Why someone gets neurodermatitis has not been researched in detail. Scientists have so far identified many different genes that could have something to do with it. But it is not the genetic makeup alone that causes children and adults to scratch their Dry Skin Itching. Atopic eczema or atopic dermatitis, as experts call neurodermatitis, occurs even without a hereditary predisposition, so there must be external influences. Many people also develop the disease when they are under stress or have eaten something specific. Therefore, it is not a hereditary disease in the classic sense.
People with neurodermatitis suffer from their own body defenses. Your oversensitive immune system reacts to all kinds of things – not just to harmful invaders, but also to substances that are actually harmless, such as pollen or food.
Those affected usually also have extremely Dry Skin Itching, which is probably due to a change in the composition of the skin’s oils. The skin protective function is disrupted, which means it loses much more moisture than healthy skin. Allergens or irritating substances can penetrate more easily, which then leads to the often unbearable Dry Skin Itching.
Things that can irritate an oversensitive immune system and trigger eczema include:
- Food, pollen , animal hair, house dust mite feces
- Substances such as tobacco smoke, perfume, preservatives, environmental toxins
- Stress and strong emotions , including joy or tension
- Certain textiles, for example wool
- Sweating, improper cleansing of the Dry Skin Itching
- Certain professional activities, for example in a damp environment or those in which the person concerned comes into contact with a lot of dirt
- Climatic factors such as extreme cold and/or dryness, humidity
- Hormonal factors such as pregnancy or menstruation
Neurodermatitis is not a disease that specifically affects children. Adults also suffer from itchy skin, although their skin tends to flake, while children develop weeping eczema. Regardless of age, those afflicted must learn to live with the torment because it cannot be cured. However, the symptoms can be alleviated by avoiding the triggers, caring for your skin appropriately and keeping stress away from yourself as much as possible. can also Medication help.
Scratching makes everything worse
In neurodermatitis, a fatal itch-scratch spiral quickly develops: the skin is inflamed and itches. Scratching only relieves the torment for a short time. The Dry Skin Itching returns and is often stronger than before because the skin has been damaged even more – a spiral that keeps spiraling up. Those affected describe this as unbearable, so experts recommend tapping the affected areas rather than scratching them. In addition, the immune system brings out heavy artillery even in the face of harmless stimuli: the body’s own defenses send special troops, the T cells, towards the Dry Skin Itching. There they cause a release of inflammatory messengers, such as histamine. These messenger substances in turn irritate certain nerve fibers and cause itching.
Scratching causes more and more of these messenger substances to be released, resulting in Dry Skin Itching more. This also increases the scratching. The inflamed skin ultimately offers loopholes for intruders: chemicals, bacteria, viruses and fungi easily enter the body through the scratched areas, which can have very unpleasant consequences.
Therefore, make sure to interrupt the itch-scratch spiral early. If a new attack is imminent, you can take targeted countermeasures – with medication.
Symptoms
Neurodermatitis looks very different depending on whether it affects a baby, a child, a teenager or an adult. Babies often have a yellowish or brown crust on their faces, necks, arms, and legs. It is reminiscent of burnt milk, which is why it is also called cradle cap.
If you have discovered such spots on your baby, there is no reason to worry: it does not necessarily have to be neurodermatitis. Eczema in babies can have many causes. Such Dry Skin Itching changes can last for a few months to two years and then heal spontaneously. Or they persist longer. Very often the disease heals during puberty, but some continue to suffer from it as adults. Boys and girls are affected about equally often.
Eczema in the elbows and back of the knees
In children, the inflammatory areas occur primarily on the face, neck and neck, in the upper chest area and shoulder girdle, but especially in the elbows and backs of the knees as well as on the backs of the hands and feet. But even then, as parents, you don’t have to worry that it will always stay that way.
Two percent of adults have attacks of neurodermatitis. Due to the recurring attacks, the skin in the affected area changes over time: it is red, thickened, has a coarser Dry Skin Itching texture, is dry and flaky.
Other typical features of neurodermatitis are:
- Double lower eyelid folds
- Dry Skin Itching on the palms of the hands and soles of the feet
- A pale face with shadows under the eyes
- Allergic reactions such as watery eyes, hay fever or asthma
- Torn corners of the mouth and earlobes
- In extreme cases, the entire skin can be affected by neurodermatitis
Diagnose
In order to find out whether you or your child suffers from neurodermatitis, the doctor will first ask you in detail about your family and your living conditions. Among other things, he would like to know whether you suffer from severe Dry Skin Itching, where the skin problems occur and how often the attacks occur, whether another family member also suffers from this disease and whether you have a pet. After the conversation, the doctor will examine you or your child. He will particularly look at those areas on the body where there is eczema.
The doctor then uses special allergy tests to check whether you or your child has an allergy. In the so-called prick test, he dabs various drops onto the forearm, each containing traces of different allergy triggers: birch pollen, cat hair, house dust mite feces, chemicals. He then lightly scratches the Dry Skin Itching under the drops. The doctor can see the result after about 20 minutes: there is a red wheal in the corresponding area. Another allergy test does not use drops and instead places a patch on the skin. This is the so-called patch test .
The doctor can use a blood test to determine whether the immune system is reacting excessively. To do this, he takes blood and sends the sample to the laboratory. The so-called IgE test is carried out there: the laboratory assistant uses special methods to look for immunoglobulin E (IgE). The immune system always produces this antibody when the body is attacked by worms, for example. People with a very sensitive immune system have a lot of IgE in their blood even without a parasite problem. This test is particularly suitable for small children who do not want to undergo extensive skin tests.
Double of neurodermatitis: eczema
What looks like neurodermatitis could also be something else. Depending on the patient’s age, various diseases come into consideration that the doctor should rule out before diagnosing neurodermatitis. This includes:
- Seborrheic eczema : It is similar to cradle cap. Yellowish, greasy scales form on the skin – usually on the head, upper body and in the armpits. In contrast to neurodermatitis, this eczema usually does not itch and it often heals without any special intervention. In addition, this eczema also occurs in the diaper region – neurodermatitis does not.
- Allergic contact dermatitis : Those affected react hypersensitively to certain substances such as nickel, house dust mites, animal hair or cosmetics.
- Toxic -irritant contact dermatitis : This occurs when the skin comes into prolonged or repeated contact with a toxic substance, such as a solvent. The so-called “diaper rash” in infants, for example, is caused by ammonia – a cell toxin that is produced when urea in urine breaks down.
- Cumulative -toxic contact dermatitis : Here the skin dries out if it comes into contact with water too often, for example because those affected have to wash their hands frequently. The hands burst open, cracks and calluses form. Those affected include, for example, hairdressers, bakers and nursing staff.
- A combination of different contact dermatitis : If the skin is already damaged, sensitization can occur more easily because the skin can no longer perform its protective function. Those affected, such as nursing staff, are then more likely to react to allergens or irritating substances.
- Scabies . : It then itches, especially on the wrists, in the folds between the fingers or toes, and in adults often in the genital area
There are also other variants, some of which are very rare, that the doctor should clarify.
therapy
Neurodermatitis cannot yet be cured. Since it occurs on the skin, you can relieve the Dry Skin Itching with moisturizing ointments and creams and thus prevent a new attack. It also makes sense to avoid known triggers.
If the neurodermatitis really flares up, doctors usually recommend ointments with so-called antihistamines or cortisone. Both substances relieve the symptoms enormously. Antihistamines block the body’s own substance histamine – it is this that causes Dry Skin Itching. Cortisone is similar to the hormone that the body produces in the adrenal gland and ensures that inflammation in the skin decreases.
Cortisone tablets can prevent children from growing
In principle, cortisone can have serious side effects: blood pressure and blood sugar levels can rise, the skin can become thinner, and the bones can become more brittle. Particularly problematic for children: cortisone hinders the bones from growing and the child can remain smaller. Fat often accumulates in the body, for example on the face. Doctors then speak of a full moon face.
Whether such serious side effects occur depends primarily on how and how much cortisone enters the body and how long it is used. If the doctor injects the medication or the patient takes cortisone tablets, there is a risk of more severe side effects than if the patient applies cream to a small area of skin. The dose in the ointment is so low that only small amounts of cortisone enter the body.
are more worrying Tablets . They help with a severe attack of neurodermatitis because the dose in the pill is significantly higher and the active ingredient enters the blood directly via the stomach. Because cortisone can inhibit bone growth, children should only take cortisone preparations for a short time.
In general, you should not use cortisone for longer than a few days, but a maximum of two weeks – only longer in certain exceptional cases. Afterwards, you should not suddenly stop using the substance, but rather slowly taper it off. Ask your doctor about the exact procedure.
Other remedies for the Dry Skin Itching
You can discuss possible alternatives with your doctor. Since 2002, in addition to cortisone preparations, so-called immunomodulators with the active ingredients pimecrolimus and tacrolimus have been prescribed, which are intended to inhibit inflammation and relieve Dry Skin Itching.
Ointments containing immunomodulators may cause a slight burning sensation on the skin. The active ingredients also make you more susceptible to inflammation caused by viruses. The European Medicines Agency has not yet been able to prove or disprove whether the risk of skin cancer and other types of cancer is increased.
The authority therefore recommends treating neurodermatitis with tacrolimus or pimecrolimus only if creams or ointments containing cortisone cannot be used or if prolonged treatment would permanently damage the skin. Due to the low side effects, immunomodulators are often applied to sensitive areas such as the face, groin or genital area. In combination with local cortisone preparations, they enable a lower dosage of cortisone. Since there are no long-term studies available, immunomodulators should only be used from the age of three and tacrolimus should only be used from the age of 17.
Treat the Dry Skin Itching to oil and moisture
In the case of open, weeping or even bloody scratched areas of skin in which bacteria are wreaking havoc, the dermatologist will also prescribe an antibiotic. Once the inflamed areas have healed, you need to treat the skin afterwards. The following applies: wet on wet and fat on dry. If the skin calms down but is still slightly red, it needs a lot of water. An oil-in-water emulsion is then the right thing. Once the skin’s protective barrier is intact again, it becomes supple again with a water-in-oil cream. The respective mixture formula is often stated on the packaging.
Ointments that contain urea help and can prevent Dry Skin Itching. Your dermatologist can tell you how much urea your skin or your child needs. However, health insurance companies do not pay for such creams and baths: they classify the products as care products and not as medications.
Phototherapie
In recent years, another treatment has been established for neurodermatitis: phototherapy . The patient’s skin is irradiated with ultraviolet light, which dampens their immune response. The current guideline recommends that doctors use high-dose UVA-1 therapy for an acute, severe attack of neurodermatitis and UVB therapy for moderately severe neurodermatitis. Since this treatment theoretically increases the risk of skin cancer and can also cause the skin to age prematurely, phototherapy is only recommended from the age of 12. In addition, no so-called immunosuppressants – drugs that reduce the functions of the immune system – should be administered at the same time as UV irradiation.
Tips
Since those affected suffer the most from Dry Skin Itching, most tips are aimed at avoiding contact with possible triggers. These include, for example, textiles such as wool and nylon and personal care products such as soaps and bath products. But rules of conduct also help to alleviate the symptoms. Avoiding stress and bringing more relaxation into your everyday life can have a positive effect on the course of the disease.
Expert advice
Ingrid Moll, Professor of Dermatology and Venereology at Hamburg University Hospital Eppendorf, answers your questions.
Can a food allergy trigger neurodermatitis?
Those affected often believe that they have the annoying rash because they are allergic to certain foods . However, allergy tests could not prove this in most cases. In only about one percent of adults and up to ten percent of children are certain proteins in food the cause of their suffering. These proteins are mainly found in cow’s milk, chicken eggs, soy and peanuts. If you don’t strictly avoid foods that contain these proteins, you’ll have to expect new attacks again and again.
How do I find out what I’m allergic to?
To find out what your skin is actually allergic to, a food diary and an allergy test from a dermatologist can help. On the other hand, blanket diets for allergy sufferers are not advisable. Neurodermatitis sufferers should eat a balanced diet, ideally with plenty of fruit and vegetables. Avoid alcohol, nicotine and citrus fruits as much as possible. They contain substances that irritate the skin.
Is it true that breastfeeding helps prevent neurodermatitis in children?
In a way, yes. Because in the first six months a baby builds up its immune system. During this time, breast milk provides the best protection against possible food allergies. If you start feeding animal milk too early, your child may develop an allergy to animal proteins, which may later worsen eczema.
What influence does the environment have on neurodermatitis?
Some environmental pollutants such as finely dispersed particles in the air from car exhaust or ozone are suspected. Fine pollen can also trigger neurodermatitis, such as pollen from birch, hazel, alder, grass and herbs.
Is it true that too much hygiene can promote neurodermatitis?
In fact, farm children are much less likely to have neurodermatitis than city children. And vice versa: children from the upper classes of society suffer from the disease at an above-average rate. Doctors suspect that hygiene plays a major role in this: if there is too much washing, cleaning and disinfection, the immune system is no longer sufficiently challenged and therefore often raises a false alarm.
Does neurodermatitis inevitably develop into asthma or hay fever?
People with neurodermatitis are known as atopics. In addition to Dry Skin Itching, they have other inflammations. This is why allergic asthma and hay fever are often constant companions. This is because all three diseases are triggered in a similar way: for hereditary reasons, the immune cells produce too many antibodies, so-called immunoglobulins, which attack foreign substances from outside and ultimately trigger allergies such as asthma and hay fever. Children with severe neurodermatitis therefore have a significantly increased risk of developing asthma and hay fever.
What role does the psyche play in people with neurodermatitis?
In around 30 percent of neurodermatitis sufferers, internal tension, fear or hopelessness trigger new attacks. If the stressful life situation continues and the psychological pressure becomes too great, more stress hormones are released. Doctors call this condition affect stasis. The already weakened immune system reacts extremely sensitively: immune cells are increasingly activated and the body’s own defenses go wild. The result: The skin becomes inflamed and the Dry Skin Itching is tormenting. Some people also react to positive stress. For them, a new attack only occurs after a stressful phase has been overcome, such as passing an exam.