The treatment
The therapy of a neurodermatitis disease is adapted to the course of the disease and the severity of the symptoms. As an orientation, one can follow a step-by-step scheme which has to be adapted individually. The first stage of the therapy is applied in dry skin and consists of a basic skin care which stabilizes the skin’s barrier function and is intended to make the skin less sensitive to irritations and allergens.
In addition, provocation factors which increase neurodermatitis should be avoided as far as possible. If mild eczema occurs, additional external active ingredients can be used as a second stage of therapy. Frequently used ointment additives include evening primrose oil, St. John’s wort extract, dexpanthenol or zinc.
Antiseptic active ingredients can also provide relief in the case of neurodermatitis, especially if there is an excessive colonization of the skin with bacteria or fungi. Since neurodermatitis is often accompanied by severe itching, the second treatment stage also includes the treatment of itching, which can be done with tanning agents, for example. So-called antihistamines can also have a soothing effect on itching.
If stronger inflammatory symptoms occur, ointments with anti-inflammatory active ingredients are used, but most frequently with the group of active ingredients known as glucocorticoids (cortisone). The glucocorticoids are effective against itching and inflammation of the skin and alleviate severe episodes of neurodermatitis. Depending on the type and severity of the symptoms, different active ingredients are used.
For the second stage of neurodermatitis therapy, weakly or moderately effective glucocorticoid preparations are sufficient. In the case of severe attacks, strong glucocorticoids can also be applied externally in the third stage when moderate eczema occurs. Irradiation with high-dose UV light can have an anti-inflammatory effect on the affected skin areas and allow temporary healing.
Long-lasting or severe eczema requires systemic therapy (stage 4) in addition to the treatment options already mentioned. In these cases, internal use of cortisone may be considered. The most severe forms of neurodermatitis are treated with the drug cyclosporine A. Cyclosporin A often causes atopic eczema to subside quickly, but it also has severe undesirable side effects, which is why it is not recommended in principle.
Cyclosporin A can, for example, lead to an increase in blood pressure, kidney damage or gum growth and can promote the occurrence of malignant tumours. Cortisone is used in neurodermatitis, particularly in the acute inflammatory phase. Cortisone is mainly applied directly to the skin by means of a cream.
It thus relieves the inflammation and also helps against itching. Usually the itching disappears within a few hours, the redness usually goes away within a few days.Since cortisone makes the skin thinner, also known as atrophy of the skin, cortisone should not be used too frequently. It can also lead to wound healing disorders, as cortisone reduces the immune system.
In cases of severe skin infestation, cortisone therapy in tablet form is also possible. However, this can lead to severe side effects such as high blood pressure, water retention or osteoporosis. The application should therefore only be carried out in consultation with a doctor.
A neurodermatitis illness is accompanied by very dry skin. It makes sense to treat this dry skin with a gentle skin care cream. For this purpose, ointments, creams and lotions can be used, which offer a high percentage of oil and moisture.
This daily basic care should be used regularly to stabilize the skin’s barrier function. The skin care should also reduce the skin’s sensitivity to allergens and irritations. The composition of neurodermatitis creams depends on the current condition of the skin.
As a rule, oil-in-water emulsions are used; in the case of very dry skin, water-in-oil emulsions can also be used. E As a skin affected by neurodermatitis has a very low concentration of urea, creams containing urea can help to reduce the characteristic dryness of the skin. However, the application of urea to the skin in the case of already irritated or cracked skin can lead to further irritation or painful burning when applied.
Many other additives in creams against neurodermatitis are said to improve the skin’s ability to retain moisture or the healing process. Specific active ingredients such as evening primrose oil, St. John’s wort extract, zinc or dexpanthenol are added to the creams to care for the skin. Multilind® Healing Ointment, which contains zinc oxide as an active ingredient, can be used as a skin care product for neurodermatitis, for example.
A cream against neurodermatitis can also contain antiseptic active ingredients. If the skin is excessively colonized by bacteria or fungi, triclosan, chlorhexidine or antibiotics can be used externally, for example. Additional treatment with diluted chlorine bleach (sodium hypochlorite solution) can also improve the skin condition if it is colonized by the bacterium Staphylococcus aureus.
If the skin rash is wet, creams containing tanning agents are available. These have a drying, anti-itching and slightly anti-inflammatory effect. Stronger episodes of neurodermatitis are treated with creams containing immunosuppressive agents, mostly cortisone.
Creams containing cortisone can be used in different concentrations and ointment bases. For mild symptoms or on the face, hydrocortisone creams are often sufficient. As cortisone has many side effects, the indication for the use of creams containing cortisone should be determined individually by a specialist.
There are many different household remedies that can be used for neurodermatitis. Since not all household remedies have the same effect on every person affected, those affected must individually test what helps and what does not. On the one hand, household remedies serve to increase the moisture of the skin.
On the other hand, household remedies can be used in acute phases of inflammation and itching to delay the use of cortisone. Aloe vera gel can alleviate itching, for example, through its cooling and skin-soothing effect. Apple vinegar diluted with water (ratio 9:1) can also be applied to the skin.
Apple cider vinegar has an anti-inflammatory effect and can also be used against redness and itching. Yoghurt or quark applied to the skin has a cooling and thus anti-itching effect. The yoghurt or quark is simply washed off after it has dried.
St. John’s wort oil can also soothe the skin affected by neurodermatitis. Hyaluronic acid gel can be applied to provide dry skin areas with more moisture. Coconut oil is also a household remedy that can reduce the symptoms of acute skin rashes.
It also provides additional moisture. However, the oil should not be applied directly to the skin, but mixed with a skin-compatible base cream beforehand (ratio of base cream to coconut oil 9:1). If this mixture is kept in the refrigerator, it can additionally reduce itching in acute inflammations by the cooling effect.
