Neurodermatitis progresses in episodes: In symptom-free phases, the skin is dry, irritated and sometimes scaly. In acute phases, it is inflamed and itchy. Acute and less acute rashes can occur simultaneously on different areas of the skin.
These symptoms are characteristic of the clinical picture:
- Scaly, dry skin
- Redness of the skin
- Cracked skin
- Itching that worsens in the evening and at night
- Blisters that burst and weep (eczema)
- Nodules and pustules
- Leathery thickening and coarsening of the skin
In adults, the disease mainly affects the eye and forehead area, the region around the mouth, and the neck and nape of the neck. Likewise, the rash occurs in the upper chest area and on the shoulder girdle, as well as on the elbows and back of the knees.
Older adults struggle with a rash on their hands and feet. Itchy crusts form under the hair on the scalp, and the edges of the earlobes tear and redden. Inflamed, itchy lips are also a sign of neurodermatitis.
Several factors come together as causes of neurodermatitis. Basically, heredity determines the risk, but it is the environmental influences that cause the disease to break out.
In atopic dermatitis patients, the protective function of the horny layer, the visible upper skin layer , is reduced. As a result, contact with germs, physical and chemical stimuli quickly leads to inflammation.
The reason for this malfunction of the horny layer is a change in the gene that inhibits the production of the protein filaggrin. As a result, the skin builds up its horny layer barrier incorrectly and loses moisture.
Atopic diseases, in which the immune system is hypersensitive to contact with allergenic substances or other irritants, increase the risk of atopic dermatitis. If both parents are affected by one or more atopic diseases, the probability of the disease in the child increases to 60-70%.
Although neurodermatitis is genetic, it is environmental stimuli that cause the disease to break out. These include, for example:
- Environmental toxins such as cigarette smoke, ozone, diesel fumes
- Sultriness, intense heat or cold, and fluctuating temperature conditions
- Dry air
- Incorrect cleaning of the skin, which leads to dehydration: skin-irritating detergents or too frequent washing
- Psychological burdens such as grief or stress
- Hormonal factors such as pregnancy or menstruation
- Fragrances and preservatives
- Clothing that causes the skin to sweat (e.g., non-breathable nylon)
- Clothing that chafes against the skin (e.g. wool)
As a neurodermatitis patient, you try to avoid or reduce your individual triggers as much as possible. You can read about how to do this below in the therapy
Between 30 and 40 percent of neurodermatitis patients suffer from an allergic form (atopic dermatitis). In this case, the immune system overreacts on contact with allergens and forms antibodies that cause inflammation in the skin. Such allergens can be:
- Dust mites
- Pollen
- Foods such as milk, eggs, nuts, fish, wheat, or soy
Allergic atopic dermatitis patients also suffer from allergic symptoms such as asthma or hay fever in addition to the classic atopic dermatitis symptoms
In Western regions, the number of neurodermatitis cases has increased sharply in recent years. Researchers suspect that there is a common reason for this: Increased hygiene. For example, cleaning the skin more frequently and thoroughly could have a negative impact on the skin barrier. In addition, people today come into contact with fewer infecting and allergenic substances from the environment than they did 100 years ago. This is why the immune system is "underemployed" in everyday life and goes crazy in the face of harmless stimuli.
Neurodermatitis is diagnosed by the dermatologist through a physical examination. For this purpose, the doctor is guided by these questions:
Does a severely itchy rash persist on the typical skin areas for many months?
Will the rash return?
Did the disease start in childhood?
Do other atopic diseases exist in the patient himself or in close relatives?
An allergy test can give an indication of an allergic form of neurodermatitis. To do this, the doctor carves small amounts of allergen into the skin and evaluates the result after 15 minutes. However, a positive result only indicates that an allergy exists; not that the allergen also affects the neurodermatitis. Therefore, a blood test is recommended for further diagnosis.
Since the risk of neurodermatitis is inherited, there are no preventive measures that have been proven to protect against the disease. For many remedies and methods, the effect is not clear or has not been sufficiently researched. These include, for example, taking vitamins and omega-3 fatty acids or certain types of diet such as avoiding dairy products.
As a chronic disease, neurodermatitis cannot be cured. Treatment is therefore aimed at alleviating symptoms and prolonging symptom-free phases.
The basic therapy serves to repair the damaged protective layer of theCallus to build up and moisturize the skin. To do this, moisturizing creams are applied generously to the skin twice a day.
For these purposes, we at Herbsom supply our allergen-free base cream . It strengthens your skin barrier and moisturizes your skin. Combined with sea buckthorn oil you get a rich basic care for your skin. And with the mallow extract you can soothe your irritated skin and relieve inflammation.
In the case of severe itching and inflammation, cortisone ointments prescribed by the dermatologist can help. Frequent episodes can be controlled with interval therapy: In addition to the basic therapy, a cortisone ointment is applied two days a week.
In particularly severe or extensive cases of neurodermatitis, those affected are offered radiation therapy with UV light. Tablets that inhibit certain reactions in the immune system are also suitable for treatment.
Neurodermatitis can severely impair the quality of life. Above all, the itching disturbs sleep and the ability to concentrate. Many people also find their skin rashes unpleasant. These 5 tips will make your everyday life with neurodermatitis easier.
1. Even if it itches: avoid scratching if possible. Superficial scratch wounds can become infected. You can wear cotton gloves while sleeping to protect your skin.
2. Wear smooth fabrics like cotton instead of irritating wool.
3. Heat aggravates the itching. Therefore, shower only briefly and lukewarm and dab your skin dry instead of rubbing it..
4. Your skin care products should be free of fragrance and preservatives whenever possible.
5. Wash your hands only when necessary and use soap-free, pH-neutral products to clean them.
Fölster-Holst, R. (2017). Neurodermitis. Der Ophthalmologe, 114(6), 498–503. https://doi.org/10.1007/s00347-017-0495-x
Höring, C. M. (2008). Neurodermitis. Der Hautarzt, 59(4), 308–313. https://doi.org/10.1007/s00105-008-1512-4
Schmid-Grendelmeier, P. & Ballmer-Weber, B. K. (2010). Neurodermitis. Therapeutische Umschau, 67(4), 175–185. https://doi.org/10.1024/0040-5930/a000031
