Neurodermatitis — also known as lichen simplex chronicus or scratch dermatitis — isn't serious, but breaking the itch-scratch cycle is challenging. Successful treatment of neurodermatitis depends on identifying and eliminating factors that may be aggravating the problem. Over-the-counter and prescription creams can help. Once the scratching stops, it can take months for the skin to return to normal.
Signs and symptoms of neurodermatitis include:
Itchy skin in a single, limited area
Leathery or scaly texture to the skin
Raised, rough patch that is red or darker than the rest of your skin
The primary symptom of neurodermatitis is itchy skin — often a single patch on the neck, wrist, forearm, thigh or ankle. Sometimes neurodermatitis affects genital areas, such as the vulva or scrotum.
The itchiness tends to come and go. It may be most noticeable when you're at rest — watching TV or sleeping, for example — and disappear when you're active. Anxiety or stress can make the itchiness worse. Eventually you may scratch simply out of habit.
The itching can be very intense. As you rub or scratch the area, it gets itchier. And the more it itches, the more you scratch. Breaking this itch-scratch cycle can be challenging.
See your doctor if:
You catch yourself repeatedly scratching the same patch of skin.
You're so uncomfortable that you're losing sleep or are distracted from your daily routines.
Your skin becomes painful.
You suspect your skin is infected. Signs of infection include pain or a yellowish, thick fluid draining from the scratched areas.
To stop the stubborn itch-scratch cycle, you must stop scratching the affected area. It's bound to be tough, but you can do it. And your doctor can help.
Your doctor may recommend one or more of the following treatments:
Prescription medication. Oral corticosteroids and antihistamines may be necessary to reduce the inflammation and relieve the intense itching. Antidepressants or anti-anxiety medications may be helpful for some people. If you develop a bacterial infection in the rash, your doctor may prescribe an antibiotic lotion or oral antibiotics.
Wet dressings. This involves applying medicated cream to affected areas and then covering these areas with damp cotton material that has been soaked in water or other solutions. The moisture in the wet dressings helps the skin absorb the medicated cream. Plastic tape with medication in the adhesive, which is changed every 24 hours, also may be used.
Counseling. A counselor can help you learn how your emotions and behaviors can fuel — or prevent — itching and scratching. Counseling may also help you learn stress management techniques.
Even after successful treatment, mild scarring or changes in skin color could remain.
Lifestyle and home remedies
The following are ways you can lessen the itch and irritation caused by neurodermatitis.
Try over-the-counter (nonprescription) creams or medications. Apply an anti-itch cream or lotion to the affected area. A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch. A nonprescription oral antihistamine, such as diphenhydramine (Benadryl, others), may be helpful if itching is severe.
Cover the affected area with cool, wet compresses. Bandages or dressings can help protect the skin and prevent scratching. This may be especially important if you scratch during your sleep.
Take a comfortably cool bath. Sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that is made for the bathtub (Aveeno, others).
Wear smooth-textured cotton clothing. This will help you avoid irritation.
Choose mild soaps without dyes or perfumes. Be sure to rinse the soap completely off your body. And after washing, apply a moisturizer to protect your skin.
Keep stress under control. Stress and anxiety can trigger itching.