Neurodermatitis (atopic eczema): causes and treatment

Atopic eczema, also known as neurodermatitis, is characterized by dry and inflamed skin and itching. Around four million people in Germany suffer from the disease – many of them children. Here you can find out how to recognize atopic eczema and how it is treated.

What is neurodermatitis or atopic eczema?

Neurodermatitis, also called atopic eczema or atopic dermatitis, is an inflammatory skin disease. This chronic, non-contagious disease is particularly common in newborns and children. In Central Europe alone, ten to fifteen percent of all those affected are children. In addition, they are more likely to develop another allergy , such as asthma , in the course of their lives .

How do you recognize atopic eczema?

Atopic eczema is characterized by the typical symptoms such as dry and sensitive skin, reddened and sometimes weeping areas and severe itching. The parts of the body affected by neurodermatitis can vary greatly throughout life.

Eczema in babies

The first symptoms of neurodermatitis in babies usually appear from the third month of life in the form of cradle cap. These are reddish blisters that mainly appear on the scalp. They fill with liquid and after drying, they form a white crust. Since the spots are reminiscent of burnt milk, they are also referred to as cradle cap . This often develops into a neurodermatitis in the baby with the following symptoms:

  • Reddened, partly weeping skin areas
  • Yellow-brown crusts on the head
  • Scaling, whitish areas of skin on the neck, in the armpits and behind the knees
  • Severe itching and scratch marks

If your baby has neurodermatitis, you should definitely consult a pediatrician or dermatologist. But even with a non-drug treatment, the intensity of neurodermatitis can be significantly reduced. More on that below.

Neurodermatitis in children

Children with neurodermatitis show the typical symptoms such as dry and reddened skin and excruciating itching. The dry skin is cracked, weeping or forms small eczema. It appears older overall because the skin fold structure has become coarser. The following parts of the body are usually affected:

  • elbow bends
  • behind the knees
  • neck
  • lateral body parts

Neurodermatitis in adults

Adolescents and adults show different neurodermatitis symptoms. The crook of the arm, the back of the knee and the face are often affected in young people – especially around the eyes and mouth. But the upper part of the upper body and the neck can also be affected. In adulthood, the typical neurodermatitis sites are the elbows, back of the knees, neck, throat and face.

Cause of atopic eczema

The exact cause of atopic eczema is different for each person affected and must therefore be determined individually. As with other skin diseases, a certain hereditary predisposition usually plays an important role. But the following trigger factors can also promote atopic eczema:

  • Heated rooms: House dust mites , to which many neurodermatitis sufferers are allergic,  spread quickly in warm rooms  .
  • Wrong diet:  Since allergies and neurodermatitis are closely related, it is important that you eat a balanced and healthy diet. Like people with histamine intolerance, you should eat a low-histamine diet. Foods such as red wine, yeast, chocolate or spinach should therefore be avoided.
  • Stress:  Whether it is psychological pressure at school or in everyday working life – it has a negative effect on the condition of the skin. Therefore, relaxation exercises should also be part of the therapy plan when treating neurodermatitis.
  • Unsuitable textiles:  Many items of clothing contain chemical substances that trigger the symptoms of neurodermatitis. In particular, items of clothing made of wool or new wool are not recommended for those who are ill, as they can trigger or intensify itching. You should also avoid zippers and buttons containing nickel and cobalt.
  • Environmental pollution:  In industrialized nations in particular, many people suffer from neurodermatitis. Therefore, researchers assume that pollution of the environment can be regarded as another trigger of the chronic skin disease.
  • Hygiene:  Avoiding unhygienic living conditions also reduces the increase in symptoms of neurodermatitis, since the immune system can then focus more on skin problems.
  • Allergens such as pollen or house dust mites
  • But infections , increased  sweating or  lack of sleep can also be the cause of neurodermatitis.
To write a diary

In order to be able to precisely determine the triggers of atopic eczema, it is ideal if you keep a diary of the course of the disease. Simply note the condition of the skin, where you are, whether your child is suffering from psychological pressure or which foods they have eaten. With the help of this documentation, you can quickly get an overview of the triggering factors in your child.

How is neurodermatitis treated?

When children suffer from neurodermatitis, a trip to the pediatrician is unavoidable for parents. The paediatricians and dermatologists usually recognize the disease reliably by the typical skin symptoms. But skin tests can also provide more information about allergies. However, they are not suitable for all young children with neurodermatitis. A blood test is therefore recommended for them. It can be used to precisely detect the antibodies to certain pollutants in the blood.

  • Basic therapy: The so-called basic care consists of regular skin care with moisturizing ointments and creams with additives such as marigold extract or St. John’s wort oil. The constant care should provide the skin with sufficient moisture and thus prevent a new attack of neurodermatitis.
  • Drug therapy: Drug therapy is an external treatment with a special neurodermatitis ointment or emulsion or an internal treatment with medication in the form of tablets or infusions. External treatment is usually sufficient for a mild to moderate form of neurodermatitis to relieve the symptoms. In the case of severe atopic eczema, the doctor usually prescribes additional anti-inflammatory tablets.
  • Complementary therapies: If you have atopic eczema, complementary therapies are helpful and provide relief. For example, light therapy, also known as phototherapy, is said to inhibit inflammation. But acupuncture, cold therapy, Bach flower therapy or Schuessler salts can also reduce the frequency of flare-ups.

Be careful with cortisone ointment!

If your baby has severe neurodermatitis, you will most likely have to resort to special creams and ointments to treat atopic eczema. Although there are also over-the-counter cortisone ointments, you should only use them on children under the age of six after consulting a doctor – only with the right dosage can side effects such as sensitization of the skin or influence on the hormonal balance be avoided. When applying, you should also note the following:

  • Do not use the cream too often or for too long
  • Scratch marks must be healed before application
  • Do not apply over large areas
  • Do not apply to the diaper area or face

Even supposed miracle cures often simply contain cortisone. Therefore, caution should also be exercised with these.

Alleviate neurodemitis symptoms – you can do that

Neurodermatitis restricts children and adults alike in their daily lives. However, if you stick to the following points, you can avoid some triggers and thus enjoy a longer symptom-free phase:

  • Apartment:  The children’s room should be regularly cleaned of dust. You should also air the room thoroughly once a day and vacuum your child’s mattress once a week.
  • Washing laundry:  You should wash your child’s cotton bedding once a week at 50°C or higher. You should also use enzyme-free detergent for this.
  • Applying lotion:  If children have neurodermatitis, extensive body care after showering and bathing is particularly important in order to bring the fat and moisture content of the skin back into balance. Creams should also be used at least twice a day, and more often in some affected areas. Ideally, the cream contains additives such as marigold extract, St. John’s wort oil or linoleic acid.
  • Clothing:  Your child should wear cotton clothing. For the night there are also special pajamas with sewn-on gloves for children with neurodermatitis. In addition, new clothing should be washed several times before wearing it for the first time.
  • Onion principle:  So that your child’s skin does not overheat, you should apply the onion principle to clothing and bedding – several layers of light fabric on top of each other. If it is too warm, the individual layers can be removed without further ado.
  • Fingernails:  To ensure that your child does not injure their skin when scratching, you should trim their fingernails regularly.
  • Vacation:  When planning your vacation, you should prefer low-allergen areas such as the high mountains or the coast if your offspring also has a pollen allergy.
  • Food:  In order to find out whether a food intolerance aggravates the symptoms of neurodermatitis, it is a good idea to keep an eye on your offspring’s diet.
  • Rituals:  Your child needs fixed rituals and clear structures in their everyday life, because factors such as stress can also worsen the complexion.
  • KiGa and school:  You should inform the kindergarten or school about your child’s illness. In this way, the educator or teacher knows why your offspring is sometimes restless, unfocused, tired or irritable. In the phases of the disease in particular, it can be difficult to fall asleep because of the itching.
Atopic Eczema – Scratch the Right Way!

To avoid scratching your skin, use gentler methods. It is often enough if you pinch or massage the skin around the itchy area a little.

Properly educate children with neurodermatitis

Children are usually curious and uninhibited about new things – so it is good if your offspring can explain their illness to other children while they are still in daycare or with a childminder. This strengthens his self-confidence, prevents misunderstandings and promotes contact with new playmates. So give your child an understanding of the disease as early as possible, because it is quite possible that they will be teased because of their skin or do not like to see themselves.

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