What is neurodermatitis?
Neurodermatitis is a skin condition that starts with a patch of itchy skin. Scratching makes it even itchier. This itch-scratch cycle causes the affected skin to become thick and leathery. You may develop several itchy spots, typically on the neck, wrist, forearm, thigh or ankle.
Neurodermatitis — also known as lichen simplex chronicus — is not life-threatening or contagious. But the itching can be so intense or recurrent that it disrupts your sleep, sexual function and quality of life.
Breaking the itch-scratch cycle of neurodermatitis is challenging. Treatment success depends on resisting the urge to rub or scratch the affected areas. Over-the-counter and prescription creams can help ease the itching. You’ll also need to identify and eliminate factors that may be aggravating the problem.
How common is neurodermatitis?
Neurodermatitis, also known as lichen simplex chronicus, is a common chronic skin disease, affecting up to 12% of the total population, and women are more affected than men. Please discuss with your doctor for further information.
What are the symptoms of neurodermatitis?
The common symptoms of neurodermatitis are:
- An itchy skin patch or patches
- Leathery or scaly texture on the affected areas
- A raised, rough patch or patches that are red or darker than the rest of your skin
The condition involves areas that can be reached for scratching — the head, neck, wrist, forearm, ankle, vulva, scrotum or anus. The itchiness, which can be intense, may come and go or be nonstop. You may scratch out of habit and while sleeping.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- You catch yourself repeatedly scratching the same patch of skin
- The itch prevents you from sleeping or focusing on your daily routines
- Your skin becomes painful or looks infected
What causes neurodermatitis?
The exact cause of neurodermatitis isn’t known. Sometimes neurodermatitis begins with something that simply rubs or irritates the skin, such as tight clothing or a bug bite. As you rub or scratch the area, it gets itchier. The more you scratch, the more it itches.
In some cases, neurodermatitis is associated with other skin conditions — such as dry skin, eczema or psoriasis. Stress and anxiety can trigger itching too.
What increases my risk for neurodermatitis?
There are many risk factors for neurodermatitis, such as:
- Your sex and age. Women are more likely to develop neurodermatitis than are men. The condition is most common between ages 30 and 50.
- Other skin conditions. People with a personal or family history of dermatitis, eczema, psoriasis or similar skin conditions are more likely to develop neurodermatitis.
- Anxiety disorders. Anxiety and stress can trigger the itch associated with neurodermatitis.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is neurodermatitis diagnosed?
A dermatologist will examine the itchy area, looking for signs of neurodermatitis. Having a dermatologist examine the area should not worry you. Dermatologists understand that neurodermatitis can develop on the genitals or anus.
Your dermatologist may also ask you some questions, such as:
- When did the itch begin?
- Does the itch come and go, or it is always there?
- What are you doing to stop the itch?
If the area looks infected, your dermatologist will swab the area. Testing the sample on the swab can tell your dermatologist whether you have an infection.
To diagnose you, your dermatologist may need to remove a small amount of skin.
Your dermatologist may also run tests to find out whether an allergic reaction could be causing the itchy reaction. This can be especially important when the neurodermatitis appears on the female genitals.
How is neurodermatitis treated?
Treatment is aimed at controlling the itching, preventing scratching and addressing underlying causes.
- Anti-inflammatory medicated creams. If over-the-counter corticosteroid cream isn’t helping, your doctor may prescribe a stronger version of this drug. A calcineurin inhibitor (tacrolimus) ointment may help if the vulva is involved.
- Corticosteroid injections. Your doctor may inject corticosteroids directly into the affected skin to help it heal.
- Anti-itch medications. Prescription antihistamines help relieve itching in many people with neurodermatitis. Some of these drugs may cause drowsiness and help with alleviating scratching while you sleep.
- Anti-anxiety drugs. Because anxiety and stress can trigger neurodermatitis, anti-anxiety drugs may help prevent the itchiness.
- Light therapy. Exposing the affected skin to particular types of light is sometimes helpful.
- Talking with a counselor can help you learn how your emotions and behaviors can fuel — or prevent — itching and scratching.
- Emerging therapies
Further study is needed, but some small studies have reported success with the following treatments:
- Botulinum toxin (Botox) injection. This technique may reduce itching and clear up the rough skin patches.
- Aspirin solution. Applying a solution combining aspirin and dichloromethane has been effective for some people with neurodermatitis.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage neurodermatitis?
The following lifestyles and home remedies might help you cope with neurodermatitis:
Follow your treatment plan. Your plan includes medicine that can stop the itch. For the medicine to work, you must use it as directed.
- If the itch starts, apply a cool compress or take a cool bath. This reduces the heat, which can reduce or eliminate the itch. Adding colloidal oatmeal (available where you buy health and beauty products) to a cool bath can also help reduce the itch.
- Try to stay calm. Emotional stress and anxiety can cause neurodermatitis to flare.
- Keep your body at a comfortable temperature. Heat and sweat can irritate your skin, causing the itch to flare.
- Wear loose-fitting cotton clothing that feels smooth to the touch. Tight clothing can irritate the skin, causing the area to itch. It’s also best to avoid clothing made of wool or a synthetic fabric like polyester or rayon.
- Avoid what irritates your skin or causes an allergic skin reaction. If you’re uncertain what can do this, ask your dermatologist about triggers.
If you’ve been scratching the same area for years, it may be difficult to stop. Until you feel that you can avoid scratching, rubbing, and touching the area, the following tips may help.
- Cover the area. Wrapping the area in plastic, covering it with clothing or a corticosteroid tape, or wearing an Unna boot (gauze dressing that contains ingredients like zinc oxide to promote healing) can prevent you from scratching. This can be very helpful if you scratch while sleeping.
- Keep your fingernails very short. If you scratch, very short fingernails tend to cause less damage.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: October 3, 2017 | Last Modified: September 13, 2019
Neurodermatitis. https://www.aad.org/public/diseases/eczema/neurodermatitis. Accessed October 3, 2017.
Neurodermatitis. http://www.mayoclinic.org/diseases-conditions/neurodermatitis/basics/definition/con-20027919. Accessed October 3, 2017.