NEURODERMATITIS                                                                       

Neurodermatitis can occur when something such as a tight garment rubs or scratches your skin. This irritation may lead you to rub or scratch your skin repeatedly. Common locations include ankles, wrist, outer forearm or arm, and the back of your neck.

Neurodermatitis, also known as lichen simplex, is a chronic form of dermatitis. Chronic itching and scratching can cause the skin to thicken and have a leather texture. Neurodermatitis results in a constant scratch-itch cycle. Although signs increase in times of stress, changes in the nerve fibers are also present.

A scratch-itch cycle happens when a small itch causes scratching which increases the itch, leading to more scratching. The cause of the itch can be anything - an insect bite, tight clothing or dry skin. Neurodermatitis appears as scaly patches of skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) that becomes intensely irritated when scratched The skin then can become very irritated when scratched over and over. Stress and tension increase the itching. This results in the scratching process turning into a habit that we do without thinking. Things in your environment can also cause itching. There may be a family history of asthma, hay fever, eczema, psoriasis or other skin disorders.

Contributing causes of Neurodermatitis include:

• Stress

• Anxiety

• Dry skin

• Sensitive skin

• Infection

Neurodermatitis can be hard to tell from other forms of dermatitis. You should see your doctor if you are losing sleep or your normal routine is upset because of the itching. Your doctor can also treat you if you have an infection, your skin is very painful or if you’re at home treatment methods are not working.

With proper treatment, you can expect itching and redness to slowly go away. Neurodermatitis is a chronic problem but it can be controlled with the right treatment and by avoiding things that are known to bother the skin.

Patients predominantly suffer from itching or intense itching. Scratching can lead to inflammation, pustules, scabbing, scaling, weeping and thickening of the skin.

Irritants and trigger factors:

• skin becomes dry and itchy during the winter

•  itch when you sweat

• eyelids or your ears itch at certain times

•  emotional stress trigger or exacerbate the itching

• certain foods trigger or exacerbate the itching. Sweets, chocolate, nuts, fish, cheese, sauerkraut, spinach, shellfish, tomatoes, wine, citrus fruits, grapes, milk proteins, kiwi.

•  Dry skin

• substances can irritate your skin, such as certain textiles, perfume, cigarette smoke.

•  working with wet materials worsens the condition

•  irritants present in your working environment

•  increased incidence of bacterial, fungal or viral infections, for example yellow scabs, warts, genital or anal eczema

•  natural healing process inhibited, due to an iron, zinc or vitamin deficiency (following a diet for example).

•  contact allergy (to costume jewelry, plasters, ointments, cosmetics, certain drugs or medicines, pollen, household dust

Irritants should be avoided as far as possible (this is especially important for foodstuffs). For cases of acute eczema, which is often accompanied by intense itching, interval therapy may be recommended, the alternate use of topical cortisone and non-cortisone preparations, gradually reducing the strength. Cortisone must only be used under the direct supervision of a physician.

The percentage of reported cases of neurodermatitis also called atopic dermatitis or endogenous eczema varies from 10 to 20 per cent for children and from 3 to 5 per cent for adults.  However, there has been a continuous increase over the last years.

There can however be established a connection between neurodermatitis and other atopic diseases like hay fever (allergic rhinitis) and allergic asthma. Generally, atopic diseases are based on a predisposition which can be attributed to a hypersensibility of the immune system. Apparently also an insufficient development of the immune system in early childhood due to cultural influences plays a role. Today, neurodermatitis is the number one skin disease among children and obviously, children with a "sheltered upbringing" are affected more frequently.

As the substances causing the attacks penetrate easier the drier the skin is, neurodermatitis patients are particularly susceptible for preservative and perfume allergies specifically in cases where the skin permeation is increased due to a long-term cortisone therapy.

 Also micro-organisms (fungi, bacteria and viruses) penetrate easier and may cause inflammations. Therefore the prevention of dry skin which is the visible symptom for a skin barrier disorder is very important. Furthermore it is recommended to aim at a cortisone-free treatment on a long-term basis.

Some ingredients are not recommended for neurodermatitis sufferers as well as for individuals with dry skin:

• Mineral oils (besides water the most frequent ingredient) and related substances like vaseline and ceresin leave a very pleasant and smooth feeling, but in the long run they slow down the self-regenerating energy of the skin. The same applies for the widely used silicones.

• Emulsifiers are additives with the useful property of combining fat substances and water into a cream and transporting the substances into the skin. Unfortunately they also have the disadvantage of dissolving ingredients of creams and skin-own substances out of the skin.

• A frequent cleansing with water rapidly leads to a dry skin condition and depending on the type of emulsifier to severe skin barrier disorders. These effects attributed to mineral oils and emulsifiers cause the consumers to think that they cannot do any longer without (lots of) skin care creams. In reality their skin has become dependent on those substances and it takes quite a while to regain their independence.

A skin care factor which frequently is neglected by individuals with skin barrier conditions is skin cleansing. Especially in areas with very hard water attention should be paid on the fact that the calcium ions included here may easily penetrate in cases of a skin barrier disorder and further continue its destruction. Dermatoses can be frequently observed with individuals who work with water and materials rich in calcium like gypsum and mortar.