Neurodermatitis – Symptoms and Causes, Diagnosis and Treatment

Neurodermatitis is a non-life-threatening skin disorder characterized by itching and scratching on  a patch of skin. Lichen simplex chronicus is another name for it. The itch can appear everywhere on the body, although it is most prevalent in the arms, shoulders, elbows, thighs, ankles, wrists, hands, back of the neck, and scalp. 

The vaginal and anal areas, as well as the face, may itch. Itching can be severe, resulting in constant scratching, or it can be intermittent. When the patient is resting or trying to sleep, it is at its most active. The patient may wake up scratching or rubbing the affected area in some circumstances.

Neurodermatitis is usually a lifelong condition and it is challenging to break the itch-scratch cycle of neurodermatitis. The success of the treatment is dependent on resisting the urge to scratch or rub the affected areas. prescription medicines or over-the-counter drugs may help alleviate the itching. You will also need to identify and remove factors that could be aggravating the problem.

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What are the symptoms of Neurodermatitis?

Neurodermatitis symptoms and signs include: 

• A rash or patches of irritated skin 
• The affected parts have a leathery or scaly feel. 
• A raised, rough patch, or patches that are reddish or deeper in color than the rest of your skin 

The illness affects parts of the body such as the head, neck, wrists, forearms, ankles, vulva, scrotum, and anus. Itching can be acute and come and go, or it can be constant. Scratching is often done out of habit or during sleeping.

What are the causes of neurodermatitis?

Neurodermatitis has an unknown underlying cause. Itching begins during times of acute stress, anxiety, emotional trauma, or sadness. Even after the mental stress subsides or disappears, the itching can persist. 

The following are some more potential neurodermatitis triggers: 

• Nerve damage. 
• Insect bites 
• Dry skin. 

Wearing clothes that is too tight, especially if it is made of a synthetic fiber such as polyester or rayon. These variables can cause sensitive skin to respond inappropriately, causing itching. Eczema and psoriasis are two conditions that can cause neurodermatitis.

What are the possible risk factors and complications of neurodermatitis?

Neurodermatitis can be influenced by several circumstances, including: 

• Age and sex – Women are more prone than men to acquire neurodermatitis. Between the ages of 30 and 50, the disorder is most common. 
• Other skin problems – Neurodermatitis is more likely to occur in those with a personal or family history of dermatitis, eczema, psoriasis, or other comparable skin disorders. 
• Anxiety disorders – Anxiety and stress can make neurodermatitis itch worse. 

Scratching can result in a wound, a bacterial skin infection, lasting scars, and color changes in the skin. Neurodermatitis irritation can interfere with sleep, sexual function, and overall quality of life.

How is Neurodermatitis diagnosed?

A dermatologist will examine the itchy region. Other skin disorders such as eczema and psoriasis are ruled out first. The doctor may obtain a thorough medical history before asking questions like: 

• When did you first notice the itch? 
• Is it always present or does it appear and disappear? 
• What are some of the treatments  that have been tried? 

The following are the tests that can be used to diagnose neurodermatitis 

• Skin swab testing determines whether or not there is an infection. 
• To determine the source of the allergy, patch testing is carried out.
• To rule out sexually transmitted infections and identify skin conditions in the general region, fungus tests are used. 
• A skin biopsy is performed to diagnose or rule out psoriasis or mycosis fungoides, a kind of malignancy. 
• Blood tests.

How is Neurodermatitis treated?

The goal of treatment is to reduce itching, avoid scratching, and address the underlying causes. 

• Creams with anti-itch medication – The doctor may recommend a high dose corticosteroid or a nonsteroidal anti-itch treatment if over-the-counter corticosteroid cream isn’t working. If the vulva is affected , a calcineurin inhibitor (tacrolimus) ointment may help. 
• Corticosteroid injections – To aid in the healing of the afflicted skin, your doctor may inject corticosteroids directly into it. 
• Medicine to ease itching – Many persons with neurodermatitis benefit from antihistamines on prescription. Some of these medications can make you sleepy and help you stop scratching while you’re sleeping. 
• Anti-anxiety drugs – Anti-anxiety medicines may help avoid irritation caused by anxiety and stress, which aggravates neurodermatitis. 
• Medicated patches – Your doctor may recommend topical lidocaine 5% of capsaicin 8% patches for persistent itching. 
• Light therapy – It can occasionally be beneficial to expose the affected skin to specific wavelengths of light. 
• Psychotherapy – Speaking with a counsellor can help you understand how your emotions and behaviors might cause itchiness and scratching, as well as how to prevent it. 

Emerging therapies 

If itching persists despite treatment, the doctor may recommend an alternative therapy. Some persons whose symptoms didn’t improve with corticosteroids reported improvement with the following treatment: 

1. Botox injection – This method may help to relieve irritation and smooth out rough skin spots. 
2. An oral drug to ease the compulsion to pick and scratch – Oral medication N-acetylcysteine proves to benefit certain people with picking and scratching issues. It may also aid those with neurodermatitis. 

What are some of the home remedies and lifestyle changes?

These self-care techniques can aid in the management of neurodermatitis: 

• Stop itching and rubbing – Although the itching may be severe, refraining from rubbing or scratching is critical to treating your disease and preventing a recurrence. 
• Apply cool, moist compresses to the affected area – These may help to alleviate itching and soothe the skin. Before applying a medicated cream, apply a cool, damp compress to the affected skin for a few minutes to assist the cream in getting absorbed into the skin. 
• Over-the-counter drugs are the best to start – On the affected area, use an anti-itch cream or lotion. The irritation can be temporarily relieved with hydrocortisone cream. An antihistamine, such as diphenhydramine, can help you sleep and ease extreme itching. Capsaicin cream has helped some people, but it can sting at first. 
• Cover the damaged area with a cloth – Bandages or dressings can protect the skin and keep it from being scratched. These could be especially handy if you tend to scratch when sleeping. 
• Trim your nails regularly – Short nails are less likely to cause skin injury, especially if you scratch while sleeping.