Neurodermatitis is a skin condition characterized by constant scratching of itchy skin. Though the cause of neurodermatitis is unknown, the development and recurrence can often be attributed to a particular trigger, such as bug bites, dry skin, uncomfortable garments, or anxiety. Prescription medication and ointments and at-home remedies can treat the condition.
Neurodermatitis or lichen simplex chronicus is a neurological skin condition, though it manifests in physical discomfort and pain. The psychological aspect lies in an individual's continuing urge to scratch and his or her inability to abstain from this action. Neurodermatitis is neither life-threatening nor contagious, but it does give rise to a variety of unwelcome symptoms and potentially harmful complications. People with neurodermatitis experience a relentless need to scratch itchy areas of skin. This reaction, however, doesn't help, and the itching gets worse. The Mayo Clinic refers to this as the itch-scratch cycle, which can damage the skin and cause issues in many other areas of a person's life.
The exact cause of neurodermatitis is unknown. Women are more likely to develop the condition than men, particularly in middle age. Having a family history of other skin conditions -- eczema or psoriasis, for example -- increases the risk. Evidence suggests an underlying psychological disorder can also predispose a person to the condition. Several triggers contribute to the development and recurrence of neurodermatitis.
People with neurodermatitis experience several common triggers. A bug bite may be the cause of the initial itchy skin and scratching. Dry skin or a skin allergy can also lead to the condition, as can uncomfortable, ill-fitting clothing, emotional distress, and anxiety. Under these circumstances, the itch-scratch cycle becomes a physiological response to a psychological trigger.
The most obvious symptom of neurodermatitis is intense itching. Those with the condition experience patches of itchy skin, typically on the neck, scalp, limbs, or extremities, and sometimes in the genital area. The itching usually worsens when at rest or during stressful situations. Constant scratching may lead to areas of rough, scaly skin.
In addition to acute pain and discomfort, neurodermatitis can have other consequences. Repeated scratching can lead to painful abrasions, open wounds, bacterial infections, and scarring. The relentless need to scratch can be disruptive to a person's quality of life; individuals often report difficulty with sleep and sexual intimacy.
Neurodermatitis may affect people on a deeper, psychological level. In an article published in the International Journal of Medical Sciences, researchers reported the development of psychological disorders in people experiencing the disease, including depression, anxiety, and social dysfunction. These disorders are generally treatable with medication or therapy, particularly therapy focused on managing and eliminating the itch-scratch cycle.
The first step in addressing the symptoms of neurodermatitis is seeking the diagnosis of a dermatologist. The dermatologist will examine the affected areas and may take a skin biopsy to rule out other, underlying conditions. He or she may also ask questions to better understand the history and occurrence of the condition. Upon diagnosis, the dermatologist will create a treatment plan.
Though neurodermatitis can be difficult to treat, a dermatologist can help a patient manage it. The doctor will first treat the itching with medicated creams, antihistamines, medicated pads, or corticosteroid injections. These treatments eliminate the need to scratch and reduce swelling and tenderness. The dermatologist may also recommend psychotherapy. The itch-scratch cycle is often motivated by psychological distress or stress and a therapist can assist in identifying triggers and providing strategies for managing or coping with the desire to scratch. If a serious psychological issue is the trigger, a psychologist may prescribe medication to treat this cause, such as anti-anxiety medication.
In addition to the treatment delivered by a dermatologist, some at-home remedies can temporarily relieve itching and scratching. Applying a cold washcloth can ease symptoms, and moisturizers can both soothe the area and eliminate dry skin that can exacerbate itchiness. Over-the-counter anti-itch ointments, such as hydrocortisone cream and capsaicin, can also provide temporary relief. The most important factor in managing neurodermatitis is resisting the urge to scratch, which is far easier said than done. The remedies mentioned above are helpful in reducing the need to scratch but, to heal the affected areas, one must stop scratching. This is difficult because the urge is as behavioral as it is physical. It may be helpful to cover the affected area with clothing or gauze to facilitate healing.
Neurodermatitis is often a chronic condition, but it is treatable and manageable. With the aid of at-home remedies, dermatological treatments, and therapy, people with neurodermatitis can overcome the itch-scratch cycle and find relief.
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