Lichen Simplex / Neurodermatitis

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Lichen simplex (neurodermatitis).

DermNet NZ

12/24/2007 06:41 PM

DermNet NZ
Authoritative facts about the skin from the New Zealand Dermatological Society Incorporated.
Home | Eczema, dermatitis and allergies

Lichen simplex
Lichen simplex, also called neurodermatitis, is a common skin problem. It generally affects adults, and may result
in one, or many itchy patches.
Lichen simplex is a type of dermatitis, and is usually the result of repeated rubbing or scratching. The stimulus to
scratch may be unrecognized, perhaps a mosquito bite, stress, or simply a nervous habit.
The result is a very itchy patch of skin, often located on the nape of the neck, the scalp, the shoulder, the wrist,
or the ankle. The genitals are less common sites.
The affected skin is thickened, often appearing as a group of small firm papules (bumps). The skin markings are
more visible, and the hairs are often broken-off. The colour may be darker or sometimes paler than the
surrounding skin.
Lichen simplex tends to be very persistent, and readily recurs despite often initially effective treatment.
Lichen simplex

Treatment
Stop Scratching
This is most important but will need a lot of will-power! Steroid creams prescribed by your doctor will help. Apply
moisturizers or a cold flannel whenever you feel the need to scratch. Pat instead of rubbing. Cut your nails short
and use the pulp of your fingers.
Steroid creams
As lichen simplex seldom responds to mild topical steroid preparations, potent topical steroids are usually
needed. Apply a thin layer of the cream to the affected areas at night. Continue until the patch has flattened with
the normal skin.
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Lichen simplex (neurodermatitis). DermNet NZ

12/24/2007 06:41 PM

the normal skin.


Your doctor or dermatologist may suggest occluding the worst patches by taping them with a plastic cling film
wrap at night-time. Do not do this for more than a few days without checking first with your doctor.
Note: this treatment may not be suitable for the face, genitals or body folds, as strong steroid creams can cause
skin thinning.
Treatment should then be continued with a weaker topical steroid if the itch continues to be bothersome.

Other measures
Coal tar preparations can work well to lessen the itching, without any risk of skin thinning.
Moisturisers should be applied liberally and often, to smooth the skin and reduce itch.
Avoid soap - try bath oils or soap substitutes.
Antihistamine pills can lessen itch. They are best taken at night.
Steroid injections into the patches may be recommended by your dermatologist.
Phototherapy (ultraviolet light treatment) is worthwhile for those with widespread neurodermatitis.
Related information
On DermNet NZ:
Dermatitis
Topical steroids
Other websites:
Lichen simplex chronicus emedicine dermatology, the online textbook

DermNet does not provide an on-line consultation service.


If you have any concerns with your skin or its treatment, see a dermatologist for advice.
Created 1997. Last updated 24 Feb 2007. 2007 NZDS. Disclaimer.

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