Neurodermatitis can be effectively managed through a combination of topical corticosteroids, oral antihistamines, local cold compresses, psychological counseling, and avoiding scratching. The condition is typically caused by impaired skin barrier function, stress, allergic reactions, mechanical irritation, and genetic factors.
Topical Corticosteroids
Mild to moderate neurodermatitis can be treated with medium to low-potency corticosteroids such as hydrocortisone butyrate or mometasone furoate cream, which can quickly relieve itching and inflammation. For stubborn lesions, high-potency corticosteroids like halobetasol propionate may be used short-term under medical guidance. For facial and thin-skinned areas, low-potency corticosteroids are recommended to avoid prolonged use exceeding two weeks.
Oral Antihistamines
Second-generation antihistamines like loratadine and cetirizine can block histamine receptors, reducing itching and the urge to scratch. First-generation antihistamines with mild sedative effects, such as diphenhydramine, can be used for nighttime itch control. In cases of anxiety, antidepressants with antihistamine properties, like doxepin, may be prescribed.
Local Cold Compresses
During the acute phase, apply a cold towel at 4-6°C to the affected area for 10 minutes, 2-3 times daily. Cold stimulation constricts capillaries and reduces nerve sensitivity, alleviating itching. Avoid direct contact with ice and apply moisturizers immediately after compresses to repair the skin barrier.
Psychological Counseling
Cognitive-behavioral therapy can help break the scratching habit, while biofeedback training can manage stress responses. For anxiety or depression, selective serotonin reuptake inhibitors (SSRIs) like paroxetine can regulate neurotransmitters. Establishing a regular sleep schedule with 7-8 hours of sleep can help lower cortisol levels.
Avoiding Scratching
Keep nails short and smooth, and wear cotton gloves at night. When itching is severe, use the pads of your fingers to press instead of scratching, or pat the surrounding normal skin to divert attention. Wear loose, cotton clothing to avoid friction from wool or synthetic fabrics. Keep bath water temperature below 37°C and reduce the frequency of soap use.
General Management Tips
Maintain a light diet, limit spicy foods and alcohol, and supplement with omega-3 fatty acids from sources like deep-sea fish and flaxseeds. Choose breathable cotton clothing and avoid synthetic materials. Keep a skin care diary to record triggers and engage in at least 30 minutes of aerobic exercise like swimming or brisk walking weekly. Clean sweat promptly after exercise. Use a humidifier in winter to maintain indoor humidity at 50%-60%, and apply ceramide-containing moisturizers within 3 minutes after bathing. If symptoms worsen or secondary infection occurs, visit a dermatologist promptly.
Conclusion
Effective treatment of neurodermatitis involves a comprehensive approach combining medical therapies, psychological support, and lifestyle adjustments. By following these strategies, patients can achieve faster relief and better manage their condition.
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