In the case of atopic dermatitis, an accurate diagnosis is first crucial. This should also include the search for the causes of the disease, because only if you know the triggers and can turn off, a treatment of neurodermatitis can succeed. How the diagnosis is made and what options are available for therapy, you can learn here.
How is neurodermatitis diagnosed?
Often, the diagnosis of atopic dermatitis is not difficult, since a doctor can already recognize the typical symptoms with the naked eye. Early and comprehensive allergy diagnostics are possible from infancy if there is a suspicion. However, the physician’s task in diagnostics is not only to determine whether neurodermatitis is present at all, but also requires determining the causes. This is often much more difficult than recognizing the skin disease. Establishing the diagnosis therefore involves various measures:
- Anamnesis, that is, a questioning by the doctor.
- Symptom diary to determine possible triggers.
- Skin tests
- Blood tests
Therapy of neurodermatitis
The following tips will help to treat atopic dermatitis:
-
Babies should be breastfed for 4-6 months (allergy prophylaxis) and no foreign protein (cow’s milk) should be fed. If this is not possible, give hypoallergenic milk. Only from the 6th month to feed, in case of positive family history allergens such as chicken egg, fish and nuts, etc. earliest from the 1st year of life in the diet.
-
For younger children, overalls with integrated mittens and extra gloves in all sizes are offered in stores.
-
If allergic to dust mites, the mattress and, if necessary, the comforter and pillow should be covered with mite-proof covers.
-
Relaxation techniques such as autogenic training or progressive muscle relaxation according to Jacobsen can help to get the discomfort (especially the itching) under control.
-
Due to the risk of developing an allergy to animal hair, it is better to avoid pets such as cats, guinea pigs or rabbits. Harmless, however, are animals such as fish and turtles.
-
Irritating agents should be avoided (including detergents and disinfectants, wool, synthetics).
Therapy principles for atopic dermatitis
Those who suffer from atopic dermatitis depend on an intensive and individualized therapy, so that the itching subsides and the dry, itchy skin changes (eczema) can heal. Those affected are on the safe side if they rely on the expertise of an allergology specialist. The therapist will not only prescribe medication, but also inform the neurodermatitis sufferer about the importance of consistent skin care and psychological help. Nutritional counseling and tips for everyday life complement the treatment. Daily neurodermatitis therapy is based on several pillars. Crucial are:
- The basic care of the dry skin
- The treatment with medicines in acute episodes of neurodermatitis
- Avoid personal irritant factors that trigger a relapse.
- The mental relief and relaxation from everyday life
The basic care
The basic care for atopic dermatitis aims – even in symptom-free periods – to consistently care for the very dry and sensitive skin, to provide “missing” fat from the outside and to regulate its moisture balance. Regular creaming of the entire body with suitable preparations is particularly important. Basic medical ointments containing urea, for example, are available in pharmacies for this purpose. For children up to 5 years of age, urea concentrations of between 2 and 3 % are appropriate; higher concentrations often leave children with a burning sensation on the skin. In adults, concentrations of 5-10% are common. Oil baths are also among the important basic therapeutics. Oil baths leave a complete greasy film on the skin and are especially recommended for large-area treatment. Salt baths have also proven to be good. How well the baths help varies from person to person. One thing is certain: Dead Sea salt contains a particularly large number of skin-soothing minerals. The salts stimulate cell renewal and have a balancing effect on the skin’s natural moisture mantle.Those who cannot take a vacation to the Dead Sea can find a selection of appropriate bath additives at the pharmacy.
Treatment of acute episodes of neurodermatitis.
In acute atopic dermatitis episodes, those affected cannot avoid drug therapy. Here, various ointments and medications to take help:
- Antihistamines
- Cortisone
- Tacrolimus and pimecrolimus
- Antibiotics
- Various creams
- Moist envelopes
Antihistamine treatment of atopic dermatitis.
The itching is relieved by antihistamines. You can take them (tablets, juice) or apply locally (gel, cream, stick). For external use, there are also products that also contain hydrocortisone. This reduces the itching and inflammation even more. Most products are now available without a prescription.
Ointments with and without cortisone
Strongly anti-inflammatory and antipruritic, cortisone ointments are effective. The doctor may prescribe them for acute flare-ups. Cortisone-free ointments containing the active ingredients tacrolimus and pimecrolimus have an anti-inflammatory effect. Their effect is comparable to that of cortisone, but they do not lead to skin thinning even after prolonged use. The corresponding products must be prescribed by a doctor and should only be used on children from the age of two. But even then, caution is advised: There is not yet enough data on long-term tolerability, which is why, according to the U.S. regulatory authority, the agents should only be used if cortisone-containing drugs do not have sufficient effect.
Antibiotics for atopic dermatitis
Antibiotics (prescription) or antibiotic-containing rubs are used for atopic dermatitis only if bacterial infections of the skin have occurred as a result of scratching.
Creams and compresses
In the case of rather dry eczema and severe itching, the use of dermatics containing polidocanol or creams containing St. John’s wort extract is recommended. In the case of extreme itching, the short-term use of a preparation containing cortisone or the use of antihistamines is also indicated. In weeping forms of eczema, either moist compresses with tannin-containing extracts (rule: moist on moist!) for example with oak bark or also zinc-containing pastes (pasta zinci mollis) are in the foreground of the therapy. Especially in childhood, tannins are used because of their good tolerability, as they have an anti-inflammatory effect, slightly relieve itching and regulate the water balance of the skin.
Preventing atopic dermatitis flare-ups
Neurodermatitis flare-ups can also be prevented if you know what you are hypersensitive or allergic to. For example, many atopic dermatitis sufferers have allergies to pollen, mold, animal dander, or dust mites. Contact with the respective allergy trigger can then trigger an attack. Neurodermatitis sufferers should avoid as far as possible anything that could irritate the skin. Clothing also plays a role. Basically, sufferers benefit from light cotton clothing, while wool on the skin tends to promote itching.
