This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition.
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Neurodermatitis

What is neurodermatitis?

Neurodermatitis, also known as lichen simplex, is a chronic form of dermatitis. Dermatitis is a skin problem where inflammation causes the skin to become scaly and sometimes itchy. Chronic itching and scratching can cause the skin to thicken and have a leather texture. Neurodermatitis results in a constant scratch-itch cycle. Although signs increase in times of stress, changes in the nerve fibers are also present. Women more often than men have this skin problem. The problem happens most often between the ages of 20 and 50.

What causes neurodermatitis?

A scratch-itch cycle happens when a small itch causes scratching which increases the itch, leading to more scratching. The cause of the itch can be anything - an insect bite, tight clothing or dry skin. The skin then can become very irritated when scratched over and over. Stress and tension increase the itching. This results in the scratching process turning into a habit that we do without thinking. Things in your environment can also cause itching. There may be a family history of asthma, hay fever, eczema, psoriasis or other skin disorders. The back of the neck, arms, legs and ankles are the most common sites of an outbreak.

How is neurodermatitis diagnosed?

Neurodermatitis can be hard to tell from other forms of dermatitis so see your doctor for diagnosis and care. You should also see your doctor if you are losing sleep or your normal routine is upset because of the itching. Your doctor can also treat you if you have an infection, your skin is very painful or if your at home treatment methods are not working.

Diagnosis is based on the appearance of the skin. The doctor should look at all skin lesions to rule out other causes. A skin lesion test, called a biopsy, may be done by your doctor to help decide the cause of your skin problem.

How is neurodermatitis treated?

The condition will not improve until the scratch-itch cycle is broken. Your doctor may suggest you wear a bandage that is hard to remove and that is left on for a week or more. Itching may be helped with drugs such as creams and lotions you rub on your skin. Drugs called, Coticosteroids, may be injected into skin lesions to reduce itching and redness.

Antihistamines, sedatives, or tranquilizers are drugs that your doctor may order for you to reduce itching and stress. These are very useful at night. Counseling, stress management measures and behavior modification can also be used to help people learn to stop scratching.

When you are at home, you should try to avoid things that increase symptoms. Reduce bathing and using soap since dry skin can make skin problems worse. Taking a bath two to three times a week is often enough for most people. Use warm, not hot water when bathing. Pat your skin dry with a towel. Moisten your skin with skin cream while your skin is still damp and many times during the day.

With proper treatment, you can expect itching and redness to slowly go away. Neurodermatitis is a chronic problem but it can be controlled with the right treatment and by avoiding things that are known to bother the skin.

U-M Health System Related Sites:
U-M Dept. of Dermatology
The Dermatology Treatment Center

Other Related Web Sites:
Dermik
American Academy of Dermatology

Reviewed by Charles N. Ellis, MD, UMHS Department of Dermatology, January, 2002