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Neurodermatitis is a skin condition that starts with an itchy patch of skin. Scratching makes it itch more. With more scratching, the skin becomes thick and leathery. You may develop several itchy spots, typically on the neck, wrists, forearms, legs or groin area.
Neurodermatitis — also known as lichen simplex chronicus — is not life-threatening or contagious. But the itching can be so intense it disrupts your sleep, sexual function and quality of life.
Breaking the itch-scratch cycle of neurodermatitis is challenging, and neurodermatitis is usually a long-term condition. It may clear up with treatment but often returns. Treatment focuses on controlling the itching and preventing scratching. It also may help to identify and eliminate factors that worsen your symptoms, such as dry skin.
Symptoms of neurodermatitis include:
The condition involves areas that can be reached for scratching — the scalp, neck, wrists, forearms, ankles, vulva, scrotum and anus. The itchiness, which can be intense, may come and go or be nonstop. You may scratch your skin out of habit and while sleeping.
See your health care provider if home remedies haven't helped after two days and:
Seek immediate medical care if your skin becomes painful or looks infected and you have a fever
The exact cause of neurodermatitis isn't known. It can be triggered by something that irritates the skin, such as tight clothing or a bug bite. The more you scratch, the more it itches.
Sometimes, neurodermatitis goes along with other skin conditions, such as dry skin, atopic dermatitis or psoriasis. Stress and anxiety also can trigger itching.
Factors that can increase the risk of neurodermatitis include:
Persistent scratching can lead to a wound, a bacterial skin infection, or permanent scars and changes in skin color (postinflammatory hyperpigmentation or hypopigmentation). The itch of neurodermatitis can affect your sleep, sexual function and quality of life.
To see if you have neurodermatitis, your health care provider will look at your skin and talk with you about your symptoms. To rule out other conditions, your health care provider may take a small sample of the affected skin to have it examined under a microscope in a laboratory. This test is called a skin biopsy.
Treatment for neurodermatitis focuses on controlling the itching, preventing scratching and addressing underlying causes. Even with successful treatment, the condition often returns. Your health care provider may suggest one or more of the following treatments:
These self-care measures can help you manage neurodermatitis:
Try nonprescription medications. Apply an anti-itch cream or lotion to the affected area. Do this three times a day for two days. A hydrocortisone cream can temporarily relieve the itch. If you keep the cream in the refrigerator, it's cool and soothing when you use it. Or try a nonsteroidal cream with menthol or pramoxine (CeraVe, Sarna, others) to help ease the itch.
An oral antihistamine, such as diphenhydramine (Benadryl), can relieve severe itching and help you sleep. Some people have success with capsaicin cream, but it may sting at first.
Take short, warm baths and moisturize your skin. Prepare your bath with warm — not hot — water. Sprinkle in an oatmeal-based, also called colloidal, bath product (Aveeno). Use mild soaps without dyes or perfumes. Limit bathing time and frequency. Ideally, shower or bathe no more than once a day, and try to limit the shower or bath to 10 minutes or less.
After washing, pat your skin dry and apply unscented moisturizer.
You may start by seeing your primary care provider. Or you may be referred to a doctor who specializes in skin conditions called a dermatologist.
Here's some information to help you get ready for your appointment.
Before your appointment, make a list of:
For neurodermatitis, some basic questions to ask your health care provider include:
Your health care provider is likely to ask you questions, such as: