Itchy, red, flaky skin? These can be signs of the insidious skin disease atopic dermatitis. Neurodermatitis (also known as “atopic dermatitis“) is one of the most common skin diseases of our time.
The skin of people with atopic dermatitis rebels: redness, dryness and, above all, agonizing itching are typical symptoms suffered by those affected. However, the exact causes are still a headache for doctors today.
We are often familiar with the skin disease in babies with scaly neurodermatitis scalp, whereas in adults it tends to appear as unsightly rashes on the face and hands.
Treatment of neurodermatitis in children
Find out more about the treatment of atopic dermatitis in children and babies.
Millions of people worldwide already suffer from atopic dermatitis and this complex disease is becoming increasingly common. Lifestyle and environmental pollution trigger them. However, with appropriate treatment, such as special atopic dermatitis creams, the symptoms can be brought under control.
Are you wondering whether you could also be ill? In this article you will learn everything you need to know about the thousand facets of atopic dermatitis, as well as its causes, symptoms and treatment.
The term “neurodermatitis” comes from the Greek. “Neuro” means nerve, “derma” is the skin and the suffix “-itis” indicates an inflammatory process. The disease therefore owes its name to the fact that in the past, medicine wrongly assumed that inflammation of the nerves was the cause.
Although this assumption has since been refuted, the name “atopic dermatitis” is much more common than the medically correct terms “atopic eczema” and “atopic dermatitis“.
The term “atopic” goes back to the Greek “atopia”, which means placelessness. Anyone who suffers from neurodermatitis knows that the term hits the nail on the head. After all, the symptoms can occur more or less on every conceivable part of the body.
It is a genetic disease in which the skin is virtually leaky and can no longer fulfill its role as a protective barrier.
As a result, allergens and irritants from the environment can penetrate more easily and the immune system becomes overactive, making those affected more prone to allergic reactions.
The majority of atopic dermatitis sufferers develop the disease during their first year of life. Although the disease often ends in puberty, adults can also suffer from the disease.
However, only around 1.5 to 3 % of Germans in adulthood are still affected by atopic dermatitis.
There is a consensus in medicine that the risk of developing the disease is hereditary. If there are already cases of atopic dermatitis in your family, there is an increased likelihood that you will also develop symptoms.
In recent decades, the number of known neurodermatitis cases has risen continuously. However, the majority of atopic dermatitis patients only experience mild symptoms.
Where exactly atopic dermatitis occurs and how severe it is varies from person to person. Nevertheless, there are some key symptoms that occur in a comparable form in sufferers of different age groups and by which atopic dermatitis can be recognized.
The course of the disease is characterized by relapses. To simplify matters, you can imagine the development of atopic dermatitis in the form of a wave: the symptoms are at their worst at the top of the wave crest. This is referred to as an acute attack.
Afterwards, the discomfort will subside and the skin can recover a little. So we have arrived in the valley of the wave. Such acute episodes and periods of recovery follow each other continuously. During the resting phases, there may be no symptoms at all or only dry skin.
Age plays a decisive role in the individual course of atopic dermatitis. Atopic dermatitis therefore progresses differently in children than in adults. Due to the constant stress, those affected not only suffer from the symptoms themselves, but also from anxiety disorders or depression.
Around every 5th child in Germany is affected by atopic dermatitis. In addition to extremely dry, tight skin, so-called flexural eczema is one of the typical symptoms of atopic dermatitis in babies and children. These terribly itchy rashes occur mainly in the bends of the arms and knees and are characterized by severe redness and inflammation.
Although flexural eczema very often oozes, the affected areas of skin are usually dry and cracked and barely able to retain moisture. In the long term, these areas can become crusty and make the skin look coarser.
However, skin eczema is not only found in the bends of the joints, neurodermatitis also often occurs on the hands and neck.
To make matters worse, young children in particular are of course not yet in a position to assess how important self-discipline is at this point. The rule is: if it itches, you have to scratch it so that it no longer itches. However, scratched areas of skin are particularly at risk of infection with bacteria, viruses or fungi. So you catapult yourself directly into a vicious circle.
Time does not heal all wounds, but in around a third of children the symptoms reduce over the years and eventually disappear completely.
Adults in whom atopic dermatitis has not receded by puberty often suffer from symptoms such as itching and severe irritability of the skin, especially during acute flare-ups.
Atopic dermatitis usually occurs on the face. Depending on the individual course of the disease, local leathery thickening of the skin or small skin nodules may also occur, which cause an unpleasant tingling sensation.
Atopic dermatitis often affects the eyes in adulthood. The areas of the body that are characteristically affected by symptoms of the disease also include the forehead and neck as well as the insides of joints.
If the disease is mild, so-called minimal variants such as slight cracks in the skin at the corners of the mouth or on the ears and fingertips can occur. Episodic inflammation of the lips and eczema in the nipple area are also possible.
To say it straight away: the cause of neurodermatitis is not transmission from others. Instead, it is fairly certain that a genetic mutation is the cause.
This genetic mutation causes the skin to lose a lot of moisture and dry out quickly. The predisposition to atopic dermatitis is therefore hereditary.
It’s a widespread belief that goes hand in hand with most skin conditions, but one that absolutely must be addressed. Neurodermatitis in children and adults is neither contagious nor due to a lack of hygiene, whatever form it takes.
The exact cause of atopic eczema has not yet been sufficiently clarified. However, science assumes that the disease is multifactorial, in a sense a chain of unfortunate circumstances.
According to current knowledge, it all starts with a disruption of the skin’s barrier function. A lack of certain proteins causes the skin to build up its protective horny layer incorrectly and therefore dries out easily. Skin that is so dry is susceptible to external influences of all kinds.
In any case, everyone agrees that genetics play an important role. For example, a newborn with one affected parent already has a 40 percent risk of developing the disease. If atopic dermatitis is present in both parents, the figure rises to 70%.
In addition to a genetic predisposition, various risk factors can affect the severity of the disease or the frequency and severity of individual flare-ups. However, the range of possible factors is enormous and varies from patient to patient.
Like the clinical picture itself, the triggers for neurodermatitis are varied. If you have a genetic predisposition, symptoms do not necessarily occur. However, it is usually only a matter of time before certain triggers trigger atopic dermatitis flare-ups.
In addition to excessive hygiene, the most important influencing factors include allergens. These are irritants that are absorbed from the environment or through food and provoke an allergic reaction.
In winter in particular, the severe cold and dry conditions put a great strain on our skin. The sun can also have negative effects on the skin due to UV radiation and UV light.
If this is already impaired by an illness with atopic dermatitis, the extreme weather conditions can not only trigger symptoms, but even make them worse.
Various textiles can also be considered risk factors for some of those affected. For example, it is possible that patients react negatively to materials such as wool or to harmful substances in new and not yet (or incorrectly) washed clothing.
Risk factors for neurodermatitis patients also come from areas of activity such as nursing or agricultural professions. During this work, the skin often comes into contact with moisture and dirt.
Last but not least, patient-specific influencing factors such as tobacco smoke, hormonal fluctuations and heavy sweating can also trigger an atopic dermatitis flare-up. Depending on the type of trigger, we distinguish between 2 typical forms of atopic dermatitis.
In the much more common extrinsic form, antibodies of the immunoglobulin E (IgE) type are significantly elevated in the blood. Classic allergies in neurodermatitis sufferers are reactions to house dust mites as well as pollen and food.
In this type of atopic dermatitis, flare-ups can be triggered by these allergens, but also independently of them. It is important to emphasize that atopic dermatitis is not a food allergy, but sometimes occurs together with it.
In the intrinsic form of atopic dermatitis, the IgE level is in the normal range. This means that allergic reactions do not play a role in triggering atopic dermatitis in this case.
Thanks to long-term observations, we now know that an allergy, for example to food, can only develop as a result of the skin barrier disorder.
Then the intrinsic neurodermatitis becomes extrinsic. Therefore, the effective treatment of atopic dermatitis alone is an important and very probably decisive preventive measure to stop the further “career” of atopic dermatitis sufferers.
The human body is colonized by a large number of different microorganisms on the skin. The totality of these microorganisms is called the ‘microbiome‘.
It serves to maintain our health and is the first line of defense against pathogens. To ensure that invaders have little or no chance, we need a microbial diversity that offers no space for harmful germs.
Every person has an individual skin microbiome, which also differs greatly from one part of the body to another. This is altered in the case of skin diseases.
Although the dry and inflamed skin in atopic dermatitis is due to a disturbed skin barrier, the altered bacterial colonization is an important factor in the development of the disease.
The diversity of natural bacteria on the skin decreases as the severity of atopic dermatitis increases, creating space for harmful microorganisms.
These can now penetrate more easily and cause allergic reactions and infections. If the skin microbiome is brought back into balance, an improvement can be achieved.
Neurodermatitis can occur at any time, but it most frequently begins in infancy. In babies, atopic dermatitis symptoms often first become visible on the face and scalp.
Atopic dermatitis on the scalp of sick babies usually develops in the form of so-called cradle cap. Cradle cap owes its name to the typical scaly crusts that resemble burnt milk due to their white color.
Furthermore, babies suffering from atopic dermatitis often also have skin changes on the inside of their arms and legs. Occasionally, weeping eczema also occurs around the mouth.
In infants, the inflamed areas of skin increasingly move to the face, ears and other areas of the head. In young children, the bends of the arms and legs are often affected.
But the neck, face, buttocks and thighs, backs of the feet and hands of small children can also show the inflammatory, itchy skin changes.
The appearance of the skin often improves significantly over time. Nevertheless, particularly in severe cases, affected regions can thicken and result in a coarser structure of the skin, which can be recognizable for years to come.
Children who have or have had atopic dermatitis have an increased risk of developing other allergic diseases such as hay fever or asthma later in life.
If there is a genetic, hereditary predisposition to atopic dermatitis, new parents should find out about prevention and treatment options before the birth. treatment for children inform themselves. There are also some tips to follow to prevent the onset of the disease or at least to alleviate the symptoms.
Consistently applying a suitable skin care cream to the entire body every day seems to have a positive effect. It can also be helpful to avoid tight clothing made of synthetic fibers. Loose-fitting garments made of cotton or linen not only give young patients freedom of movement, but also reduce skin irritation and eczema.
However, according to a study, breastfeeding does not protect babies from developing atopic dermatitis. In the British-German ISAAC study, over 51,000 children between the ages of 8 and 12 from 21 countries were examined.
Overall, the study provided no evidence that breastfeeding protects children from developing atopic dermatitis. 1
A child with atopic dermatitis can go to kindergarten normally without any risk factors. Unfortunately, the looks and comments of other children, other parents and also teachers are often judgmental.
It is therefore particularly important that parents or guardians take care of their children. In this way, you can educate people about how to deal with the disease. It is important to note that the disease is not contagious. This enables children to better understand the disease and its treatment.
We not only need to sensitize ourselves, but also educate our children. Atopic dermatitis is not dangerous, but the skin disease can be extremely unpleasant for those affected.
Neurodermatitis cannot be cured and usually persists for the rest of the patient’s life. But there are many ways to alleviate the symptoms or at least make them disappear for a while.
However, there is no specific medication that helps all those affected. Every neurodermatitis sufferer must find out for themselves which therapy helps them best. If you suffer from atopic dermatitis, you should pay attention to three important points.
Whether it’s the winter cold or frequent bathing in summer, the skin of neurodermatitis sufferers is dry and stressed all year round. It is therefore particularly important to find individually effective care products. Use rich creams and cleansing products that provide your skin with lasting moisture instead of drying it out.
Which product is suitable in each individual case depends very much on the condition of the skin. As a general rule, the better the skin condition, the more oily the care product can be. If the itching is severe, it is better to use aqueous lotions. These are also better tolerated in contact with weeping skin eczema.
Atopic dermatitis creams are generally not only moisturizing. They may also contain additional substances to alleviate the symptoms.
Products containing urea, for example, not only moisturize but also relieve itching. In the severe stage, often only ointments containing cortisone, which are individually formulated by the dermatologist, can help.
In any case, it is important to ensure that the creams used are free from preservatives and fragrances. Otherwise there is a risk of developing an additional contact allergy. It is therefore advisable to obtain skin information and product tips from a dermatologist.
First and foremost, of course, it is important to avoid your individual triggers. The correct handling of provocation factors can provide initial help. Try to eliminate foods, fragrances or other triggers that usually trigger acute flare-ups from your life as much as possible. The rule here is: every beginning is difficult. Especially when your favorite chocolate is responsible for acute flare-ups, giving it up is often not easy.
But discipline definitely pays off here. You should notice an improvement in the appearance of your skin and relief of symptoms after just a short time.
If you see initial success, abstinence is usually no longer a major challenge. What’s the saying? Humans are creatures of habit.
Many doctors now agree that some food ingredients trigger allergies and promote skin diseases such as neurodermatitis.
The ingredients of certain foods include, for example, flavor enhancers such as glutamate, but also spices and colorings. Eggs, milk, citrus fruits and nuts are also a common problem. In addition, coffee and alcohol can also lead to a worsening of skin symptoms and eczema.
For these reasons, it is particularly important to consider the diet for atopic dermatitis. Any ingredients and foods that could exacerbate the disease should be removed from the diet.
However, there is no general guideline for the right atopic dermatitis diet. It is therefore always advisable to consult your doctor about your diet in order to discuss possible diet plans.
Skin and psyche are closely linked. It’s not for nothing that people say that you “don’t feel good in your skin” or “fly off the handle”.
With neurodermatitis, it is not only physical health that plays a decisive role, but also mental health in particular. Stress and psychological strain can significantly increase the symptoms of atopic dermatitis.
People with atopic dermatitis suffer from stigmatization, bullying and exclusion, especially during puberty. Frequent absences from school and severe restrictions on leisure activities with friends are part of everyday life for those affected by the skin disease. Agonizing itching often prevents them from sleeping.
It triggers irritability and a lack of concentration, which in turn increase stress. A cycle that is difficult to escape. At this particularly difficult time of life, this enormous loss of quality of life can quickly have a strong psychological and emotional impact.
However, neurodermatitis in adults can also be exacerbated or triggered by psychological stress. Atopic dermatitis sufferers are usually advised to reduce stress and psychological strain, but this is not as easy as it sounds.
Relaxation techniques such as autogenic training or meditation have proven to reduce existing tension.
The environment should be informed about neurodermatitis, especially in children. If the classmates know about the illness, it is often easier for everyone involved and the emotional burden on the patient is less.
Neurodermatitis affects the whole family. Parents and siblings should therefore seek professional training. The more calmly relatives deal with the disease, the more support atopic dermatitis sufferers receive and the lower the stress level.
There are a variety of over-the-counter and prescription creams and ointments to help manage the symptoms of atopic dermatitis. Nevertheless, classic dermatitis home remedies can also be recommended for treatment. For example, a tincture or certain herbs can help against neurodermatitis.
They can combat itching in a natural way and help to rebuild the body’s own protective barrier of dry skin. The effect has not yet been scientifically proven, but some neurodermatitis patients report positive effects after using home remedies.
There are various healing methods of alternative or complementary medicine that are used in the treatment of neurodermatitis. Although its effectiveness has not been scientifically proven, homeopathy is predominantly used.
Symptoms of neurodermatitis such as dry skin or inflammatory skin changes can be successfully alleviated with Schuessler salts, for example.
Some patients also use the moisturizing and regenerative properties of aloe vera to supplement the treatment of atopic dermatitis. The cactus-like plant has a cooling effect and antibacterial properties, which can particularly promote the healing of skin eczema.
In addition, valuable plant oils such as evening primrose oil, black cumin seed oil and borage seed oil are said to have positive effects on skin diseases. They provide a lot of gamma-linolenic acid.
This omega-6 fatty acid can have an anti-inflammatory effect on eczema. The linoleic acid in argan oil is also said to promote the healing of skin eczema. ern
Newer approaches, on the other hand, focus more on the weakened skin microbiome. The aim is to prevent or at least better control atopic dermatitis infections with the help of so-called bacteriophages. The microbiome of the skin is stabilized and strengthened by the phage application for neurodermatitis.
Although no cure is possible, the microbial skin balance can be restored with the use of phages, thus reducing redness and itching.
Ultimately, neurodermatitis is more than just a skin disease. It is a major challenge of our time – for the individual affected, their social environment and medicine. The effects on everyday life and interpersonal relationships are very real and should not be neglected.
However, there are solutions: If you suffer from atopic dermatitis, you should see a dermatologist who will confirm the diagnosis, recommend appropriate treatment and improve the course of this chronic disease.
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