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- Requires medical diagnosis
- Symptoms: Patch of rash or scales, chronic itching and scratching
- Color: Typically red or violet, then leathery brown
- Location: Most commonly on arms, legs, back of the neck, around the anus and genital areas
- Treatment: Corticosteroid, antihistamine, capsaicin cream or doxepin cream.
Neurodermatitis, or lichen simplex chronicus, begins with an itch. It is a neurological disorder involving chronic itching and scratching.
An irritant initially causes the person to scratch the affected area, and the skin thickens after contact. The itch typically begins during a stressful period and lasts after the stress subsides.
The condition is most common among people between the age of 30 and 50. Women are also more likely to develop neurodermatitis. While it is rare in children, some children who have eczema (atopic dermatitis) can develop neurodermatitis.
Triggers of neurodermatitis include:
- Injury to a nerve
- Period of intense stress or emotional trauma
- Bug bite
- Tight clothing, especially clothing made of wool or a synthetic fabric like rayon or polyester
- Dry skin
- Traffic exhaust
- Poor blood flow
Symptoms of Neurodermatitis
Neurodermatitis is marked by the development of an itchy patch. It can occur anywhere on the skin, most commonly on arms, legs, back of the neck, around the anus and genital areas. When it appears in the genital area, it often appears on the scrotum or vulva.
Unlike eczema, psoriasis and other itchy skin conditions, people tend to develop just 1 or 2 patches that itch.
The itch can be intermittent, but also so intense that the affected person scratches or rubs the itchy patch frequently. The intensity is especially when the person is relaxing or sleeping, which can cause sleep deprivation.
In some cases, the scaly red to violet-colored patch may cause pain. More scratching leads to more thickening, which may cause the thickening to spread into a leathery brown patch. Very thick skin can even have a grayish hue.
If the neurodermatitis develops on the scalp, the scratching and/or rubbing can cause hair loss. If the repeated scratching leads to an open sore that bleeds, there is an increased risk of infection and scarring. Signs of infection include honey-colored crusts and fluid leaking from the area. You may also see pus-filled bumps.
What can I do?
Avoiding stress and anxiety can eliminate neurodermatitis triggers. Also, lubricate the affected areas with moisturizer frequently.
Covering the affected area can help the medicine penetrate thickened skin and prevent scratching. Other ways to avoiding scratching include cutting fingernails very short or using coal tar preparation.
Applying a cool compress or soaking the area for 5 minutes before you apply a corticosteroid can help the medicine penetrate thickened skin more easily. This also reduces the itchiness.
Should I seek medical care?
Neurodermatitis rarely goes away without treatment.
If you think that you might have neurodermatitis, an accurate diagnosis and proper treatment are important. In some situations, performing patch testing to look for allergens can be used to determine a possible allergic cause that can then be eliminated.
Treatment for Neurodermatitis
The inflamed area can be treated with topical creams, such as corticosteroid, antihistamine, capsaicin cream or doxepin cream.
American Academy of Dermatology. Neurodermatitis. Available at: https://www.aad.org/public/diseases/eczema/neurodermatitis
National Eczema Association. Neurodermatitis. Available at: https://nationaleczema.org/eczema/types-of-eczema/neurodermatitis/
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