities on a flight.
  • Airlines may not require a person with a disability to travel with another person, except in certain limited circumstances where the rule permits the airline to require a safety assistant. If a passenger with a disability and the airline disagree about the need for a safety assistant, the airline can require the assistant, but cannot charge for the transportation of the assistant.
  • Airlines may not keep anyone out of a specific seat on the basis of disability, or require anyone to sit in a particular seat on the basis of disability, except to comply with FAA or foreign-government safety requirements. FAA's rule on exit row seating says that airlines may place in exit rows only persons who can perform a series of functions necessary in an emergency evacuation.

Please note, this is not an exhaustive summary. There are also several specific accommodations for wheelchairs. For more information, view the Airline Passengers with Disabilities Bill of Rights https://www.transportation.gov/airconsumer/disability

FIRST Members’ Tips

“We have a letter from our son’s doctor with us when we fly. We will pack his lotions in a gallon size bag and put them through security. Once they go through the scan they will pull us to the side to test them and read the letter. They don’t always read the letter. We only checked the lotions when we flew out of country. When he was little we always carried some sort of cooling device with us on the plane. We also notify the crew if for some reason it is getting warm and they have always accommodated us.”

“We have never really encountered any issues, thankfully. We don’t try to board early, because our son does not want to feel different or have special privileges. I would suggest anyone traveling to always carry a letter from their doctor stating ichthyosis and what lotions are needed, just in case.”

“For air travel, most of my experiences through security have been fine. I live in Canada, and when I travel domestically it is fine. If I go internationally, I will sometimes bring a doctor’s note just saying it is not contagious and it’s a genetic disorder. The only problem I have really experienced is when I used to travel to India with my family when we were younger as they used to question it and the Vaseline we carried. Security might be easier with a doctor’s note. “

“I will usually bring a travel sized Vaseline, moisturizer and the usual things like a good book and earphones. In my check in luggage, I will pack a larger sized moisturizer depending on where I am going and how long. I went to Europe for a wedding last summer and brought with me an Eau Thermal spray in a small bottle and that really helped with heat. Also wet wipes are nice once in a while to cool the neck. A cap and sunglasses are great too. Since I shed skin sometimes, I also pack a mini dust sweeper and pan for the place I am staying.”

“I use a lotion that is compounded- Aquaphor combined with lactic acid. I typically bring it in a carry-on bag for fear of my luggage getting lost and being without it during a trip. It is not in a approved TSA sized container so they usually do some type of chemical test on it. I have noticed that it is better to leave the prescription on the lotion container and explain to them what it is for. Having a prescription seems to be useful!”

“I always carry the cream and lotion in cabin baggage and have to explain about the contents. Have to wear layers as it gets cold on flight. I ask for last row or first row because I feel less cold there.”

Members shared these tips for coping with their ichthyosis or related skin types on FIRST’s Facebook Group pages. FIRST does not endorse or recommend any treatment regimens, diets, medications, or products.

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This information is provided as a service to patients and parents of patients who have ichthyosis.  It is not intended to supplement appropriate medical care, but instead to complement that care with guidance in practical issues facing patients and parents.  Neither FIRST, its Board of Directors, Medical & Scientific Advisory Board, Board of Medical Editors, nor Foundation staff and officials endorse any treatments or products reported here.  All issues pertaining to the care of patients with ichthyosis should be discussed with a dermatologist experienced in the treatment of their skin disorder.

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