How is neurodermatitis treated?
Neurodermatitis rarely heals without treatment. A dermatologist will write a treatment plan that is unique for each patient. The main goal is to stop the itching and scratching. Treatments can include medications like:
- Corticosteroids. These medicines can be applied to the itchy patch or injected into the patch. Corticosteroids help reduce redness, swelling, heat, itching and tenderness, and can soften thickened skin.
- Antihistamines. Taken before bedtime, an antihistamine can cut back on itching during sleep. It can also help prevent allergic reactions that would worsen the condition.
- Antibiotics. These are prescribed if the patchy area is infected. Antibiotics can be applied to the skin or taken orally in pill form.
- Moisturizers. These reduce dryness and itching.
- Coal tar preparations. This type of medicine causes the skin to shed dead cells and slows the growth of new cells. Patients can place it directly on their skin or add it to their bath.
- Capsaicin creams. These can relieve both pain and itching.
Your doctor might also suggest:
- Coverings. Using bandages, socks or gloves can prevent night scratching, allowing better sleep. Covering also helps medicine applied to the skin penetrate better. (This is also called occlusion.)
- Cool compresses. These can be placed on the skin about five minutes before applying corticosteroids. The compress softens the skin so the medicine can penetrate easier, and it can also relieve itching.
- Antidepressants and/or therapy. This type of treatment may be suggested if it is believed that anxiety, depression or stress is causing the itch.
If none of these treatments are effective, nontraditional treatments include:
- A solution that mixes aspirin and dichloromethane applied to the itchy area.
- Treatments usually used for atopic dermatitis/eczema (tacrolimus and/or pimecrolimus).
- An injection of botulinum toxin (Botox®), a toxic protein that can cause flaccid paralysis, or muscle weakness in the body. In a study of three neurodermatitis patients, all three itched less after one week of treatment and within four weeks the itchy patches were gone.
- Phototherapy, or light therapy. This approach should not be used on genitals.
- Traditional surgery to remove the itchy patch or cryosurgery to destroy unwanted tissue using intense cold.
What if scratching has caused a wound?
If scratching due to neurodermitis has caused a wound, the doctor may wrap a dressing over the area.
Another potential treatment is negative-pressure wound therapy, which involves vacuuming fluid out of the wound and increasing blood flow there.
Hyperbaric oxygen therapy confines the patient in an oxygen chamber to inhale pure oxygen, which enhances the body’s ability to heal itself. Surgery on the wound is another option.
What can you do to promote healing if you have neurodermatitis?
If you have neurodermatitis, you should follow the treatment plan from your doctor and try to keep calm so anxiety and stress don't trigger a flareup. Also, keep these points in mind:
- Try to stop scratching and rubbing. But, keep your fingernails short so you minimize damage if you do scratch.
- Apply ice, anti-itch medication or a cool compress to the itchy area. Take a cool bath to reduce heat, which will relieve itching. Add colloidal oatmeal, which can also relieve itching, to the bath.
- Keep the body at a comfortable, cool temperature.
- Wear loose clothing, preferably made of cotton.
- Cover the itchy area with clothing, tape with corticosteroid medicine or apply an Unna boot, which is a dressing containing healing ingredients like zinc oxide. The covering can discourage scratching.
- Avoid anything that irritates the skin or causes an allergic reaction.