What is neurodermatitis?
Neurodermatitis is a common itchy skin condition that is maintained by scratching or rubbing. Other names used are lichen simplex chronicus and prurigo nodularis.
How does it develop?
Often it is unclear what first prompted the scratching (an insect bite, eczema, dry skin). The fact is that the itch is maintained by repeated scratching or rubbing. Not only does the itch gradually increase, the skin can also change: often there is thickening of the epidermis and a dark discolouration. Sometimes there is a whole field of countless small (often pink-brown) bumps. Skin defects from scratching are also often present, and sometimes there is even scarring.
Where is it located?
The most common location is the lower legs. The neck, wrist and ankle are also frequent sites. Strikingly, the lesions often occur on only one leg or arm — unlike eczema, which is almost always symmetrical. Neurodermatitis can also occur on the genitals, particularly the vulva and scrotum. It occurs at all ages, with adults most affected, and there is not rarely a clear relationship between stress and flares.
How is neurodermatitis treated?
The core of the solution is to stop scratching: the cycle of itch → scratch → itch must be broken, which is of course easier said than done. Generally (strong) corticosteroid ointments are needed to suppress the itch, and tar ointment can sometimes have a good effect. Besides the active ointment, it is important to keep the skin in good condition with a greasy ointment, because drying out of the skin leads to itch again and the whole process can start over. In very extensive cases, UVB light therapy can be a good option to counter the itch.
What is the outlook?
Even after successful treatment, the complaints can gradually return. Keeping the skin well moisturised prevents drying out and helps prevent the complaints from recurring.
When to see a doctor
See a doctor for a persistent, very itchy, thickened patch that you keep scratching, so the itch-scratch cycle can be broken with treatment.