Neurodermatitis/atopic dermatitis is a chronic disease with an episodic course which typically occurs in infancy.
The skin disease is based on a hereditary predisposition. The symptoms appear in the first five years of life in 85% of cases. In atopic dermatitis the condition of the skin is constantly changing. The symptoms can appear simultaneously or in varying degrees.
The causes of neurodermatitis are many and varied. Genetic predisposition, environmental factors as well as inflammation taking place in the skin play a role. This reduced skin barrier is caused by a deficiency, an imbalance or defective functioning of substances (e.g. proteins or fats) that are responsible for the formation of the upper layer of the skin. As a result, more water evaporates and the skin becomes dry. In addition, the skin becomes more permeable to allergens and other environmental substances. These can trigger inflammatory reactions.
As well as the changes to the structure of the skin, climate/weather, psychological stress, chemical irritants (e.g. shower and washing products), etc. have an influence on the skin’s condition. The triggers for an episode of neurodermatitis differ from one person to the next and can change during the course of a lifetime. Several factors frequently play a part, which is why it is often difficult to identify the trigger or triggers.
In atopic dermatitis the condition of the skin is constantly changing. The following symptoms may occur:
These symptoms can appear simultaneously or in varying degrees. The eczema appears on typical areas of skin, depending on the sufferer’s age. During infancy it mainly affects the face, the upper body, hands and extensor surfaces of the arms and legs. In small children, the episodes mainly occur in the hollows of the knees, elbows, on the face, neck and throat. Hand and foot eczema may additionally be observed in older children, adolescents and adults.
There is no laboratory test to establish atopic dermatitis. The diagnosis is based on the typical symptoms listed above. This requires a thorough discussion between the doctor and the parents or the sufferer as well as examination of the skin. Atopic illnesses in the family can be an important indicator.
Skin diseases such as psoriasis can sometimes cause similar symptoms. Detailed investigations with a dermatologist can provide the necessary information.
Basic care is the foundation of treatment for atopic dermatitis. It involves cleansing and moisturizing the skin. This can prevent infections while suitable care products supply the skin with fat and moisture. Unfortunately, there is no general “all-in-one product” for all sufferers. The choice of care product should be adapted to the seasons:
Many sufferers experience severe itching. Scratching will temporarily get rid of the itching but it damages the skin, which in turn encourages itching. The aim of treatment is to break this vicious circle between itching, scratching and deterioration in the skin's appearance. Various measures may be helpful in this situation, e.g. cooling, skin-friendly and breathable fabrics, compresses and dressings with black tea, table salt or ointments.
If the condition of the skin deteriorates despite good basic care, anti-inflammatory therapy is often necessary as an additional measure. Cortisone creams and ointments and calcineurin inhibitors/immunomodulators are available for this purpose.
There are various possible factors, such as stress or miscellaneous irritants, that have an adverse effect on the condition of the skin. These should be avoided as far as possible.
Around 20% of children in Switzerland are affected by atopic dermatitis. The rate in adults is thought to be 4–5%. The symptoms appear in the first five years of life in 85% of cases.