Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentSkin Care TipsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Skin Care Tips
Frequently Asked Questions
Koebner’s phenomenon(pronounced KOHB-nurs) is a skin condition that occurs after skin trauma. The condition is named after Heinrich Koebner, the scientist who discovered it in 1876.
This article will help you understand what Koebner’s phenomenon is, how to avoid it, and how to treat it if you have it.
Suriyawut Suriya / EyeEm / Getty Images
What Is Koebner’s Phenomenon?
Koebner’s phenomenon (also called an isomorphic response or Koebnerization) is a psoriatic rash that appears around an injury, such as a cut or a burn. The rash can show up anywhere on the body where trauma to the skin has occurred.
Koebner’s phenomenon looks like raised skin lesions. The lesions tend to have the same features as a person’s existing dermatologic condition. The lesions usually follow the injury lines, and they may cover the entire skin injury or develop on only one part.
Although Koebner’s phenomenon occurs after skin trauma, it is not an acute condition. Rather, it activates an underlying disease.
People with preexisting skin conditions are most susceptible to Koebner’s phenomenon. For example, Koebnerization occurs 11% to 75% of the time in people with psoriasis and 21% to 62% of the time in people with vitiligo.
What Causes Koebner’s Phenomenon?
Psoriasis
Psoriasisis an autoimmune disorder in which the body attacks normal skin cells. There are many types of psoriasis, all of which affect the body in different ways:
A 2011 study found that 28% of participants with existing psoriasis developed Koebner’s phenomenon aftergetting a tattoo. Of the participants who developed Koebner’s, 30% reported a flare-up at the tattoo site between a week and two decades after getting the tattoo. Fewer than 7% had a flare-up on other parts of their body.
Vitiligo
Vitiligois an autoimmune condition where skin pigmentation is lost, resulting in smooth white patches on the body. People with vitiligo may also experience early graying of their hair and itching on the affected skin regions.
Like psoriasis, vitiligo has certain triggers, including stress, sunburn, chemicals, and viruses. Skin injuries can also trigger Koebnerization.
What Triggers Vitiligo?
Studies have shown that Kobernization is more likely to occur when vitiligo covers a larger amount of the body’s surface area as well as when disease activity is greater.
Lichen Planus
Lichen planusis an autoimmune disease that causes a purple, itchy rash. The condition can affect many parts of the body, including the inside of the mouth.
Koebner’s phenomenon is believed to be an activation of an underlying disease, and lichen planus is an autoimmune disease that may trigger it.
In addition, some experts believe that both the epidermis and dermis of the skin must be injured for the condition to be triggered.
True vs. Pseudo Koebner’s ResponsesA true Koebner’s response occurs alongside preexistingautoimmune conditionsthat affect the skin. A pseudo Koebner’s response is when an infection, such asviral wartsormolluscum contagiosum, spread lesions across the injured skin.
True vs. Pseudo Koebner’s Responses
A true Koebner’s response occurs alongside preexistingautoimmune conditionsthat affect the skin. A pseudo Koebner’s response is when an infection, such asviral wartsormolluscum contagiosum, spread lesions across the injured skin.
Limited case studies have suggested that Koebner’s phenomenon may occur in people without preexisting autoimmune skin conditions.However, the overall body of research indicates that the condition is most closely associated with autoimmune conditions that affect the skin, such as psoriasis, vitiligo, and lichen planus.
Body Modifications
Tattoos and piercings may lead to Koebner’s phenomenon in people with preexisting autoimmune skin conditions because tattoos and piercings, while added to decorate and beautify the body, also injure the skin (which is a risk factor for developing Koebner’s phenomenon).
Although body modification can increase the risk of developing Koebner’s phenomenon if you have psoriasis, vitiligo, or lichen planus, it’s important to also consider the value of the potential tattoo or piercing.
In a study of tattoo-induced Koebner’s, 82% of participants said that their tattoo positively affected their body image. The study concluded that tattooing should not be a contraindication for people with psoriasis but that they should receive proper counseling beforehand.
Can You Get a Tattoo If You Have Psoriasis?
Seeing a Dermatologist
If you notice changes in your skin, make an appointment with adermatologist. If you notice lesions on a skin injury—especially if you have an autoimmune disease like psoriasis—a dermatologist will be able to screen for and treat Koebner’s phenomenon.
If Koebner’s is diagnosed, the treatment usually includes either systemic treatment of psoriasis to suppress Koebner’s phenomenon or topical creams, lotions, and ointments (both over-the-counter and prescription) to cover the lesions.
Skin Care for Psoriasis Flare-Ups
When you experience flare-ups, there are some things your dermatologist may prescribe to calm and heal your skin:
What Is Psoriasis?
You can often treat mild flares at home.The National Psoriasis Foundation suggests using:
Always ask your doctor or dermatologist about any at-home therapies you are considering. That way, you can be sure they are safe for you and will not interfere with your treatment plan or medications.
8 Common Psoriasis Triggers
What does Koebner’s phenomenon look like?
The appearance of Koebner’s phenomenon depends on which autoimmune condition a person has. Koebner’s phenomenon tends to present in the same way as the preexisting condition.
For instance, if a person has psoriasis, Koebner’s would present as a raised, itchy, flaky rash that runs over the skin injury.
What is an isomorphic response?
An isomorphic response is another term for Koebner’s phenomenon. Isomorphic is Greek for “equal shape.” The phrase is used because the lesions from Koebner’s are identical to a person’s underlying condition.
How can I prevent psoriasis flare-ups?
Psoriasis tends to flare up if a person encounters specific triggers. Triggers are different for every person. Common triggers include stress, skin trauma, dry skin, medications, alcohol, and infections.
Identifying the things that tend to trigger your psoriasis and avoiding them is important, but it might take some detective work. A symptom journal may help you figure out what causes your flare-ups.
Medications That Can Trigger Psoriasis
A Word From Verywell
If you have psoriasis or another autoimmune disease of the skin, you might be at increased risk of developing Koebner’s phenomenon.
If you have an injury to your skin, including those from tattoos and piercings, watch your injury closely for lesions. If any changes develop, contact your doctor or dermatologist.
An Overview of Skin Pigmentation Disorders
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sanchez D, Sonthalia S.Koebner phenomenon. National Center for Biotechnology Information, U.S. National Library of Medicine.New Zealand Dermatological Society.Koebner phenomenon.Kluger N.Tattooing and psoriasis: demographics, motivations and attitudes, complications, and impact on body image in a series of 90 Finnish patients.Acta Dermatovenerologica Alpina Pannonica et Adriatica. 2017;26(2). doi:10.15570/actaapa.2017.9van Geel N, Speeckaert R, De Wolf J, et al.Clinical significance of Koebner phenomenon in vitiligo.British Journal of Dermatology. 2012;167(5):1017-1024. doi:10.1111/j.1365-2133.2012.11158.xArias-Santiago S, Espiñeira-Carmona M, Aneiros-Fernández J.The Koebner phenomenon: psoriasis in tattoos.Can Med Assoc J. 2012;185(7):585-585. doi:10.1503/cmaj.111299National Psoriasis Foundation.Treatments for psoriatic disease.National Psoriasis Foundation.Integrative approaches to care.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sanchez D, Sonthalia S.Koebner phenomenon. National Center for Biotechnology Information, U.S. National Library of Medicine.New Zealand Dermatological Society.Koebner phenomenon.Kluger N.Tattooing and psoriasis: demographics, motivations and attitudes, complications, and impact on body image in a series of 90 Finnish patients.Acta Dermatovenerologica Alpina Pannonica et Adriatica. 2017;26(2). doi:10.15570/actaapa.2017.9van Geel N, Speeckaert R, De Wolf J, et al.Clinical significance of Koebner phenomenon in vitiligo.British Journal of Dermatology. 2012;167(5):1017-1024. doi:10.1111/j.1365-2133.2012.11158.xArias-Santiago S, Espiñeira-Carmona M, Aneiros-Fernández J.The Koebner phenomenon: psoriasis in tattoos.Can Med Assoc J. 2012;185(7):585-585. doi:10.1503/cmaj.111299National Psoriasis Foundation.Treatments for psoriatic disease.National Psoriasis Foundation.Integrative approaches to care.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sanchez D, Sonthalia S.Koebner phenomenon. National Center for Biotechnology Information, U.S. National Library of Medicine.New Zealand Dermatological Society.Koebner phenomenon.Kluger N.Tattooing and psoriasis: demographics, motivations and attitudes, complications, and impact on body image in a series of 90 Finnish patients.Acta Dermatovenerologica Alpina Pannonica et Adriatica. 2017;26(2). doi:10.15570/actaapa.2017.9van Geel N, Speeckaert R, De Wolf J, et al.Clinical significance of Koebner phenomenon in vitiligo.British Journal of Dermatology. 2012;167(5):1017-1024. doi:10.1111/j.1365-2133.2012.11158.xArias-Santiago S, Espiñeira-Carmona M, Aneiros-Fernández J.The Koebner phenomenon: psoriasis in tattoos.Can Med Assoc J. 2012;185(7):585-585. doi:10.1503/cmaj.111299National Psoriasis Foundation.Treatments for psoriatic disease.National Psoriasis Foundation.Integrative approaches to care.
Sanchez D, Sonthalia S.Koebner phenomenon. National Center for Biotechnology Information, U.S. National Library of Medicine.
New Zealand Dermatological Society.Koebner phenomenon.
Kluger N.Tattooing and psoriasis: demographics, motivations and attitudes, complications, and impact on body image in a series of 90 Finnish patients.Acta Dermatovenerologica Alpina Pannonica et Adriatica. 2017;26(2). doi:10.15570/actaapa.2017.9
van Geel N, Speeckaert R, De Wolf J, et al.Clinical significance of Koebner phenomenon in vitiligo.British Journal of Dermatology. 2012;167(5):1017-1024. doi:10.1111/j.1365-2133.2012.11158.x
Arias-Santiago S, Espiñeira-Carmona M, Aneiros-Fernández J.The Koebner phenomenon: psoriasis in tattoos.Can Med Assoc J. 2012;185(7):585-585. doi:10.1503/cmaj.111299
National Psoriasis Foundation.Treatments for psoriatic disease.
National Psoriasis Foundation.Integrative approaches to care.
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