Treatment

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.

Emerging therapies

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.