Neurodermatitis (atopic eczema, atopic dermatitis) is a chronic and inflammatory disease of the skin that occurs in episodes, i.e. is chronic-recurrent. A typical feature of a neurodermatitis episode is excruciating itching, in adults especially of the scalp, face and hands.
About 15 percent of children in Germany and two to four percent of adults have to cope with atopic dermatitis in everyday life. In the course of life, the expression of the eczema changes and varies in appearance. Most of those affected develop atopic dermatitis within their first year of life.
Neurodermatitis: symptoms of atopic eczema
Together with allergic bronchial asthma and allergic rhinitis, neurodermatitis is part of the medical group of atopic diseases. Atopy refers to the genetically determined tendency to physical hypersensitivity reactions to usually harmless substances. The pathologically increased formation of the antibody immunoglobulin E (IgE) on initial contact with environmental substances leads to allergic reactions on subsequent, renewed contact.
The skin is the largest organ of the human body. It provides a particularly large surface area for allergens to come into contact with the body. The skin of neurodermatitis sufferers can no longer serve as a barrier to ward off air pollution and other environmental influences. This barrier function is disturbed and the skin is particularly sensitive.
Symptoms of atopic eczema include:
- Dry skin -> The skin is tight, feels rough and can appear flaky.
- Itching -> Even minor irritations can trigger severe itching, which often intensifies in the evening and at night. The itching is intensified by the reflex of scratching and the skin is injured.
- Inflammation, redness and changes in the skin -> Occurring eczema can show itself as redness, swelling, blisters as well as weeping skin changes and crust formation. In addition to inflammation, dehydration and itching lead to changes in the skin layer over time (thickening of the epidermis, enlarged furrows up to deep tears, formation of darker or lighter skin areas).
Neurodermatitis sufferers must also reckon with further complications. The skin damaged by scratching can lead to so-called super infections, in which viruses, bacteria or fungi penetrate through the wounds and aggravate the symptoms. Bacterial infections can cause pain and fever. The herpes viruses, which are harmless for most people, can lead to herpes eczema in neurodermatitis sufferers and, in the worst case, even cause inflammation of the brain (herpes encephalitis).
The psychological stress as a result of acute neurodermatitis should also not be underestimated. The severe itching often leads to sleep deprivation. This in turn leads to concentration problems and reduced performance. The overtiredness weakens the immune system, which can also impair the physical development of children and overall aggravate the symptoms of atopic eczema.
Since most people cannot tell whether a sufferer has atopic dermatitis as a non-contagious disease or, on the contrary, is contagious, sufferers with visible redness and eczema often feel outcast. They withdraw and, in the worst case, can develop depression.
Ozone, VOCs or particulatess affect the skin
The skin serves as a protective shield against harmful chemical substances such as ozone or volatile organic compounds as well as physical pollutants such as particulatess. But the substances can still cause various problems for the skin. Effects such as brown spots or uneven complexion, dehydration or wrinkling are rather harmless. However, air pollution can also cause serious skin conditions such as acne, acute and chronic eczema, psoriasis and rosacea, or even skin cancer.
As the skin is constantly exposed to air pollutants, its ability to defend itself is weakened. As a result, it loses its ability to produce natural antioxidants. These are responsible for neutralising free radicals that otherwise deprive the body's cells of oxygen. If the skin does not produce enough antioxidants, this leads to so-called oxidative stress. This impairs the regeneration of the skin.
Nitrogen oxides and sulphur dioxide(SO₂) have the property of scattering UV radiation and thus increase the exposure strength of UV rays. In addition, nitrogen dioxide(NO₂) destroys the protective moisturising film, which irritates the skin and increases its sensitivity. In addition, nitrogen dioxide forms ground-level ozone (O₃) together with volatile organic substances. This is suspected of accelerating skin ageing and being responsible for wrinkling, discolouration and sagging. Volatile organic compounds can also cause skin irritation and inflammation.
The particulates suspended in the air can clog the pores. This leads to restrictions in the skin's functions, which in turn increases ageing processes and reduces elasticity. In addition, a wide variety of allergens attach themselves to particulates particles and can thus trigger allergic reactions in the skin.
Risk factor air pollution: How can the skin be protected?
Basically, trying to protect the skin from the risk factor of air pollution is virtually impossible. Therefore, for neurodermatitis sufferers, the focus must be on alleviating the effects of the disease.
Cosmetics can contribute to this in the different phases of the disease and counteract an aggravation. Moisturising creams, ointments or lotions with lipid-replenishing components help with dry skin - they support the skin's own protective mechanisms. Often, substances are added that further improve the supporting effect. Among the best known are urea, St. John's wort, hemp oil, zinc, dexpanthenol and evening primrose oil.
Ointments containing chlorine and antibiotic or antimycotic agents help to prevent infections in open areas. Preparations with tanning agents are used to treat weeping eczema. There are also a large number of anti-inflammatory ointments that reduce itching and heal inflammation.
Those affected usually have to test for themselves which preparations actually help in individual cases.
In order to prevent episodes of neurodermatitis or at least to reduce the effects of eczema, so-called provoking factors should be avoided. The reduction of external irritants plays an important role in this. Therefore, it is recommended to avoid irritating or irritating textiles, such as wool, as well as fabric softeners and odour-intensive detergents. As with the other atopic diseases, a low-histamine diet is also recommended.
Control air quality - avoid air pollution
A low allergen environment plays a special role. Special covers and regular cleaning of living spaces reduce exposure to dust mites and thus the risk factor of air pollution.
Air quality control can also help to detect allergen-contaminated air (e.g. due to pollen count) at an early stage and thus reduce its effects. However, non-allergenic pollutants such as particulates, nitrogen oxides, ozone, sulphur dioxide and carbon monoxide can also irritate the skin and thus cause flare-ups. Therefore, their concentration should also be constantly monitored and, if necessary, reduced to a healthy level.
Furthermore, temperature and humidity also have an impact on skin health. Dry air also dries out the skin and thus promotes the development of eczema. Excessive humidity, on the other hand, increases the spread of dust mites as well as the risk of mould development, which can be perceived by the body as allergens.
Heat and sweat are further factors that can irritate the skin unnecessarily. In addition, heat and noise represent a psychological burden that negatively influences the immune system and thus promotes overreactions of the skin.
(Image1: Shutterstock / Image2: chezbeate from Pixabay)
