Eczema types: Neurodermatitis overview

What is neurodermatitis?

Neurodermatitis around an ankle

The more you scratch or rub neurodermatitis, the itchier it often becomes.

Scratching the itchy patch of skin is what causes the rash. This itchy patch often develops on an arm, leg, back of the neck, scalp, or groin area. When it begins in the groin area, it tends to develop on the anus, scrotum, or vulva.

While this patch can be intensely itchy, the itch tends to come and go. Many people say that the patches feel the itchiest when they are relaxing. It’s common for the itch to be most intense right before falling asleep.

Without treatment, the itch can worsen. Some people say the itch wakes them from a sound sleep. If this happens often, the loss of sleep can affect your quality of life.

While the itch may be most intense while you’re relaxed, the condition often begins during an intensely stressful time in life. People often recall feeling stressed out, depressed, or frustrated before the itch begins. Some people say they felt extremely anxious or worried.

Although the itch tends to begin when you feel stressed out, anxious, or worried, it can continue long after these feelings fade away. If you scratch the area frequently, you can develop a skin infection or sores that bleed.

Over time, the repeated scratching will cause the skin to thicken. This is the body’s way of protecting you. The thickened skin bleeds less and develops fewer infections.

While the thickened skin may protect you in some ways, it won’t stop the itch. As the skin thickens, it tends to itch more. Some people may scratch so often that they stop noticing that they’re scratching.

Neurodermatitis rarely goes away without treatment. The goal in treating neurodermatitis is to stop the itch-scratch-itch cycle.

Because other skin diseases can cause the itch-scratch-itch cycle, it’s helpful to see a dermatologist. Each skin disease requires different treatment.

Signs that you may have neurodermatitis include:

• Repeatedly scratching or rubbing a few itchy patches of skin

• Having an itch that interferes with your life, such as waking you up or preventing you from doing certain activities like dating or a favorite sport

• Developing a rash or sores that bleed

You will find more pictures of what neurodermatitis can look like, along with other signs and symptoms, at: Neurodermatitis: Signs and symptoms.

Image
Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

References
An JG, Liu YT, et al. “Quality of life of patients with neurodermatitis.” Int J Med Sci. 2013;10(5):593-8.

High WA. “Lichenoid skin eruptions.” In: Fitzpatrick JE, et al. Dermatology Secrets Plus (5th ed.), Elsevier. China, 2016:113.

Juarez MC, Shawn G Kwatra SG. “A systematic review of evidence-based treatments for lichen simplex chronicus.” J Dermatolog Treat. 2020 Mar 6;1-9.

Legat FJ, Weisshaar E, et al. “Pruritus and dysesthesia.” In: Bolognia JL, et al. Dermatology. (4th edition). Elsevier, China, 2018:116-7.

Lotti T, Buggiani G, et al. “” Prurigo nodularis and lichen simplex chronicus.” Dermatol Ther. Jan-Feb 2008;21(1):42-6.

Plaza JA, Prieto VG. “Inflammatory skin conditions.” In: Modern Surgical Pathology (2nd ed.), 2009. p. 1843+.

Written by:
Paula Ludmann, MS

Reviewed by:
Pearl E. Grimes, MD, FAAD
Ivy Lee, MD, FAAD

Last updated: 1/20/21