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Diseases and Conditions
Neurodermatitis (lichen simplex chronicus)
From MayoClinic.com
Special to CNN.com


Neurodermatitis — also known as lichen simplex chronicus — is a stubborn skin condition characterized by chronic itching and scratching. Eventually, the affected skin becomes thick and leathery.

Neurodermatitis isn't serious — but breaking the itch-scratch cycle can be challenging. Successful treatment depends on identifying and eliminating factors that may be aggravating the problem. Over-the-counter and prescription creams can help. Once the scratching stops, it can take months for the skin to return to normal.

Signs and symptoms

The primary symptom of neurodermatitis is itchy skin — often on the neck, wrist, forearm, thigh or ankle. Sometimes neurodermatitis affects genital areas, such as the vulva or scrotum.

The itchiness tends to come and go. It may be most noticeable when you're at rest — watching TV or sleeping, for example — and disappear when you're active. Anxiety or stress can make the itchiness worse. Eventually you may scratch simply out of habit.

The affected patches of skin often have a leathery or scaly texture. The patches may be raw, red or darker than the rest of your skin.


The exact cause of neurodermatitis isn't known. Sometimes neurodermatitis begins with something that simply rubs or irritates the skin, such as tight clothing or a bug bite. As you rub or scratch the area, it gets itchier. The more you scratch, the more it itches.

In other cases, neurodermatitis is associated with other skin conditions — such as dry skin, eczema or psoriasis. Stress and anxiety can trigger itching, too. Allergies don't seem to be a factor.

Risk factors

Neurodermatitis is most common between ages 30 and 50. Women are affected more often than men. You're more likely to develop neurodermatitis if you have a personal or family history of eczema, psoriasis or similar skin conditions.

When to seek medical advice

Consult your doctor if you notice changes in your skin or if you catch yourself repeatedly scratching the same patch of skin.

Screening and diagnosis

Diagnosis is typically based on your skin's appearance and a history of itching and scratching. A tissue sample (biopsy) can be examined to confirm the diagnosis. Blood tests or other lab studies may be done as well.


Persistent scratching can lead to a bacterial skin infection and permanent scars or changes in skin color.


To stop the stubborn itch-scratch cycle, you must stop scratching the affected area. It's bound to be tough, but you can do it. And your doctor can help.

  • Try an over-the-counter or prescription cream. Over-the-counter hydrocortisone creams or prescription steroid creams can help ease itching and inflammation. Soaps or lotions containing coal tar may be helpful, too.
  • Try other types of medication. Sometimes antihistamines help stop itching. In other cases, steroids may be injected directly into the affected area to reduce itching. Antidepressants or anti-anxiety medications are helpful for some people. If you develop a bacterial infection in the rash, your doctor may prescribe an antibiotic lotion or oral antibiotics.
  • Cover the affected area. Bandages or dressings can help protect the affected area. This may be especially important if you scratch during your sleep.
  • Avoid things that increase itching. Limit your time in the tub or shower. Bathe in warm — not hot — water. Use gentle cleansers or gels with added moisturizer. Gently pat your skin dry. Use plenty of moisturizer.
  • Keep stress under control. Stress and anxiety can trigger itching.
  • Consider counseling. A counselor can help you learn how your emotions and behaviors can fuel — or prevent — itching and scratching.

Even after successful treatment, mild scarring or changes in skin color may remain.


Taking good care of your skin is the best way to prevent neurodermatitis. Use gentle cleansers and plenty of moisturizer. Increase the humidity in your home. Keep stress under control — and seek additional support if you need it.

May 05, 2006

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