Neurodermatitis - causes, symptoms and care tips

You don't want to be in that skin. However, around 2 million children and 2.5 million adults are affected by the skin condition atopic dermatitis every year (source: German Dermatological Society). It is estimated that around 14% of all people will suffer from this skin condition at some point in their lives. This makes atopic dermatitis one of the most common chronic skin diseases and is now even considered a disease of civilization. All the more reason to pay a little more attention to the topic. Because the more you know about your unpleasant companion, the better you can deal with it. In this article, you can find out the best way to make friends with it and what you can do about it. 

1 What is atopic dermatitis? Atopic eczema or atopic dermatitis? Clarity in the jungle of terms  

The term "neurodermatitis" is derived from the Greek and refers to nerve, skin and inflammation. Although it is now known that inflammation of the nerves is not the cause of these skin changes, the term atopic dermatitis is still widely used. Doctors, on the other hand, prefer the terms "atopic dermatitis" or "atopic eczema". Both indicate an inflammatory reaction of the skin in combination with an increased tendency to allergies and hypersensitivity reactions. 

2 How does atopic dermatitis develop and where does it come from? 

The jungle of terms makes it clear how complex the causes of atopic dermatitis are. Many are still unexplored. However, one thing is clear: it is a complex interplay of genetic predisposition and environmental factors.

In most cases, the starting point is a genetic predisposition. If both parents suffer from atopic dermatitis, the probability that the child will also be affected is 60 to 80%. Over time, 31 gene regions have been identified that play a role in the development of atopic dermatitis. Genetic defects lead to a lack of certain proteins that the skin normally needs to build up its protective horny layer. The composition of skin lipids also appears to be disturbed in people with atopic dermatitis, which leads to an enormous loss of moisture. The defective structure of their barrier layer leads to extremely dry and cracked skin, making it the weak point of our body. However, this predisposition alone does not make us ill, but only susceptible. If unfavorable environmental influences are added, the disease reveals its unpleasant side. Pathogens and allergens, which normally find it difficult to pass through our skin, now penetrate more easily. The substances, which are usually completely harmless, are wrongly identified as enemies by allergy-prone people and trigger inflammatory processes. The immune system reacts with a so-called sensitization, in which cells of the immune system produce antibodies/immunoglobulins against the substances (antigens). When an antibody binds to an allergen, it activates the release of inflammation-promoting messenger substances.

Atopic dermatitis often develops in infancy or early childhood. The good news is that in around 60% of children with the disease, the symptoms subside by early adulthood. 

3. how can I tell if I have atopic dermatitis?

Atopic dermatitis often manifests itself with the following symptoms: 

• Dry and sensitive skin
• Agonizing itching
• Reddened skin, blisters
• Scaly, weeping patches 

Typical symptoms of an acute episode of neurodermatitis are

• Severe itching with scratching attacks
• Reddening of the skin
• Swelling and blisters
• Weeping skin areas
• Crust and scale formation

Apart from the visible skin symptoms, the itching in particular is extremely stressful. The constant scratching causes additional damage to the skin. Injuries to the skin with bloody wounds further fuel the inflammatory processes. Insomnia and fatigue are noticeable through reduced performance.

For many sufferers, this means a considerable reduction in quality of life. And the psychological stress often contributes to a further worsening of the skin condition. In the following sections, you will find a little help on how to break this treacherous itch-scratch cycle.  

4. provocation factors - atopic dermatitis skin does not like that at all!

Once your skin's reactivity is increased, it reacts extremely sensitively to certain key stimuli. The severity and threshold at which the body reacts to these stimuli varies from person to person: 

• Climate 
• Allergens (animal hair, pollen, food)
• Infections
• Psychological factors (stress, overexertion, anxiety, excitement) 
• Chemical skin irritants (chemicals, alkalis, soaps) 
• Mechanical skin stimuli (wool, brush)
• Drying out of the skin
• Heavy sweating (sport, sauna, warm and humid climate) 

5. how you can make friends with your skin again!

Although there is still no cure for atopic dermatitis, it can be managed well. As we have learned, the causes, trigger factors and symptoms are so complex that the most important thing is to get to know your atopic dermatitis. You don't have to become their best friend, but if you show a little understanding and respond to their individual needs, you may be able to establish a more relaxed relationship between you. Once you have swallowed your anger and rage at the itchy spots, they may leave you alone for longer periods of time. But even at these times, atopic dermatitis skin needs attention and care. To improve the general condition of your skin, you cannot avoid continuous skin care. The best way to counteract the skin's barrier effect is with a moisturizing cream . And with quite a lot of it: an adult with atopic dermatitis needs a good kilogram of cream per month! 

Once you have found out what additionally irritates your skin, avoid or reduce these provoking factors. This also includes foods to which you are allergic. And if you do start to itch, try to stop scratching. The skin will only react with renewed inflammatory processes and won't be able to rest. You can also clench your fists or gently tap the affected areas, even if you are annoyed. 

Skin care - how to cleanse and moisturize your skin properly
The same applies here: get to know your skin and adapt your skin care routine to your individual skin condition and the course of the disease. Pay particular attention to the ingredients in your skincare. If possible, avoid products with fragrances, colorants and preservatives as well as substances that can trigger contact allergies. Your basic skincare should always be a combination of oil and moisture. Keep the following rule in mind: the more inflamed the skin, the more moisturized the base should be. For extremely dry areas and in winter, it can be a little greasier. 

You should use as little water and cleanser as possible when cleanser cleansing your skin. This encourages the skin to dry out and further weakens the barrier function. Oil and Dead Sea salt baths are particularly suitable, which you can also try out as a cure over a few weeks.

You should also make sure not to use irritating products at Haircare and avoid fragrances. I recommend our Sensitive care line. Panthenol works calming and moisturizes. Lactococcos Ferment Lysate from peas protects the skin microbiome and reduces the sensitivity of the scalp. Almond Oil provides the scalp and hair with vitamins and nutrients and sodium PCA helps to bind and retain moisture. 

Time out for you and your skin
A proven therapy for atopic dermatitis is spending time in skin-friendly climatic regions. Why certain climatic conditions achieve such good results cannot be explained with scientific precision. It may be due to a lower pollen and pollutant load in the air or the peace and relaxation that patients experience during these days. The Dead Sea region is said to have a particularly beneficial effect. This climate filters out harmful UVB rays so that you can stay in the sun longer than usual and benefit from its anti-inflammatory potential. The high salt content of the sea makes it easier for the sun's rays to penetrate into the deeper layers of the skin and, thanks to magnesium, has an additional effect anti-inflammatory. 

A stay in the mountains can also have a positive effect on your skin condition. The healing effects of high altitudes are recommended by many patients. However, if you don't have any options or simply aren't the type for mountains and the sea, bring your vacation home and create your own oasis of calm. Effective relaxation techniques are offered by sports clubs, adult education centers and online, and range from breathing exercises, meditation and autogenic training to yoga. The influence of your emotional world on the course of atopic dermatitis should not be neglected under any circumstances. 

However, you should always seek medical advice for the treatment of acute flare-ups. The German Dermatological Society has developed a step-by-step plan that recommends a specific range of treatments depending on the severity. If the inflamed eczema is treated effectively, the skin barrier can regenerate and a worsening of the symptoms can be prevented.

The right diet as a game changer?
Many food allergies are directly linked to atopic dermatitis, particularly when it comes to diet. In some cases, various foods can actually have a negative impact on the condition of your skin:What should you not eat if you have atopic dermatitis? Histamine (cheese, red wine), citrus fruits, alcohol and coffee are often not well tolerated by neurodermatitis patients. As our gut and its mix of microbes also influence our immune system, diet plays an important role in our well-being and health. However, there is no one-size-fits-all diet to improve the symptoms of atopic dermatitis; it is necessary to find out in each individual case which foods cause the skin to deteriorate. If you have any suspicions, you should consult your doctor for a more precise diagnosis. 

The best way to track down suspicious ingredients is to keep a food diary. As a blanket avoidance of important staple foods can lead to a nutrient deficiency, you should really only avoid foods that have been proven to be a provoking factor for you Treat. 

6 My personal tips: What helps with neurodermatitis?

Easy to write, hard to do! If you are affected yourself, you can probably only laugh at the "don't scratch" tip. Maybe you can manage to agree on a peaceful "coexistence" with your atopic dermatitis skin. With enough attention - without too much of it. Because as the saying goes, "too much attention makes even a donkey think it's a lion".

Sources:
https://www.allergieinformationsdienst.de/krankheitsbilder/neurodermitis/therapie.html
https://fet-ev.eu/neurodermitis-krankheitsbild/
https://www.apotheken-umschau.de/krankheiten-symptome/hautkrankheiten/hautpflege-bei-neurodermitis-720747.html
Elsässer Sabine, Körperpflegekunde und Kosmetik, Springer Medizin Verlag Heidelberg 2008