In addition to other skin conditions such as perioral dermatitis, psoriasis & co., which we have already discussed here on the blog, but also in our #skintalk series on Instagram, atopic dermatitis should of course not be missing.

And why should it not be missing? Because it is one of the most common skin conditions of all, although you are probably more familiar with it as atopic dermatitis. That's why I'm particularly keen to write about it and give you tips on how you can support your skin in the best possible way.

It is therefore particularly important to understand what happens to the skin with atopic dermatitis. If you are affected yourself, you may already know this, but I am still in favor of educating as much as possible in order to bring more and more knowledge into these areas of skin care and thus also more understanding and at the same time less shame. 

This is because changes to the skin are usually easy to see from the outside and are difficult to hide. This makes the whole thing very psychologically stressful for those affected. Keyfact to this: Factors such as stress and internal pressure are often among the triggers, as they stimulate certain immune cells which in turn send out inflammatory messengers! Not good. 

So the more we talk about it openly, the more we can take the pressure off and give the skin the chance to heal. 

In this article you will learn 

1. What exactly is atopic dermatitis and how does it manifest itself? 
2. How does atopic dermatitis develop? 
3. What factors can promote a new flare-up? 
4. What else you should look out for
5. What you can do for atopic dermatitis 
6. My 7 tips for atopic dermatitis  
   
   

1 Definition: What exactly is atopic dermatitis and how does it manifest itself? 

Neurodermatitis is a chronic skin disease that improves in phases, but can also worsen again. In technical terms, this condition is called chronic recurrent. 

This mainly manifests itself in pronounced itching, dry skin and eczema, i.e. severely inflamed areas. Typically, these symptoms already occur in childhood and are more widespread here: 10-15% of all children suffer from it. However, in most cases it disappears again during puberty, which is why only 1-3% of all adults are affected. 

In adults, atopic dermatitis usually manifests itself on the arms, knees and other flexed areas, but also on the hands. In children, it is more common on the cheeks, arms and legs. 

In infants, one indication of atopic dermatitis could be so-called cradle cap. A crusty rash on the head and to face. In childhood, the rash is mainly found on the flexor sides of the arms and legs, but also to face and on the neck. Due to the itching, children often find it difficult not to scratch the affected areas. Therefore, in addition to the dry skin flakes, papules and redness typical of the disease, the open areas of skin quickly become inflamed and crusty.

Atopic eczema on the elbow 

Neurodermatitis can therefore manifest itself very differently and particularly in different areas. However, the main symptom remains severe itching, which is also obligatory for the final diagnosis, i.e. it must be present. 

Of course, the increased risk of infection from bacteria, which can penetrate more quickly due to the dry, cracked skin and the resulting damaged skin barrier and cause additional illnesses, is particularly problematic here. More on this below under point 5.

Although the number of new cases has doubled in the last 10 years, the cause of this skin disease is not yet fully understood. However, links are seen between the functioning of the immune system and allergic reactions. In most cases, certain trigger factors have triggered the skin reaction. 

However, the fact that it can be passed on through hereditary predisposition has already been proven and applies to around 70% of all sufferers. 

2 Pathogenesis: How does atopic dermatitis develop?

As the triggers for neurodermatitis, apart from genetic heredity, have not yet been fully researched, I can only give you the suspected and currently discussed causes: 

• a malfunction of the skin immune system
• Disorders of the neurovegetative system, i.e. the body's main control center is not functioning properly
• The horny layer of the skin exhibits unusual properties and structural changes occur in important components such as Ceramides, proteins and enzymes
• According to new findings, researchers also assume that the natural skin barrier is not fully functional in atopic dermatitis, as it has been established that it lacks an essential protein that is responsible for the formation of structure and keratinization, i.e. stabilization of the skin. Another aspect of the impaired skin barrier is a lipid metabolism disorder in the skin. This results in a lack of lipids, which is why the skin is dry and irritated. This condition promotes inflammation and thus favors infections.
• It is also assumed that neuropeptides, i.e. messenger substances released by nerve cells, are associated with the development of atopic dermatitis. Stress and psychological strain are also known to be factors in the development of atopic dermatitis. 
• In the case of genetic predisposition, the probability is 60-80% if both parents have the disease.
  
  

We can therefore see that atopic dermatitis can have many different causes. It is therefore a so-called multifactorial disease, as is the case with many other skin conditions! 

3. trigger factors: Which factors can promote a new flare-up?

Neurodermatitis in the décolleté

As I mentioned at the beginning of the article, the manifestation of atopic dermatitis can be weaker or stronger in phases and can also be completely absent. This is why we talk about so-called flare-ups. These flare-ups are often triggered by substances or situations. Here are some general examples:

• Aggressive cleaning agents
• Contact with environmental allergens (animal hair, pollen, house dust mites, etc.)
• certain ingredients in food (e.g. milk, citrus fruits, etc.)
• Stress
• Sweat
  
  

It is therefore best to pay particular attention to the following circumstances and factors that could either trigger a flare-up or make it worse: 

• Allergens / pollen Animal hair Food 
• Infections 
• emotional strain / stress overexertion anxiety excitement 
• Mechanical skin stimuli / scratchy fabrics, brushes
• Drying out of the skin / heating air
• heavy sweating / sports, sauna, warm and humid climate 
• Climate and weather fluctuations in general
• Hormone fluctuations
• Nutrition / best. Intolerances
• Intestinal health 
  
  

4. complications: What else you should look out for! 

Due to deficits in the skin barrier, the skin flora is usually disturbed. This means that the bacteria, viruses and fungi that are naturally present on our skin are out of balance and can no longer protect us as well against unwanted intruders Protect. 

Weeping, scratched areas pose a high risk of infection, e.g. from staphylococci, which can be extremely persistent in severe cases. Therefore, take special care not to scratch the itchy areas. Even though this is probably one of the hardest exercises!

The dryness of the skin also makes it particularly easy for yeasts and fungi to settle in the small cracks, further intensifying the inflammatory reaction. 

A weakened immune system can also allow herpes viruses to become established more quickly. 

5. therapy: What you can do for neurodermatitis!

With all the causes and unpleasant effects that are not entirely clear, I would now like to give you a small glimmer of hope on the horizon. 

The most important thing is to avoid substances and situations that trigger flare-ups. For example, make sure not to wear wool, wear gloves when cleaning and avoid mechanical irritants such as friction. To counteract the dryness, oil baths or creams containing urea can help. 

In acute flare-ups, antihistamines and glucocorticoids, which are steroid hormones, can relieve itching. However, you should not use glucocorticoids for too long in order to avoid thinning or atrophy of the tissue. If possible, you should of course avoid them altogether, but I would still like to show you all the options here. 

In the case of more serious infections, it is of course always advisable to consult a dermatologist to prevent the infection from spreading! 

In 2018, dupilumab was approved for treatment as a so-called biological and shows great promise as a low-side-effect alternative to systemic, i.e. oral, therapies. Biologicals are drugs that are produced with the help of biotechnology and genetic engineering. They are usually antibodies, the body's own messenger substances and proteins.

The approval of further biologicals is currently under review, so we can assume that dupilumab will soon no longer be the only alternative. 

6 My 7 tips for neurodermatitis

However, as it is important to me that you can also support your skin yourself and are not dependent on doctors etc., I will give you some more tips that you can also implement for yourself, so that you can take the health of your skin into your own hands! 

The be-all and end-all of skin care for atopic dermatitis is good basic care and the awareness that your skin is an organ that needs a lot of attention and loving care. 

This will support your skin barrier, relieve itching and minimize the risk of inflammation.