Introduction
Neurodermatitis, also known as atopic eczema, is a chronic, mostly intermittent skin disease. It usually recurs in the same areas of the skin. In addition to elbows, hollow of the knee, extensor sides of legs and arms and hands, the scalp can also be affected.
Neurodermatitis also manifests itself in the area of the scalp through chronically dry skin, whereas in acute attacks, weeping and often very itchy eczema occurs. In babies, the beginning of neurodermatitis can manifest itself as a so-called milk crust. However, not every child with milk crust develops neurodermatitis in the course of the disease.
The causes
The causes for neurodermatitis of the scalp are the same as for neurodermatitis of other localizations. Various factors play a role in the development of neurodermatitis. Besides a hereditary predisposition, which leads to the fact that children of affected parents have an increased risk of also developing neurodermatitis, various allergies are suspected to be possible triggers for neurodermatitis.
These include food allergies, for example to nuts, soy, fish, eggs, cow’s milk and wheat. In addition, an animal hair or house dust mite allergy can increase the risk for the occurrence of neurodermatitis. If neurodermatitis is present, various triggers can trigger an acute attack. These include the consumption of certain foods such as tomatoes or strawberries, but also heavy sweating or certain cosmetic ingredients. In the case of neurodermatitis in the scalp area, the choice of shampoo and protection against dehydration plays a decisive role in curbing acute attacks.
The diagnosis
The diagnosis is made clinically, i.e. on the basis of the medical history (recording of the patient’s medical history) and the appearance of the skin. A positive family history, i.e. the occurrence of neurodermatitis in first-degree relatives, can provide initial indications. In an acute episode, the often weeping eczema, accompanied by dry skin at intervals, is usually sufficient to enable the diagnosis of neurodermatitis to be made. If there is a suspicion in the medical history that certain foods lead to a worsening of the skin condition, it may be useful to perform blood tests for food allergies. If there are accompanying illnesses such as asthma or hay fever, it can also be useful to exclude further allergies, for example to animal hair or house dust mites, by means of blood tests.
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