Neurodermatitis (atopic dermatitis)

Protection against new bouts

Prevent the skin from drying out

• Do without lengthy and hot showers or baths.
• Use lukewarm water and avoid alkaline soaps that dry the skin out. You can use a mild syndet instead. The term 'syndet' is an abbreviation for 'synthetic detergents', i.e. artificially produced skin cleansing agents without soap.
• Products that contain lipid-regulating components and do not dry out the skin should be preferably used (e. g. Balneum^® Intensive shower/wash lotion).
• After carefully rinsing off the skin cleansing product, put your usual medical skincare product on your skin.
• Products that dry the skin out considerably such as, rubbing alcohol or arnica tinctures, should not be used.
• Skin-irritating substances can include, among other things, cleaning and cleansing agents as well as certain plants.

Combating allergy triggers

• With known allergies, avoid triggers!
• With a house dust mite allergy, particularly mite-proof mattress covers (so-called encasings) can be used if necessary.
• As a basic principle, the aim is to identify and avoid contact noxa that aggravate the neurodermatitis. Keeping a corresponding diary can help to recognise the trigger of a bout with the help of a doctor.

Correct clothing

• Clothing and bed linen must be air-permeable, non-sweat-inducing, and pleasantly soft.
• Synthetic fibres may be compatible, but are not suitable at all for people who sweat slightly, as the material does not soak up any sweat. The most suitable are breathable substances with a smooth surface, close-knit pattern, as well as clothes made of pure cotton or silk.
• Neurodermatitis sufferers frequently have a wool intolerance. Clothing made of wool should therefore not be worn directly on the skin. Cotton blouses or shirts can be worn under them.
• As washing powder residue in clothing and bed linen can irritate the skin, the washing should always be thoroughly rinsed.
• If the hands in particular are affected, wearing gloves is recommended.

Combating the itching

• As a basic principle, everything that can dry out and irritate the skin should be avoided. This includes, for example, a dry room climate (low level of humidity), alcoholic compresses and coarse items of clothing.
• Short-term alleviation of the itching can be achieved with cool compresses or a cool shower. A warm bath at a temperature of around 32 - 36ºC with additives which can alleviate itching and which are lipid replenishing (e. g. Balneum Hermal^® Plus Oil Bath) can also improve the itching.
• The skin care products can also be stored in the fridge, thus enhancing the cooling effect when they are applied to the skin.
• Alternatives to scratching can be practised with children: these help the child to convert the reflex to scratch into other activities and thus protect the skin. The children are shown, for example, how to press, stroke, or gently pinch the skin instead of scratching it. A 'scratching block' also helps some children. The child can scratch on this when he or she has a scratching attack.
• At night, it is recommended, in particular for infants and young children that they wear neurodermatitis overalls and cotton mittens to prevent them scratching the skin open.
• In addition, relaxation exercises, such as autogenic training, have also proven useful for children and adults. A relaxed, harmonious atmosphere in the family also has a favourable effect on the skin.

Neurodermatitis and job

Neurodermatitis sufferers should take their skin condition into account when choosing a career. Professions with which a constant burden on the skin is already to be expected during an apprenticeship must be critically checked. There are substances that can irritate the skin in all work areas. This also applies for the home. When selecting a profession, the following questions need to be answered:

• Is there a disposition towards allergies?
• Are incompatibilities already known?
• Can contact with allergy-triggering substances be avoided?

These aspects need to be considered before choosing an occupation, although a complete elimination of skin-damaging substances is virtually impossible, as these occur not only at work, but also in the personal sphere and in the environment.

Patient groups

Information sheets and contact addresses for the patient groups can be obtained via the German Neurodermatitis Sufferers Association. Contacts to other neurodermatitis sufferers or parents of children with neurodermatitis can be established here.

Prevention

Parents who themselves suffer from neurodermatitis or other atopic diseases, such as hay fever or allergic asthma, should note the following recommendations:

• There is a strict ban on smoking during pregnancy and when the child is present.
• Infants should be breastfed for at least four months. Feeding with solids is not recommended until from the fourth month onwards.

With risk children, the following preventive measures are also recommended:

• If feeding with breast milk is not possible, hypoallergenic infant food should be used.
• In addition, a low-allergen diet for the mother while breastfeeding is under discussion. Potent food allergens (such as those contained in milk, egg, fish, nuts, wheat, or soya) are to be avoided during breastfeeding. It is important that this is not decided and carried out independently, but only after intensive medical support. Otherwise, it can easily result in malnutrition.
• Rodents (rabbits, guinea pigs) and cats should not be kept. However, tests show that keeping dogs does not represent an increased risk.
• Whether taking so-called probiotic food (e. g. Lactobacillus GG) in pregnancy and while breastfeeding or as an additive in your child's diet reduces the risk of atopic diseases cannot be conclusively assessed. The tests on this topic yield different results.