Atopic dermatitis – it itches all the time

People with neurodermatitis are always itchy. Only scratching seems to be the solution. But this doesn't help. The torment remains. It has not yet been possible to investigate down to the last detail why a person develops neurodermatitis. So far, scientists have researched many different genes that may be related. In any case, it is not the genetic material alone that causes children and adults to scratch their skin. Neurodermatitis also occurs without a hereditary predisposition , which is why there must be external influences. Many people develop the condition even when they are under stress or when they have eaten something specific. It is therefore not a hereditary disease in the classic sense. People with neurodermatitis suffer from their own body defenses. They have an overly sensitive immune system that reacts to just about anything. Not only are these harmful invaders, but they can also be substances that are normally harmless, such as food or bee pollen.


So far, neurodermatitis cannot be cured

Those affected usually have very dry skin. This is probably due to the changed composition of the skin fats. The protective function of the skin is disturbed, which is why it loses more moisture than healthy skin. Irritant substances can penetrate more easily, which then probably results in unbearable itching. The neurodermatitis explicitly affects children. Adults can also suffer from itchy skin. But then the skin tends to flake. Weeping eczema is more likely to develop in children. No matter how old they are, neurodermatitis sufferers have to learn to live with the itching. Because neurodermatitis cannot be cured. However, the symptoms can be alleviated by avoiding the triggers, taking appropriate care of the skin and avoiding stress as much as possible and possibly medication.

Worse from scratching

An itch-scratch spiral quickly develops in neurodermatitis. The skin is itchy and inflamed. The agony is only briefly alleviated by scratching. The itching comes back and is often worse than before because the damage to the skin is even worse. This spiral continues to escalate . Those affected describe this as unbearable. Experts recommend patting the affected areas rather than scratching them. The immune system also deploys hard artillery in the event of harmless stimuli. Special troops are sent out by the body's defenses. These are the T cells that migrate towards the skin. There they cause a release of inflammatory messengers, such as histamine. Certain nerve fibers, in turn, are irritated by these messenger substances and trigger the itching. Scratching releases more and more of these messenger substances, which causes the itching to get worse. Ultimately, the inflamed skin offers loopholes for intruders. Chemicals, viruses, bacteria and fungi easily enter the body. This has unpleasant consequences. Breaking the itch-scratch spiral early is very important. Attention must be paid to this. A new attack can be counteracted with medication.

The symptoms

Depending on whether a baby, child, adolescent or adult is affected, neurodermatitis looks different. Babies' faces, necks, arms and legs are often covered with a yellowish or brown crust. This is reminiscent of burnt milk, which is why it is also called cradle cap. If such spots are discovered in the infant, there is no cause for concern. It does not necessarily have to be neurodermatitis. Eczema in infants can have many causes. These skin changes can remain for a few months up to two years and then heal spontaneously. They may also last longer. The disease often heals during puberty, some suffer from it, but also when they are adults. Boys and girls are affected about equally often.

Eczema in the crooks of the elbows and behind the knees

In children, the inflamed areas appear particularly on the face, neck and neck, as well as on the shoulder girdle and in the upper chest area, but especially in the hollows of the knees and elbows and also on the backs of the feet and hands. But even in these cases, parents do not have to fear that it will always be like this. Two percent of adults have neurodermatitis flare-ups. The skin changes over time in the affected areas due to the recurring flare-ups. It is thickened, reddened and has a coarser skin texture, is scaly and dry.

The diagnosis

In order to find out whether neurodermatitis is present, the doctor will first ask about the family and personal circumstances. Among other things, he would like to know whether you are suffering from severe itching, which areas are affected by the itching and how often flare-ups occur, whether other family members also suffer from neurodermatitis and whether there is a pet. After this conversation, the doctor examines you. In particular, during the examination he will look at the areas on the body where there is eczema. The doctor then uses special allergy tests to check whether an allergy is present. Different drops are put on the forearm in the skin prick test. The drops contain traces of various allergy triggers. Cat hair, birch pollen, house dust mite droppings, chemicals, etc. Then he scratches the skin under the drops. Results are available after around 20 minutes. A red wheal sits on the affected area. Another test dispenses with drops and patches are placed on the skin. This is the epicutaneous or patch test. The doctor can use the blood test to determine whether the immune system is reacting very sensitively. For this purpose, blood is taken and the sample is sent to the laboratory, where the IgE test is carried out. Special methods are used to search for the immunoglobulin E. The immune system always forms these antibodies if the body is infested with worms, for example. However, people who have a sensitive immune system also have a lot of IgE in their blood without a parasite problem. The test is particularly suitable for children who should not be expected to undergo extensive skin tests.

The double of neurodermatitis

What looks like neurodermatitis can also be something else. Depending on the age of the patient, different diseases can be considered, which should be ruled out by the doctor before the diagnosis of neurodermatitis is made. The doubles include: scabies, the combination of different contact eczema, cumulative-toxic contact eczema, toxic-irrative contact eczema, allergic contact eczema and seborrheic eczema.

Viet Trinh

People with neurodermatitis are always itchy. Only scratching seems to be the solution. But this doesn't help. The torment remains. Read more!

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