Neurodermatitis: Causes, Symptoms, and Treatment

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Neurodermatitis, also known as lichen simplex chronicus, is a skin condition that involves excessive itching and scratching, leading to inflamed patches on the skin. It is not life-threatening or contagious, but it rarely goes away on its own without treatment. When people scratch areas of neurodermatitis, they can irritate the nerves in the skin, which can lead to a chronic itch-and-scratch cycle that prevents healing.

If you are suffering from any itching or scratching on your skin, read on to see if it might be neurodermatitis and what you can do about it.

Woman scratching arm

Science Photo Library / Getty Images

Causes and Risk Factors

Neurodermatitis affects up to 12% of the population.

The exact cause of neurodermatitis is unknown. However, it tends to occur more often in women than men, and in people with skin conditions such as atopic dermatitis, contact dermatitis, or psoriasis.

The condition is most common in adults between the ages of 30 and 50, and it rarely occurs in children.

Research suggests that having an anxiety disorder such as obsessive-compulsive disorder (OCD) can increase your risk of neurodermatitis. Stress also may increase your risk.

Other potential causes, or "triggers," for neurodermatitis may include:

  • Extremely dry skin
  • Allergies
  • Poor blood flow
  • Bug bites
  • An injured nerve
  • Wearing clothing that is too tight
  • Sweating or heat
  • Exposure to traffic exhaust

Signs and Symptoms

Neurodermatitis is usually found on the arms, legs, hands, back of the neck, scalp, face, and genital areas. However, it can occur anywhere on the body.

The dry, itchy areas of skin usually measure between 3 centimeters and 10 centimeters in length and width. The patchy areas can be red, brown, gray, or purple and can eventually scar.

The areas may also appear:

  • Scaly
  • Dry
  • Leathery
  • Thicker than surrounding skin

The most common and irritating symptom of neurodermatitis is intense and frequent itchiness. The itching can be constant or come and go over time. The itching may also become more intense when trying to rest or sleep. For this reason, neurodermatitis can impair a person's quality of sleep and cause additional stress, especially if the condition goes untreated.

Other symptoms of neurodermatitis include:

  • Pain
  • Bleeding
  • Open sores due to constant scratching
  • Hair loss if the condition occurs on the scalp
  • Infection

Chronic scratching can also lead to scarring on the skin.

Diagnosis

To be diagnosed with neurodermatitis, make an appointment with a healthcare provider, including a dermatologist (a doctor who specializes in skin conditions).

Neurodermatitis can be diagnosed using tests that can help rule out other conditions, including:

  • Skin swabs to test for infection
  • Patch tests to test for allergies
  • Fungal tests, which can rule out certain types of skin infections
  • Skin biopsies (removing sample tissue for further examination) to look for other skin disorders
  • Blood tests

Treatment

If diagnosed with neurodermatitis, the most important step in treating it is to stop scratching, touching, or rubbing the affected area.

However, avoiding the site altogether can be challenging for patients as the itching may become intolerable. It's essential to see your healthcare provider and develop a treatment plan that can help you prevent itching the area.

Follow your healthcare provider's recommendations for treatment. Treatment might include:

  • Topical corticosteroid medication that can stop itching and allow the skin to heal
  • Antihistamine medications that can reduce itching
  • Covering the affected areas if you accidentally itch due to habit or while sleeping
  • Cutting fingernails so if you do forget to not scratch, there will be minor damage to the site

Some people need to try several types of treatments to see what is most effective for them.

Eliminating neurodermatitis from ever returning can be difficult. However, there are ways to help prevent a recurrence, such as:

  • Reduce stress. Ongoing stress might trigger a flare-up (worsening of symptoms) or recurrence. You may want to speak with a mental health professional to help you manage your stress or anxiety.
  • Wear loose clothing that is not irritating to the skin. Avoid wearing shapewear and tight clothing, especially wool or polyester and other synthetic fabrics.
  • Avoiding being unnecessarily overheated, especially if sweat is a trigger for you.
  • Continue to go to your medical appointments and follow the recommended plan of action.

Talk with your healthcare provider if you have any difficulties with your treatment plan to find a solution that works for you.

Keeping Skin Moisturized

Your healthcare provider may want you to continue applying moisturizer even after your skin has healed. Keeping the skin moisturized might help prevent neurodermatitis from returning.

Coping With Neurodermatitis

Neurodermatitis rarely goes away without medical treatment, and it can also recur.

Medications that help stop the itching by numbing the area may help people cope with neurodermatitis while it is healing. Other oral medications such as antihistamines can help to relieve itching and break the itch-scratch cycle.

Stress and anxiety can trigger neurodermatitis, and having the condition also can lead to stress and anxiety. It may help to:

  • Work with a therapist to deal with mental health issues that may be contributing to your neurodermatitis.
  • Practice relaxation techniques such as yoga, meditation, and mindfulness.

If you have any questions regarding coping strategies for neurodermatitis, talk to your healthcare provider for other recommendations that might help you.

Summary

Neurodermatitis is a skin condition that is characterized by excessive itching or scratching. It can lead to painful, inflamed patches on the skin. Treatment options are available to treat neurodermatitis, and there are measures a person can take to prevent it from recurring.

A Word From Verywell

Neurodermatitis can be a frustrating and irritating condition. If you have dry, itchy areas of skin, it may be time for you to see a healthcare provider or a dermatologist for a diagnosis. An effective treatment plan can help you treat and cope with neurodermatitis and even prevent future flare-ups.

Frequently Asked Questions

  • What is the difference between eczema and neurodermatitis?

    Eczema is the name for a group of skin conditions that cause the skin to become itchy and inflamed. Neurodermatitis is one of several different types of eczema.

  • What does neurodermatitis look like?

    Neurodermatitis appears as patchy areas of skin that usually measure anywhere about 3–10 centimeters in length and width. The patchy areas can be reddish, brownish, gray, or purple and can eventually scar. The areas might also appear scaly, dry, leathery, and thicker than the surrounding skin.

  • How do you get rid of lichenified skin?

    The best thing you can do to prevent lichenified skin—skin that becomes thickened and leathery from scratching—is to stop scratching the skin and allow it to heal. This can be difficult because the urge to scratch the affected area may be very strong.

    Talk with your healthcare provider for the best treatment plan to heal your skin, which may include a combination of medications and other at-home treatments. Other helpful ways to improve lichenified skin include wearing gloves while you sleep to prevent scratching and avoiding and managing stress that can trigger inflammation in the body.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. An J-G, Liu Y-T, Xiao S-X, Wang J-M, Geng S-M, Dong Y-Y. Quality of life of patients with neurodermatitisInt J Med Sci. 2013;10(5):593-598. doi:10.7150/ijms.5624

  2. National Eczema Association. What is neurodermatitis and how do you know if you have it?

  3. National Eczema Association. An overview of the different types of eczema.

  4. American Academy of Dermatology Association. Eczema types: Neurodermatitis causes.

  5. Liao Y-H, Lin C-C, Tsai P-P, Shen W-C, Sung F-C, Kao C-H. Increased risk of lichen simplex chronicus in people with anxiety disorder: a nationwide population-based retrospective cohort studyBr J Dermatol. 2014;170(4):890-894. doi:10.1111/bjd.12811

  6. Cleveland Clinic. Neurodermatitis: symptoms, causes, treatments, tests & recovery.

By Sarah Jividen, RN
Sarah Jividen, RN, BSN, is a freelance healthcare journalist and content marketing writer at Health Writing Solutions, LLC. She has over a decade of direct patient care experience working as a registered nurse specializing in neurotrauma, stroke, and the emergency room.