What is Neurodermatitis

Neurodermatitis is inflammation and thickening of the skin. It is caused by severe itchiness, which leads to repeated scratching and rubbing of the skin. It can happen anywhere on the body.

Common places include the neck, head, arms, and legs. Neurodermatitis may have mental or emotional (psychogenic) causes that must be treated.

Usually, this is a lifelong (chronic) condition, but in some cases it may go away on its own or with treatment.

What are the causes?

This condition is caused by repeated scratching and rubbing of the skin. This happens because of feelings of severe itchiness. Often, the cause of itchiness is not known. Common causes include:

• Materials or substances that irritate the skin.
• Skin conditions, such as chronic dermatitis or eczema.
• Allergic reaction.

In some cases, neurodermatitis may have psychogenic causes, such as anxiety or stress.

What increases the risk?

This condition is more likely to develop in:

• People who have dry skin or other skin conditions.
• People who have anxiety disorders or high amounts of stress.
• People who are 20–50 years of age.
• Women.
• People who are exposed to irritating chemicals.
• People who spend time in hot places or sweat a lot.

What are the signs or symptoms?

The main symptom of this condition is one or more patches of skin that are red, swollen, itchy, and thicker than normal skin. These patches can be anywhere on the body, but they are often found on the head, neck, legs, and arms. Neurodermatitis can also affect the genital and anal areas. In severe cases, bleeding, crusting, and scaling of the skin can occur.

Symptoms often come and go over time. The frequency and severity of symptoms varies from person to person.

How is this diagnosed?

This condition is diagnosed based on your medical history and a physical exam of your skin. You may be referred to a health care provider who specializes in skin care (dermatologist). You may also have tests, including:

• Skin allergy tests. These tests will determine if you have an allergy that is causing your condition.
• Tests for certain infections, hemorrhoids, psoriasis, or other conditions. These tests may be done if your groin or anal area is inflamed.

In some cases, your health care provider may remove a small amount of skin cells to be examined under a microscope (biopsy).

How is this treated?

This condition is managed by stopping all scratching and rubbing of the affected area. It is also important to remove all skin irritants and treat any underlying causes of neurodermatitis. Depending on the cause, your health care provider may recommend certain medicines, such as:

• Creams, lotions, or pills to reduce inflammation and itching (corticosteroids).
• Medicines to prevent or treat infection (antibiotics).
• Medicines to relieve allergy symptoms (antihistamines).

Therapy to learn how to stop feelings of itchiness and stop scratching (behavioral therapy or psychotherapy) may be a treatment option. Your health care provider may recommend a doctor who specializes in human behavior (psychologist).

Follow these instructions at home:

Skin Care

• Avoid scratching and rubbing your skin. This is the best way to manage neurodermatitis and prevent it from returning.
• Keep your skin clean and moisturized.
  • Avoid very hot water.
  • Apply lotion at least one time per day.
  • Avoid products, such as soaps and lotions, that have harsh chemicals, scents, and dyes.
  • Try to shower and take baths only as often as you need to. Frequent bathing can dry out your skin.
• Drink enough fluid to keep your urine clear or pale yellow.
• Always wear sunscreen.

General instructions

• Use over-the-counter and prescription medicines only as told by your health care provider.
• Avoid tight or rough clothing that irritates your skin.
• Avoid irritating chemicals.
• Pay attention to your symptoms. Watch for things that trigger itching and scratching.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your condition gets worse or does not get better after 3–4 days of treatment.
• You have blood or fluid leaking from an irritated patch of skin.
• You have a fever.