Neurodermatitis or atopic dermatitis is an inflammatory disease of the skin that causes chronic and episodic reactions. Neurodermatitis is triggered primarily by environmental factors and allergens. Typical symptoms are dry and scaly skin and severe itching.
What is neurodermatitis?
The skin of the affected person shows neurodermatitis by a very sensitive and dry skin, in addition, skin redness. On external stimuli, it is particularly susceptible. It quickly becomes itchy. Typical areas are usually the crooks of the arms, the backs of the knees, and the neck and face. In addition to hay fever and asthma, neurodermatitis or atopic dermatitis belongs to the so-called atopic diseases. Here it comes to an overreaction of the immune system, which develops with the production of defense materials already with harmless environmental influences to an allergy-like illness. Particularly pollen and foods then trigger known allergens. Other names for neurodermatitis are: Endogenous Eczema, Neurodermatitis atopica and Atopic Eczema. The term neurodermatitis is borrowed from the Greek and means “nerve-related skin inflammation“. However, the reference to a nervous cause is considered outdated.
Causes
As with other allergies, the cause of atopic dermatitis is an overreaction or defensive response of the immune system to various environmental substances. Dust, pollen, and various foods, in particular, are considered triggers. If these allergens get into the blood, the white blood cells (lymphocytes) try to fight these substances. As a result, the human body produces masses of these antibodies, even though the allergens do not actually pose a threat to humans. In particular, the defense substance immunoglobulin E (IgE) then acts with other messenger substances (cytokines) to produce an inflammatory skin reaction. In addition, white blood cells such as T-lymphocytes and the messenger substance histamine promote the inflammation of the skin. This process is also considered to be the cause of the strong itching in neurodermatitis. Other causes of neurodermatitis are: Friction and contact with wool, foods such as milk, wheat products and nuts, cold and heat, and infections. Psychological stress and over-exertion can also trigger neurodermatitis. In most cases, those affected are particularly at risk due to hereditary or genetic predispositions. Parents who already have neurodermatitis are also very likely to have children who will suffer from this disease.
Typical symptoms and signs
Neurodermatitis usually occurs on the face, hands or scalp. At the same time, the symptoms of the disease can vary greatly, depending on its severity and the age of the patient. It usually occurs in episodes and the symptoms vary in severity with each episode. They are most severe in infancy and childhood, but sufferers also complain of symptoms during puberty. The attacks can also be triggered by certain external factors, such as poor air quality. Neurodermatitis triggers severe itching of the skin. Either only certain parts of the body are affected, or the entire skin itches. It is also very red. In infancy, the disease also often forms in the bends of the arms and knees. It can also occur in the area of the mouth. The areas are scaly, reddened and sometimes weeping. In adults, a leathery thickening of the skin often forms, mostly on the face, but also on other parts of the body. Often the eye and forehead area, the neck and also the bends of the joints are affected. Sufferers often also suffer from psychological stress due to neurodermatitis. It may be that they no longer dare to be among people, as they are ashamed of the reddened skin areas, which is why they withdraw strongly.
Course of the disease
The course of the disease of neurodermatitis usually begins in infancy. In this process, atopic dermatitis exhibits a recurrent and chronic course. Although no 100 percent cure is possible, the symptoms can be treated favorably with early diagnosis and intensive therapy. For this purpose, there are various medications and therapeutic approaches with which a reasonably normal life, despite neurodermatitis, can be led.
Complications
Due to atopic dermatitis, those affected usually suffer from various skin complaints. In most cases, this is dry and can flake.Redness and itching also occur with this disease and significantly reduce the patient’s quality of life. As a rule, neurodermatitis can also spread to other parts of the body. Those affected are not infrequently ashamed of the symptoms and thus suffer from a significantly reduced self-esteem and in some cases also from depression or other psychological complaints. A general feeling of illness or fatigue can also occur as a result of neurodermatitis and make everyday life more difficult. In children, bullying or teasing may occur due to the visible symptoms. Furthermore, it is not uncommon for pain to occur when the affected skin regions are used in everyday life. The treatment of neurodermatitis is usually carried out without complications with the help of various care products. In this case, success is achieved relatively quickly and the symptoms disappear in most cases without complications. Life expectancy is likewise not affected by neurodermatitis.
When should one go to the doctor?
Only a doctor can determine whether neurodermatitis is present. Individuals who notice unusual skin changes as well as itching or scaly eczema around the elbows and knees should seek medical advice. Other symptoms of the skin – even if they are only mild – should also be clarified medically. Medical advice must be sought at the latest when the skin changes become more severe or other complaints develop. The family doctor can diagnose neurodermatitis and, if necessary, consult a dermatologist. If there are cases of neurodermatitis or allergic diseases such as hay fever or allergic asthma in the family, there is an increased risk. People with existing skin diseases or hormonal complaints, as well as people who are under great stress or suffer from food intolerance, also belong to the risk groups and should have the symptoms mentioned clarified quickly. The right contact point is the family doctor, a dermatologist or an allergist. In consultation with the doctor, neurodermatitis can also go to an alternative practitioner.
Treatment and therapy
At the first signs of neurodermatitis, a doctor should be consulted. Neurodermatitis is not life-threatening, but the accompanying symptoms can make the life of those affected partly a torment, so that medical therapy is advisable. Up to now, the treatment of neurodermatitis has been based on two components. The first therapeutic measure is the basic therapy, which mainly involves specific treatment or care of the inflamed skin. The care products prescribed by the doctor should be applied generously to the affected skin areas. The main aim is to ensure that the skin is well lubricated and moisturized. In addition, the skin is usually treated with medicines or drugs. These mainly include creams, ointments and emulsions for external treatment, as well as infusions and tablets for internal treatment. However, this form should be used only in severe cases of neurodermatitis. The earlier therapy against neurodermatitis is started, the better and more sustainably they can alleviate or delay the relapses of the disease.
Aftercare
In the rarest cases, endogenous eczema occurs once; rather, it progresses in relapses. Therefore, in addition to therapy in the acute phase, aftercare between relapses is particularly important. With the help of adequate skin care, supportive measures and special infant nutrition, the symptoms of the relapses can be alleviated and secondary flares can be avoided. According to the current standard, the optimal daily skin care is a moisturizing and neutral cream, which is applied thinly several times. Water temperatures below 39 degrees Celsius also protect the lipid barrier and regenerate damaged skin cells. In addition, clothing and bedding made of cotton or silk support air circulation and thus prevent heat accumulation and maceration. Most patients also find the friction of cotton or silk on the skin pleasant in contrast to wool or polyester. Children in particular should keep their nails short, as many scratch bloody marks while sleeping at the beginning of an episode. Supportive measures such as phototherapy or a low allergy diet can effectively replace medications such as cortisone.It is also advisable to create a low-allergen environment and to ensure room temperatures below 22 degrees Celsius. If acquaintances are known to have herpes, chickenpox or MRSA, patients with atopic dermatitis should avoid contact, as vulnerable areas of skin are extremely susceptible to infection. In the case of familial disposition, experts also recommend breastfeeding infants with breast milk for six months and increasing food allergens only slowly and feeding them separately.
Outlook and prognosis
Atopic dermatitis is an incurable disease. However, the disease resolves in about two-thirds of affected children by adulthood. At any age, atopic dermatitis can heal and then not reoccur for a lifetime. In other cases, the condition persists throughout life and causes typical complaints that limit the quality of life. Chronic neurodermatitis affects about 30 percent of patients. Consistent therapy brings about a significant alleviation of symptoms in most patients. Acute episodes of the disease can cause severe irritation of the skin, especially in infants. In addition, repeated scratching of the affected areas leads to sores and infections. The well-being is therefore considerably limited, especially in small children. Drug treatment and the associated side effects and interactions is often the only alternative. Adults experience equally severe symptoms, although the triggers are usually known and can be effectively avoided. The prognosis is usually determined by the dermatologist in charge. Since the skin disease can subside spontaneously, the prognosis is always made anew. For this purpose, the physician consults the symptoms and the previous course of the disease.
What you can do yourself
Neurodermatitis can be very annoying and unpleasant in everyday life. The affected skin areas itch constantly, the clothes scratch and as a sufferer you have to avoid the swimming pool, a lot of sun and sports. In addition, the red, scratched and sometimes bleeding skin attracts unpleasant glances from strangers. All this is a great burden. In order not to aggravate the neurodermatitis, some tips can be followed. In any case, sufferers should resist the urge to continue scratching the affected itchy skin areas. At night, light cotton gloves can be used for this purpose to avoid scratching during sleep. Special care should be taken when choosing skin care products and clothing. It is recommended not to use soap, but to clean the body parts only with clear water. When drying, dab, do not rub. Clothing should not be made of synthetic material and should only lie loosely on the skin. It should not scratch and heavy sweating should be avoided. Care should also be taken with cleaning agents. These should be as environmentally friendly as possible. When cleaning, be sure to wear lined rubber gloves. Often the cause of neurodermatitis lies in the diet. It is therefore recommended to pay attention to particularly healthy food and, if necessary, to have an allergy test at the doctor.
