All you need to know about neurodermatitis: delve into its itchy realities, uncover why it occurs, and explore proven strategies for alleviating symptoms and improving skin health
Normal, dry to atopic skin
Neurodermatitis: Symptoms, Causes & Treatment
Reading time : 5 min
Introduction to neurodermatitis
Neurodermatitis is a chronic skin condition like eczema and characterized by an intense itch-scratch cycle leading to thick, leathery skin patches. Explore the symptoms, causes and treatments of this condition happening in about 12% of the population in the US.
What is neurodermatitis?
Neurodermatitis, also known as lichen simplex chronicus, is a skin condition starting with an itchy patch of skin. Because of repeated rubbing or scratching of that same skin area, it causes it to become thick and leathery. Neurodermatitis is one of the seven types of eczema.
Affected areas
In neurodermatitis, areas commonly affected are the neck, wrists, forearms, thighs, ankles, and scalp. The anal and genital areas might also be affected.
Symptoms of neurodermatitis
The main symptoms of dermatitis include:
Persistent itching
Thickened skin patches
Visible scaling
Open sores that bleed
Discoloration that is often red, brown or gray
Unlike atopic dermatitis, the symptoms are confined to one or two patches of skin measuring between 3 centimeters by 10 centimeters (about the length of the long edge of a credit card). Itching can be intense, or it might come and go. It often worsens during stress or inactivity.
Psychological impact
Neurodermatitis is a long-term condition which can have a psychological impact and disrupt your quality of life.
Chronic itching can lead to significant stress, anxiety, and sleep disturbances, impacting daily life and mental health. Patients can scratch without even realizing it. The urge to scratch became a habit that often happens unconsciously, and scratching becomes pleasurable.
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Causes and risk factors
The exact cause of neurodermatitis is still unknown. What we know is that it is more certainly linked to nerve abnormalities in the skin and excessive response to minor irritations. The more you scratch, the more it itches.
Risk factors include a personal or family history of eczema, psoriasis, or other atopic disorders. Itching is often triggered during times of stress, anxiety, emotional trauma or depression.
Other risk factors likely to trigger neurodermatitis include nerve injuries, insect bites and tight clothing.
Environmental triggers
Environmental triggers can also be responsible for neurodermatitis symptoms to develop. Here are some examples of environmental factors proven to be triggers of neurodermatitis:
Rough fabrics
Allergens like dust and mites
Perfumes
Changes in temperature and humidity
Complications from neurodermatitis
Neurodermatitis symptoms can worsen and lead to frequent complications. Indeed, neurodermatitis can turn into:
Bacterial infections
Permanent skin discoloration
Scarring from intense scratching
Skin cancers like squamous cell carcinoma
This skin condition can also be responsible for avoidance of social activities due to visible skin marks and the urge to scratch all the time. People with neurodermatitis can have a hard time dealing with the visible symptoms on their skin.
Diagnosing neurodermatitis
Neurodermatitis needs to be diagnosed by a dermatologist. Diagnosis will first include clinical examination of the affected skin and then go through the patient's medical history.
If clinical examination is not enough to diagnose the skin condition, additional tests like patch testing, fungal tests or skin biopsy may be conducted to rule out other dermatological conditions.
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Treatment options and management
Neurodermatitis is a chronic but manageable condition, symptoms can be significantly relieved with appropriate treatment and lifestyle adaptations.
Without treatment, neurodermatitis rarely heals.
Treatments options can include:
Topical corticosteroids: reduce inflammation, redness, swelling and itching and can be applied to the itchy patch.
Calcineurin inhibitors: tacrolimus or pimecrolimus help manage inflammation without the side effects of steroids.
Antihistamines: used to control itching, particularly effective at night if taken before bedtime.
Coal tar preparations: help the skin to shed dead cells and slow down the growth of new ones.
Antibiotics: if there is an infection, antibiotics can be applied to the skin or taken orally.
Injection of botulinum toxin: toxic protein which causes flaccid paralysis.
Phototherapy
Surgery: remove the itchy patch
Behavioral therapy: techniques like cognitive-behavioral therapy to help patients reduce scratching habits.
In case of wounds caused by scratching, another treatment possible is negative pressure wound therapy to remove fluid out of the wound and increase blood flow.
Home remedies
Home remedies can also be used alongside your treatment to relieve your symptoms.
Regular application of thick moisturizers
Cool compresses on itchy areas
Coverings using bandages to prevent night scratching and helping medicine to better penetrate skin
Bathing with lukewarm water
Using mild soaps
Prevention strategies
To help your skin heal and prevent neurodermatitis symptoms from developing, try to follow the next tips:
Avoidance of known irritants
Maintaining a stable and cool environment
Stress, anxiety or depression management
Stop scratching and rubbing
Keep fingernails short
Wear loose clothing
FAQs and common misconceptions
Neurodermatitis can heal with a treatment. But it is important to see a dermatologist to find the best treatment plan. It may even be necessary to try different options before finding one which is right for you. The treatment may be stopped when the symptoms are gone. Unfortunately, in some cases, you may have to continue the treatment to prevent the condition from returning if activated by one of the triggers.
Neurodermatitis is more likely to develop in adults between 30 to 50 and especially in women. It is rarely diagnosed in children. Psoriasis skin condition and anxiety increase risk of neurodermatitis.
If home remedies have not helped reduce your symptoms, and the latter have worsened, you need to see your health care provider as soon as possible.
What’s more, if the itch prevents you from sleeping, you can’t avoid scratching and the skin becomes infected, seek immediate medical care.
Neurodermatitis is a challenging skin condition which even if it can be managed, leads to itching that can be so intense that it will have negative impacts on your quality of life. Neurodermatitis is a long-term condition which may clear up with treatment but often returns. Identifying and avoiding factors will help relieve your symptoms.
