Neurodermatitis is a chronic skin condition that develops when a person repeatedly scratches or rubs the same area of skin. Over time, this leads to irritation, thickening, and visible lesions. Although neurodermatitis can affect any part of the body, it most often appears on the arms, neck, or legs.

Also called lichen simplex chronicus, this condition can be triggered by emotional stress, fatigue, extreme temperatures, allergies, or insect bites. Because scratching increases irritation, breaking the itch-scratch cycle is key to healing.

Treatment for neurodermatitis focuses on repairing the skin and relieving itching. In some cases, identifying and avoiding triggers such as allergens or irritants is essential for preventing flare-ups.

Main symptoms

Common symptoms of neurodermatitis include:

Persistent itching in a specific area;
Thickening of the skin;
Flaking or scaling of the affected area;
Redness or darkening of the skin;
Well-defined, rough, or scaly lesions;
Small open sores caused by scratching.

These symptoms are most often seen on the arms, neck, and legs but can also affect the scalp, elbows, wrists, hands, and ankles.

Confirming a diagnosis

A dermatologist can diagnose neurodermatitis based on a physical exam, along with a review of symptoms, medical history, and any known allergies.

Additional tests may include dermatoscopy, which allows a closer look at the affected skin, and blood tests such as a complete blood count (CBC) or immunoglobulin levels to rule out underlying conditions.

A skin biopsy may also be performed to rule out other skin diseases, including psoriasis or cutaneous T-cell lymphoma.

Possible causes

Several factors can contribute to the development of neurodermatitis:

Emotional: Stress, anxiety, and fatigue can overstimulate the nerves in the skin, triggering itching;
Physical: Contact with irritants like certain fabrics, insect bites, or allergens can provoke inflammation;
Environmental: Excessive heat, cold, or sweating may also worsen symptoms.

Localized forms of neurodermatitis often result from allergic reactions, such as insect bites or contact dermatitis.

Treatment options

Treatment is prescribed by a dermatologist and aims to calm the skin, reduce inflammation, and prevent further scratching.

1. Medications

Common treatment options include:

Topical corticosteroids (such as hydrocortisone or clobetasol) to reduce inflammation and skin thickening;
Topical calcineurin inhibitors (like tacrolimus or pimecrolimus) to relieve itching when corticosteroids are not suitable for long-term use;
Topical doxepin cream or salicylic acid formulations to reduce itching and help smooth the skin;
Oral antihistamines (such as cetirizine or diphenhydramine) or anxiolytics in cases where stress or anxiety worsen symptoms;
Topical lidocaine or capsaicin creams to desensitize the nerves and relieve itching;
Topical or oral antibiotics if the affected area becomes infected;
Coal tar preparations, available in over-the-counter creams and shampoos, to soothe itching and inflammation under medical supervision.

Dermatologists may also recommend covering the area with a zinc oxide dressing or plastic wrap to prevent scratching and enhance treatment absorption.

2. Daily care

Daily habits are essential for managing neurodermatitis. Helpful steps include:

Applying dermatologist-recommended moisturizers regularly to keep the skin hydrated;
Drinking plenty of water to support skin moisture;
Using cool compresses before applying medicated creams to improve absorption and relieve itching;
Wearing loose-fitting clothing made from natural fibers like cotton to minimize irritation;
Taking short, lukewarm baths instead of hot showers;
Keeping nails trimmed to avoid injuring the skin while scratching.

Relaxation practices such as yoga, mindfulness, or progressive muscle relaxation can also help lower stress and reduce the urge to scratch.

3. Talk therapy

When emotional stress is a major factor, talk therapy can help manage anxiety, identify triggers, and break the habit of scratching.

Working with a mental health professional may improve both emotional well-being and skin health.

4. Botox injections

In rare cases where other treatments are ineffective, botulinum toxin type A (Botox) injections may be used off-label to treat neurodermatitis. This treatment reduces nerve activity in the affected skin, decreasing itching and promoting healing.

5. Phototherapy

For chronic or severe neurodermatitis, phototherapy using controlled ultraviolet light can reduce inflammation and calm the immune response. It is typically used when topical or oral treatments are not sufficient.

Can neurodermatitis be cured?

With proper treatment, neurodermatitis can heal completely. Most people notice improvement within 3 to 5 days of starting treatment.

To prevent recurrence, it is essential to identify and avoid triggers that cause itching and to refrain from scratching the affected area.

Maintaining healthy daily habits and managing stress also play key roles in long-term prevention.

Neurodermatitis: Symptoms, Causes & Treatment