Skin Challenge: Acrodermatitis

Lyme disease is caused by a number of different strains and species of Borrelia bacteria, generally Borrelia burgdorferi in the United States and Borrelia afzelii and Borrelia garinii in Europe.

Acrodermatitis chronica atrophicans (ACA) is the late and chronic manifestation of the Lyme borreliosis seen more commonly in Europe than the US.

This physical manifestation of late Lyme disease begins as an inflammatory phase marked by edema and erythema, usually on the distal extremities; an on occasion, a faint bluish discoloration is found on extensor surfaces. The lesions also appear at the back of the heels on the feet as well as for the posterior heels and upper side of hands, feet, elbows, and knees. These lesions tend to become symmetric.

As this skin issues develops, atrophy occurs and the skin starts to look like “cigarette-paper” which is seen commonly with scleroderma. As a result of loss of subcutaneous fat, the underlying venous structures become more visible, and the skin becomes thin, atrophic, and dry. 


What is the cause of Acrodermatitis chronica atrophicans in your client?

This rash is a skin infection caused by the bacteria Borrelia.

Determine any medications; contraindications and cautions before proceeding with any spa treatment.

Treatments that can be offered:

  • Soothing, hydrating non-aggressive services with sun protection
  • Retinol creams and sun protection
  • Typically corticosteroids help with atrophied skin, however, Elidel (pimecrolimus 1%), does not suppress collagen production in the skin, like steroids do.  Elidel is a prescribed medication and can cause skin irritation initially so soothing, hydrating services or products are recommended if client is experiencing an inflamed reaction.

DISCLAIMER: Work within the scope of your license/certification.

Portrait of Mórag Currin. About the Author

Mórag Currin is a highly sought-after esthetic educator with more than 27 years of spa industry experience and more than twelve years of training and training management experience. She travels around the globe with her training and expertise, helping to raise the bar in the spa industry and to open the door to all people, regardless of skin type or health condition. To learn more about this topic and many other skin challenges, diseases, and symptoms, check out Mórag’s book, Health Challenged Skin: The Estheticians’ Desk Reference.

ASCP Logo.
ASCP Member Discount

ASCP Members receive 30% off Health Challenged Skin: The Estheticians’ Desk Reference. Click the link here to access your exclusive discount!


Please note: We have recently updated our Privacy Policy and Terms of Use. Learn more...