Neurodermatitis, also known as lichen simplex chronicus, is a type of eczema. It begins with an urge to scratch that irritates nerves, leading to a chronic itch-and-scratch cycle that prevents skin healing.
Rather than affecting large areas of the skin, this type of eczema typically confines to one or two patches of skin. Neurodermatitis is a chronic skin condition — over time, it can lead to the formation of thickened patches of skin.
Psychological factors, such as stress, may trigger the condition in some people. Also, the persistent itching and scratching can make daily life challenging living with neurodermatitis.
This article explores neurodermatitis, examining its causes, diagnosis, and treatment. It also covers lifestyle adjustments that can help a person cope with symptoms.
While neurodermatitis can occur anywhere in the body, it typically affects the following:
- arms
- legs
- hands
- back of the neck
- scalp
- face
- genitals
Dry, itchy patches occur on the skin. They can appear red, brown, gray, or purple, depending on a person’s skin tone. Over time, the patches scar over, becoming thick and leathery.
Itchiness
The most common symptom is an intense itchiness that may be constant or come and go. Patches may also bleed and become painful, open sores. Sores have the potential to become infected.
Some people notice that the itching is worse when trying to rest or sleep, ultimately having the following consequences:
- reduced sleep quality
- stress
- fatigue
A self-perpetuating itch-scratch cycle is a key component of neurodermatitis. The initial itch — whether resulting from an irritant, dry skin, or an allergic reaction — prompts scratching. However, repeated scratching only intensifies the itching sensation and triggers more inflammation, leading to further itching and scratching.
Brain imaging studies show that scratching at the skin lights up the brain’s reward center. Therefore, it is pleasurable, providing relief and satisfaction. Scratching can become an unconscious habit that is challenging to overcome.
Furthermore, stress and anxiety may contribute to neurodermatitis. The condition often tends to appear during intensely stressful, depressing, or frustrating times. Stress may further exacerbate symptoms, triggering flare-ups or prolonging the healing process.
Diagnosing neurodermatitis involves a comprehensive evaluation. Since the condition shares similarities with many skin conditions, a thorough assessment can help differentiate it from others.
A neurodermatitis
- Medical history: A detailed medical history, including symptoms, duration, and known triggers or exacerbating factors, is essential. The doctor may also enquire about personal or family history of allergic conditions or skin disorders.
- Physical examination: The doctor examines the skin, specifically looking at the following characteristics of any lesions:
- location
- appearance
- texture
- severity
- Dermoscopy: A dermascope is a handheld device that magnifies and illuminates the skin’s surface, allowing the dermatologist to examine the skin lesions carefully.
- Patch testing: This type of test involves applying small amounts of common allergens to the skin and monitoring for any allergic reactions over a designated period. It can identify potential allergens or irritants that can trigger or exacerbate symptoms.
- Biopsy: Taking a skin sample and examining it under a microscope allows doctors to rule out other underlying skin conditions, such as psoriasis.
Treatment of neurodermatitis aims to:
- alleviate itching
- reduce inflammation
- promote healing
- prevent the itch-scratch cycle
The specific approach may vary depending on the severity of symptoms, the extent of skin involvement, and individual factors.
Some common treatment options for neurodermatitis include:
- Topical corticosteroids: These creams or ointments help suppress the immune response, reduce inflammation, and relieve itching.
- Emollients: Regular and frequent application of moisturizers is crucial in managing neurodermatitis. Moisturizers help hydrate the skin, restore its barrier function, and reduce dryness and itching.
- Antihistamines: Oral antihistamines can help alleviate itching and promote better sleep. These medications block histamine receptors, which play a role in triggering itch sensations.
- Antibiotics: If the affected skin has infected sores, antibiotics can treat the infection, allowing the skin to heal.
People should keep their nails short and consider wearing cotton gloves or protective coverings while sleeping. These measures may help to prevent unconscious scratching.
In addition to medical treatments, certain lifestyle modifications and home remedies can help manage the symptoms of neurodermatitis.
Here are some considerations for people with neurodermatitis:
Skin care
Use mild, fragrance-free cleansers or soap substitutes to cleanse the skin.
Avoid harsh products that strip the skin of natural oils or exacerbate dryness and itching. Also, apply moisturizers immediately after bathing or showering while the skin is still damp to optimize skin hydration.
Irritants
Keep track of potential triggers that worsen neurodermatitis symptoms. These may include certain fabrics, detergents, perfumes, or environmental factors such as extreme temperatures or humidity. Taking steps to minimize exposure to these triggers can help prevent flare-ups.
Clothing
Opt for loose-fitting, breathable clothing made from soft fabrics such as cotton. Avoid wearing tight or rough materials that irritate the skin and worsen symptoms.
Stress reduction
Stress and anxiety can trigger or exacerbate neurodermatitis symptoms. Engage in stress-reduction techniques such as relaxation exercises, deep breathing, yoga, and meditation. Alternatively, engaging in enjoyable activities can help promote relaxation and well-being.
Aim for sufficient and restful sleep, as lack of sleep can increase stress levels and potentially worsen symptoms.
Cool compresses
Applying cool, damp compresses to the affected areas can temporarily relieve itching and help reduce inflammation.
Hydration
Stay hydrated by drinking plenty of water throughout the day. Proper hydration helps moisturize the skin from within.
Emotional support
Seek emotional support from friends, family, or support groups to help cope with the challenges of living with neurodermatitis. Sharing experiences and feelings with others who understand can provide comfort and practical tips for managing the condition.
Neurodermatitis is a localized condition that affects specific areas of the body, while eczema is often more generalized, impacting larger areas. They are both chronic skin conditions that have an association with chronic inflammation.
The American Academy of Dermatology states that neurodermatitis is a type of eczema. For both conditions, symptoms can increase and decrease.
Neurodermatitis and eczema can coexist. Treatment approaches may also overlap. For example, doctors may recommend similar medications, topicals, or lifestyle modifications.
Consulting a dermatologist can ensure someone receives an accurate diagnosis and personalized treatment for each condition.
Neurodermatitis is a chronic skin condition featuring localized itching, which triggers a chronic itch-scratch cycle. Eventually, affected skin can become discolored, thick, and leathery.
It is crucial to differentiate neurodermatitis from other skin conditions, particularly eczema, which has broader skin involvement and different underlying mechanisms. Consulting a dermatologist can help a person receive an accurate diagnosis and personalized treatment plan.
Treatment options include topical medications, moisturizers, antihistamines, behavior modification techniques, and wound care. For some people, lifestyle modifications and home remedies can be helpful. These may include identifying triggers, stress management, gentle skin care, or other measures that complement medical treatments and improve symptom control.