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Neurodermatitis, also called scratch dermatitis or lichen simplex chronicus, is a persistent skin condition that could cause the affected skin to become thick and wrinkled. When a patch of skin itches, people scratch it and scratching makes the area itchier; ultimately, people might scratch simply out of habit and this cycle of chronic itching and scratching is a symptom of neurodermatitis.
Neurodermatitis is not serious, but breaking that cycle of itching and scratching is challenging and it could take months for the skin to return to normal once this cycle stops. Over-the-counter and prescription creams could help in the treatment; however, successful treatment of neurodermatitis depends on identifying and eliminating factors that might be worsening the disease.
The primary symptom of neurodermatitis is itchy skin, often a single patch on the neck, forearm, wrist, thigh or ankle, and sometimes affecting genital areas such as the scrotum or vulva. The area gets itchier as people scratch the area, and the more it itches, the more they scratch; that’s why the itching can be very intense. The itchiness tends to come and go and it might be most noticeable when people are at rest, like sleeping or watching TV, as well as during anxiety or stress which could make the itchiness worse; on the contrary, the itchiness disappears when people are active.
Other signs and symptoms of neurodermatitis include wrinkled or scaly texture to the skin and raised rough patch which is red or darker than the rest of the skin.
Sometimes, neurodermatitis may begin with something that simply irritates the skin such as tight clothing or a bug bite, and in some cases it may be associated with other skin conditions like eczema, psoriasis, or dry skin. Allergies do not seem to be a factor, but stress and anxiety can trigger the itching cycle; nevertheless, the exact cause of neurodermatitis is still not known.
Persistent scratching could lead to:
People must stop scratching the affected area in order to stop the persistent itch-scratch cycle, and they can do it with the help of doctors, though it is bound to be difficult.
Even after successful treatment, mild scarring or skin color changes could remain. The doctor might recommend treatments such as wet dressings, prescription medication, and counseling.
This treatment involves applying medicated cream to the affected areas then covering them with damp cotton material that has been soaked in water or other solutions; the moisture in the wet dressings help the skin soak up the medicated cream. Plastic tape with the adhesive medication may also be used, but it should be changed every day.
Oral corticosteroids and antihistamines might be necessary to relieve the intense itching and reduce the inflammation. The doctor might prescribe an antibiotic lotion or oral antibiotics if the patient acquires a bacterial infection in the rash. Anti-anxiety or antidepressant medications may also be helpful for some people.
A counselor could help people understand how their emotions and behaviors could provoke or prevent itching and scratching, and the counseling might also help people learn techniques of stress management.
Samir Moussa M.D.
Yaser Habrawi , F.R.C.S.Ed
Dr. Tahsin Martini
Dr. Talal Sabouni
Dr. Samer Al-Jneidy
Dr. Hani Najjar
Dr . Dirar Abboud
Dr. Faisal Dibsi