Neutralizing Neurodermatitis

You have one or two patches of itchy, dry skin. It is even more persistent at night when you are trying to get some sleep. You may have a case of neurodermatitis.

Neurodermatitis is a skin condition where itching and scratching are prominent on one or two patches of skin. The patches can be found on the arms, shoulders, elbows, legs, ankles, wrists, hands, back of the neck or scalp. The face, anal and genital areas might also itch.

The itching can be intense or come and go, according to the Cleveland Clinic. The patches can look dry, thick, scaly, leathery or differently colored (reddish, brownish, yellowish, gray or purple). Older patches may appear white or pale in the center surrounded by darker colors. Over a period of time, scarring may develop. The patches measure between 3 centimeters by 6 centimeters and 6 centimeters by 10 centimeters.

According to the National Eczema Association, neurodermatitis affects 12 percent of the population. Unlike atopic dermatitis, which is widespread, neurodermatitis is confined to one or two patches.

Some research indicates that people between ages 30 to 50 years old are more likely to acquire the condition. The disease is more common among women than men. Patients who suffer from anxiety disorders, obsessive-compulsive disorders, eczema and contact dermatitis are more likely to develop neurodermatitis. If you have family members who have the condition or other skin conditions, you are also more likely to get it.

Some studies suggest that those with certain personality traits such as tendency towards pain avoidance, poor social skills, people-pleasing, dependent on other people, and lack of flexibility are more likely to get neurodermatitis.

The cause of neurodermatitis is unknown. But it can be observed that the itching occurs during heightened periods of stress, anxiety, emotional trauma or depression. The itching continues even when the mental stress dissipates.

Other possible neurodermatitis triggers include:

§  Insect bites.

§  Nerve injuries.

§  Dry skin.

§  Other skin diseases such as eczema and psoriasis.

§  Tight clothing made from synthetic materials like polyester and rayon.

Some symptoms of neurodermatitis besides the itching and scratching are pain, open sores and bleeding due to excessive scratching, hair loss (if itching takes place on the scalp), infection (which is indicated by yellow-colored crusts or pus-filled bumps), scarring from scratching and skin lines in the affected skin.

Neurodermatitis is diagnosed by a dermatologist, who will start by ruling out other conditions and possible allergies. Your doctor will take a complete medical history. Then your doctor will perform certain tests like a skin swab test (to find out if there is an infection); patch test to check for allergies; fungal tests to rule out skin disorders in the general order and sexually transmitted diseases; skin biopsy to rule out psoriasis or a form of lymphoma known as mycosis fungoides; and blood tests.

Neurodermatitis must be treated in order to promote healing. The goal of any treatment plan is to stop the itching and scratching. Medicines that can do just that are:

§  Corticosteroids. These types of medicines can be applied to the patch or injected into the patch. Corticosteroids reduce the itching, swelling, redness, heat and tenderness of skin. It also softens thickened skin.

§  Antihistamines. It can decrease allergic reactions that may worsen the skin.

§  Antibiotics. For use if the patch of skin is infected.

§  Moisturizers. To sooth dryness and itching.

§  Coal tar preparations. It causes the skin to shed dead cells and slows the growth of new cells.

§  Capsaicin creams. Relieves itching and pain.

§  Coverings. Bandages, gloves or socks may help prevent scratching.

§  Cool compresses. May soften the skin to prepare medicine to penetrate further.

§  Antidepressants and/or therapy. Suggested if anxiety, depression or stress is behind the itch.

§  A solution of aspirin and dichloromethane applied to the itchy area.

§  Treatments used for atopic dermatitis/eczema (tacrolimus and/or pimecrolimus).

§  A dose of botulinum toxin (Botox), which may result in less itching after one week of treatment and healing of the itchy patches after four weeks of treatment.

§  Phototherapy or light therapy.

§  Traditional surgery for the itchy patches or cryosurgery to remove unwanted tissue by using cold temperatures.

If you have neurodermatitis, you should learn how to handle anxiety and stress so that a flare-up isn’t triggered. Try to keep your fingernails short, so you don’t wound the skin because of scratching. Apply a cool compress to itchy areas. Take a cool bath in order to decrease heat and add colloidal oatmeal (helps relieve itching) to your bath. Maintain a comfortable, cool temperature. Try to wear loose cotton material. Cover the itchy area with clothing. Tape with corticosteroids or apply an Unna boot (a dressing containing zinc oxide).

With the right treatment plan, those itchy patches can be completely healed. Unfortunately those patches can return if activated again by a trigger. Sometimes neurodermatitis may lead to skin cancers, possibly because of the continuous rubbing and scratching.

But you and your dermatologist must work hand in hand to figure out how to keep those itchy patches at bay. With the right strategy, you can heal your skin. You just have to learn how to manage triggers such as anxiety and stress. Then your skin can heal completely.