Neurodermatitis, also known as lichen simplex chronicus is a skin condition that starts with an itchy patch of skin. The more you scratch the affected area, the itchier it becomes due to irritation of nerve endings in the scrappings. Neurodermatitis is an itch-scratch cycle type of condition, and as a result, the affected skin area becomes thick and leathery. Adding to that, the patch of affected skin appears darker, while the other skin area remains healthy, with the skin lines on the patch being more pronounced. The commonly affected areas include the neck, shoulders, scalp, wrists, legs, ankles, forearms, and even the anal region.
How To Diagnose Neurodermatitis?
The process of diagnosing Neurodermatitis is a rather short one since there are not many technicalities to the condition. In other words, based on how it manifests, it can be a rather direct diagnosis. But since there are other skin conditions, which may have similar characteristics to lichen simplex chronicus, a biopsy may be necessary. Doctors diagnose Neurodermatitis by examining the affected skin area and determining whether you have been itching and scratching.
For further confirmation of the diagnosis, a skin biopsy is performed to rule out any other condition. Skin scrappings can also be taken to examine any possible tinea infection. In severe cases, tests such as X-ray, CT, and MRI scan may be done for spinal imaging purposes. Also, electrophysiology nerve condition studies may be conducted.
Regardless, these testing procedures might not be helpful in the end, and will not contribute to the final diagnosis of the condition. 
What Is The Best Medicine For It?
Treatment for Neurodermatitis is aimed at reducing the itching and scratching of the affected skin area. In the case of the known underlying cause, medication will be provided to manage the underlying condition as well. Treatment options for patients with lichen simplex chronicus include; potent anti-itch medicated creams, corticosteroid injections, medication to ease itching, anti-anxiety drugs as well as medicated patches. Antihistamines are the prescribed medicines for easing itching, as they help many patients with the conditions. As much as they may cause drowsiness, they are beneficial in that while you are asleep, you will not be itching and scratching.
Corticosteroid injections are injected directly into the affected skin area to prompt healing, which should be done every 4-6 weeks. Anti-itch medicated creams are basically over-the-counter corticosteroid creams which help alleviate itching and scratching. If mild corticosteroid creams are ineffective, then the doctor may advise that you go for stronger corticosteroid creams or nonsteroidal anti-itch creams. If the vulva has also been affected, then a calcineurin inhibitor (tacrolimus) may be helpful in easing the condition. Since anxiety and stress can trigger Neurodermatitis, in addition to anti-itch medication and creams, your doctor may prescribe anti-anxiety drugs, so as to prevent itching.
In stubborn cases of itching and scratching, medicated patches may prove to be more helpful to alleviate the symptoms. Ideal medicated patches are topical Iiodicane 5percent, and capsaicin 8 percent. Antifungal agents for dermatophyte infections may also be prescribed to help improve the condition. Additional treatment methods include light therapy, whereby exposing affected skin area to particular types of light may help with the symptoms. Psychotherapy may also be essential in an aim to help the patient understand how some of their emotions and behaviors can fuel itching and scratching. Thereafter, they can be in a better position to manage the said emotions and behaviors, thus preventing itching and scratching.
If medication is not working for you, you can try an alternative therapy such as OnabotulinumtoxinA (Botox) injections, and N-acetylcysteine, which is an oral drug that helps ease the urge to pick and scratch. There are also home remedies which will help you stop itching and scratching, which can be helpful in improving the condition. They include; use of cool or wet compresses, bandaging/dressing the affected area, taking short warm baths and moisturizing your skin, as well as keeping your nails trimmed – to reduce skin damage on scratching. It will also be helpful to avoid any triggers that prompt you to itch and scratch. You can do so by observing what initiates the urge to itch and scratch, then avoiding whatever that is. 
Neurodermatitis (lichen simplex chronicus) is diagnosed through physical examination of the affected area and the symptoms one exhibits. To be extremely sure of the diagnosis, a skin biopsy may be done to confirm the condition and rule out any other condition with similar characteristics. The major approach to treating Neurodermatitis is aimed at inhibiting itching and scratching, and there are several ways you can do that including anti-itch creams, medication to ease itching, and corticosteroids injections. If that does not help, try home remedies that may be helpful and other treatment approaches such as light therapy and Botox injections.
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