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Your doctor may diagnose neurodermatitis by examining the affected skin and determining whether you've been itching and scratching. To rule out other causes, he or she may take a small sample of the affected skin (skin biopsy) for testing.
Treatment is aimed at controlling the itching, preventing scratching and addressing underlying causes.
Anti-itch medicated creams. If over-the-counter corticosteroid cream isn't helping, your doctor may prescribe a stronger corticosteroid or a nonsteroidal anti-itch product. A calcineurin inhibitor (tacrolimus) ointment may help if the vulva is involved.
Corticosteroid injections. Your doctor may inject corticosteroids directly into the affected skin to help it heal.
Medicine to ease itching. Prescription antihistamines help relieve itching in many people with neurodermatitis. Some of these drugs may cause drowsiness and help with alleviating scratching while you sleep.
Anti-anxiety drugs. Because anxiety and stress can trigger neurodermatitis, anti-anxiety drugs may help prevent the itchiness.
Medicated patches. For stubborn itching, your doctor may suggest topical lidocaine 5 percent or capsaicin 8 percent patches.
Light therapy. Exposing the affected skin to particular types of light is sometimes helpful.
Psychotherapy. Talking with a counselor can help you learn how your emotions and behaviors can fuel — or prevent — itching and scratching.
If your itching persists despite treatment, your doctor may suggest a nontraditional approach. For example, in small studies some people whose symptoms didn't improve with corticosteroid use did report success with the following treatments.
OnabotulinumtoxinA (Botox) injection. This technique may reduce itching and clear up rough skin patches.
An oral drug to ease the compulsion to pick and scratch. An oral drug called N-acetylcysteine has been shown in a small study to help some people with picking and scratching disorders and may be of help to people with neurodermatitis.