Neurodermatitis

First, check the cause

Neurodermatitis (lichen simplex chronicus) starts with an itch. Scratching makes it itch more, and over time the skin thickens. Breaking this itch–scratch cycle is the key. Stress, anxiety and other skin problems such as eczema can set it off.

How it is treated

• A thick, fragrance-free moisturizer every day, and lukewarm, not hot, showers.
• A steroid cream or ointment for a few weeks, used as directed. Covering the patch helps the cream work and stops the scratching.
• Breaking the scratch habit: short nails, cotton gloves at night, a cool pack instead of scratching.
• Treating stress, anxiety and poor sleep, which keep the itch going.
• Acupuncture: very thin needles. It eases the itch and the urge to scratch, and calms the stress and poor sleep that keep it going.
• Chinese herbs, prescribed for your pattern, to calm the itch and soften thickened skin. They are checked against the medicines you already take.
• A referral to a dermatologist, if needed.

How many visits

Usually once a week at first. Six to eight visits make a course; then you and Dr. Pan look at how much better you are: less itch, less scratching, softer skin.

Common questions

Is it contagious?

No. It cannot spread to other people.

Are steroid creams safe?

Used as directed, for a limited time, yes. Long use on the same spot can thin the skin, so Dr. Pan checks how strong a cream you use, and where. Milder creams are used on the face, groin and skin folds.

How do I keep it away?

Keep the skin moist, and stop the scratching early, especially at stressful times. This helps keep it away.