Neurodermatitis is not caused by bacterial infection but is associated with impaired skin barrier function, immune abnormalities, and neuro-psychological factors. Key triggers include chronic scratching, stress, allergic reactions, genetic predisposition, and dry environments.
Chronic Scratching
Repeated mechanical friction can damage the skin barrier, leading to thickening of the stratum corneum and the release of inflammatory mediators. Long-term scratching creates a vicious cycle of “itch-scratch-itch,” clinically presenting as lichenification and hyperpigmentation.
Stress
Emotional fluctuations such as anxiety and depression can trigger the release of neurokinin P substance, stimulating mast cell degranulation and causing itching. Approximately 60% of patients experience significant stressors, such as work pressure or family changes, before the onset of the condition.
Allergic Reactions
Contact with allergens like nickel and hair dyes can induce Type IV hypersensitivity reactions. Some patients have a history of atopic dermatitis, with elevated serum IgE levels indicating abnormal Th2 immune responses.
Genetic Predisposition
Mutations in the FLG gene lead to insufficient filaggrin synthesis, reducing the skin’s water retention ability. Individuals with a family history have a threefold increased risk of developing the condition, often co-occurring with psoriasis, asthma, and other immune-related diseases.
Dry Environment
Low humidity environments accelerate transepidermal water loss and disrupt the skin’s microbiome balance. The incidence significantly increases in winter, closely related to reduced sebum secretion and the use of heating.
Management Tips
Avoid hot water and alkaline cleansers, wear pure cotton clothing to reduce friction, and use moisturizers containing urea or ceramides to repair the skin barrier. Cold compresses 2-3 times a week can help relieve itching. For those with significant anxiety, mindfulness meditation may be beneficial, and severe cases may require dermatological and psychiatric intervention. Maintain indoor humidity at 40%-60% in winter, and keep bath water temperature below 38°C.
Conclusion
Neurodermatitis is a complex condition influenced by multiple factors, none of which involve bacterial infection. Understanding these factors and implementing appropriate management strategies can help alleviate symptoms and improve quality of life.
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