Define Neurodermatitis
Feeling constantly itchy and having to persistently scratch can be an irritating—and sometimes painful—way to spend your evening in front of the television. Imagine having a patch of skin on your forearm or ankle that is so itchy you can’t find relief, and every time you touch it, another flare-up begins. Chances are you have neurodermatitis, a skin condition characterized by cycles of itching and scratching that just won't let up. Although there are treatments you can try, be prepared for a long recovery.
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Identification
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Neurodermatitis—a type of eczema—is a persistent and chronic itchy skin condition also called lichen simplex chronicus or “scratch dermatitis.” The affected patch of skin becomes thick and leathery, and any amount of scratching only makes matters worse. Neurodermatitis results when nerve endings in the skin become aggravated—such as when a tight piece of clothing rubs or scratches—and itching and scratching becomes unstoppable and sometimes painful.
Symptoms
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According to the Mayo Clinic, "The primary symptom of neurodermatitis is itchy skin--often a single patch on the neck, wrist, forearm, thigh or ankle. Sometimes neurodermatitis affects genital areas, such as the vulva or scrotum." Whenever the area is lightly scratched, rubbed or touched, an angry cycle of itching and scratching develops, usually while a person is resting or relaxing. The itchiness can become so intense that it can keep a person awake at night and cause anxiety and depression. Neurodermatitis can also appear on skin previously aggravated by atopic dermatitis, contact dermatitis or psoriasis.
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Risks
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Women between the ages of 30 and 50 are more susceptible to getting neurodermatitis than men. Dry skin is also a risk factor, as is wearing tight clothes or those made of wool or synthetic fabrics. People with a family history of skin conditions, such as eczema and psoriasis, are also more prone. Less common risks can include long-term exposure to vehicle exhaust, certain allergens and skin irritants (such as hair color), insect bites, intense heat and keloid scars.
Complications
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The persistent scratching associated with neurodermatitis can cause skin to open, crack or burn, leaving a person susceptible to bacterial infections. Scratch marks can be highly visible and scaly patches can form. Skin can also appear pink, red, reddish-brown or gray. Skin that is persistently scratched and irritated can thicken and feel like leather, and lines in the skin become more noticeable.
Diagnosis
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According to the Mayo Clinic, "Diagnosis is typically based on your skin's appearance and a history of itching and scratching." A patch test—or a contact delayed hypersensitivity allergy test—is one method to diagnose and pinpoint what may be causing the condition. Allergens are applied to small patches of skin for two days and then checked for allergic reactions. This test can potentially rule out other causes of the itchiness. A punch biopsy uses a surgical tool to remove a deep layer of skin for microscopic examination.
Treatment & Remedies
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According to SkinCarePhysicians.com, "The goal of treatment is to stop the itch. What makes treatment so challenging is that the patient must quit scratching, rubbing, and even touching the affected skin." Over-the-counter or prescription topical corticosteroid or oral antihistamines can help ease itchiness and inflammation. Topical antibiotics are applied to skin to prevent infection. Thick skin is remedied with a topical cream containing urea, salicylic acid or lactic acid. A damp cloth placed on areas treated with medicated cream speeds absorption. Ice packs applied to itchy areas help avoid scratching, and fingernails should be cut short. Bathing in cool water with baking soda can also help.
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