Skin Problems Associated with Thyroid Disease

Over activity and under activity of the thyroid gland may result in alterations of the skin, hair, or the nails. This may be as a result of the abnormal level of thyroid hormone, or a consequence of another underlying condition.

Thyrotoxicosis (Overactive Thyroid Gland)

Excess thyroid hormone (thyroxine) may be due to:

• Grave’s Disease
• Thought to be caused by auto antibodies, the mistaken immune T-cells, which cause Grave’s Disease.
• The result of this is thickened and inelastic skin, filled with excessive hyaluronic acid and chondroitin sulphate.
• This disease can also be associated with Vitiligo.
• Pretibial Myxedema – this condition will affect 5% of patients with Grave’s Disease. Appearing before, during, or after the thyrotoxic state.
• Presents a lumpy appearance over the shins.
• Skin may be discolored pink or purple, hair follicles are prominent with a warty appearance.
• Thyroid nodule(s)
• Excessive intake of thyroxine medication

Thyrotoxicosis will cause an increased metabolic rate. This can result in:

• Smooth, moist, warm skin
• Flushing of the face and hands
• Overgrown nails which may lift off of the nail bed (Onycholysis)
• Fine, soft, thinning scalp hair
• Generalized itching
• Urticaria (or hiving)
• Increased skin pigmentation

Hypothyroidism (Underactive Thyroid Gland)

Can possibly be related to auto-immune diseases, such as:

• Pretibial Myxedema
• Idiopathic Hypothyroidism
• A condition of unknown cause in which the thyroid undergoes a destructive and scarring process.
• Hashimoto’s Thyroiditis
• An inflammatory condition causing destruction and scarring on the thyroid.

Hypothyroidism can result in:

• Cold, pale, and dry skin
• Delayed wound healing
• Carotenaemia – a yellowish hue to the skin
• Slow growing, ridged, and brittle nails
• Dry skin – more prone to develop various form(s) of dermatitis