Atopic dermatitis can also be treated without medication

Scaling, itching, weeping, redness: The symptoms of the inflammatory skin disease neurodermatitis are unpleasant – but usually easy to treat. For the treatment of neurodermatitis, there are therapies with and without medication.

According to experts from the European Center for Allergy Research Foundation (ECARF), an estimated ten to 15 percent of the population in Germany are affected by neurodermatitis (also known as atopic dermatitis or atopic eczema).

The course of neurodermatitis changes with age. It often disappears before puberty, but it can always flare up again.

Babies and toddlers are among the most affected age group at 23 percent. At school age, it is still about eight percent of children. Two to four percent of adults suffer from the inflammatory skin disease. Neurodermatitis is not curable.

Neurodermatitis symptoms: This is how the skin reacts

The suffering of those affected is often great. The self-protection of the skin is disturbed. It is significantly drier and more sensitive than in healthy people. This means that the natural barrier function of the skin is disturbed. Viruses and bacteria are harder to fight off and severe skin inflammation is often the result.

Neurodermatitis is most common on the scalp, face and arms. It is particularly uncomfortable when large areas of skin are affected, such as the entire scalp.

Common neurodermatitis symptoms include:

dry skin
(oozing) eczema
thickened skin
itching
redness
swelling
inflammation
nodules
pustules

Neurodermatitis treatment requires patience

The treatment of neurodermatitis depends on the severity of the disease and its progression. There is no universal neurodermatitis therapy. The treatment is put together individually. Those affected often need a lot of patience until the right combination of different forms of therapy is found.

Treating neurodermatitis without medication: skin care is important
The basis of neurodermatitis treatment is consistent skin care. Rich and strongly moisturizing ointments and creams aim to provide dry skin with moisture and oils and to strengthen the protective barrier. Caring additives such as urea and omega fatty acids support the effect. Special, mild washing lotions also help to protect the skin and strengthen its natural protective function.

Caution: Pure oils are not recommended, as they dry out the skin under long-term treatment. Skin experts also advise against pure vaseline and milking grease. Preservatives, fragrances and dyes, emulsifiers and paraffin oil should also be avoided.

Cortisone can relieve itching in neurodermatitis

In addition, coordinated skin care, for example with creams containing cortisone, helps to heal inflammation and small wounds and to relieve itching. Above all, the severe itching is a burden for those affected and often almost unbearable. They scratch themselves – which leads to small injuries to the skin and promotes inflammation.

There are also anti-inflammatory cortisone-free ointments, such as tacrolimus ointments and creams with the active ingredient pimecrolimus. They help to reduce eczema flare-ups and can often avert the use of cortisone ointments. Regular salt baths also help relieve itching and reduce inflammation.

Tip for children: Children often scratch themselves at night. If you wear cotton gloves while sleeping, scratch marks can be avoided.

Treating neurodermatitis: finding and avoiding trigger factors

Trigger factors (provocation factors) that can trigger an atopic dermatitis flare-up should be consistently avoided. These can vary greatly from person to person. It is often:

scratchy fabrics
spicy food
Sweat
tobacco smoke
stress
strong temperature fluctuations

Allergies and neurodermatitis are often related

It is often a neurodermatitis caused by allergies. Those affected should therefore always consult an allergist and have it examined to see whether certain allergens are causing the skin reactions. As the German Lung Foundation knows, many neurodermatitis sufferers suffer from an allergy to house dust mites.

Other allergens include pet dander and pollen. In the case of an existing allergy, taking antiallergic drugs helps in addition to avoiding the allergen. Neurodermatitis patients can also consider hyposensitization.

Is there a special neurodermatitis diet?

As a precaution, many of those affected avoid dairy products, eggs, sugar and other foods in the hope of preventing flare-ups of neurodermatitis. Experts are skeptical about the waiver.

A so-called elimination diet only makes sense if a specialist has diagnosed a food intolerance that could trigger or worsen neurodermatitis and recommends the diet, advises ECARF. In addition, such a change should always be accompanied by a qualified nutritionist to ensure a balanced diet.

Phototherapy: treat neurodermatitis with UV light
Since the inflammatory skin symptoms usually improve under the influence of the sun, phototherapy (light therapy) is a way of improving neurodermatitis symptoms. The skin is treated with UVA and UVB light. The doctor treating you slowly approaches the amount of UV light and the mixture of UVA and UVB light so as not to unnecessarily stress the skin.

Treating neurodermatitis with medication

For those affected by neurodermatitis with a persistently serious illness, the doctor will prescribe a so-called system therapy – i.e. prescribe medication that works throughout the body. This includes cortisone in the form of tablets or injections. Cortisone is mainly used when large areas of skin are affected.

Taking antihistamines weakens the effects of histamine in the body. Itching can be relieved and allergies treated. Antibiotics and antimycotics are used in the treatment of neurodermatitis when there is a bacterial infection of the skin or a fungal infestation.

As reported by the professional association of paediatricians, children and adolescents with a very severe course of the disease can be treated with ciclosporin A in exceptional cases. This substance suppresses the immune system. Alternatively, the active ingredients azathioprine, methotrexate or mycophenolate mofetil could be used in very severe disease progression, especially when ciclosporin A is ineffective or cannot be used. The doctor treating you will inform and advise you accordingly.