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(9) Skin Disorders


Skincare for very sensitive skin (neurodermatitis/eczema)

itch scratch

I feel like I need to scratch my skin all of the time and that I may have bugs. What do I do?

It is estimated that at least one third of individuals presenting to a dermatologist have a skin condition primarily due to a psychologic factor.


Authors use many different names to refer to skin conditions that are psychologically related, including neurodermatitis, psychocutaneous diseases, psychodermatologic disorders, psychosomatic dermatology, and psychocutaneous medicine.

Neurodermatitis includes delusions of parasitosis, dermatitis artefacta, lichen simplex chronicus, neurotic excoriations, prurigo nodularis, and trichotillomania.

Signs and symptoms include often intense itching and perception of bugs in the skin. You may show multiple excoriations at all different stages of healing. Often you will have clear areas on the central back that cannot be reached by scratching.

Certain other diseases, such as scabies, eczema, generalized pruritus, bullous disorders, and systemic disease, must be eliminated from consideration first. Treatment may include topical antipruritic creams and ointments, oral psychiatric medicines, and counseling.

Lichen simplex chronicus (Plate 3) is a Latin term that means “skin that thickens and scales due to long-term scratching.” It may start as a minor itching place; however, scratching the spot damages the skin, thus making it heal slightly thicker than before. The skin tries to protect itself by thickening. As the healing progresses, the itch fibers in the skin are activated by slight scar contraction in the damaged area, and the new itching causes more scratching. What is the result? More damage, thickening, healing, and itching - the itch - scratch cycle - and it can continue incessantly unless interrupted.

A cortisone ointment or cream may help end the vicious itch-scratch cycle, but you also must keep the nails short to eliminate the scratching tools at hand. By rubbing the topical medicine into the itchy area with the flat of your finger pad, you avoid triggering the nasty cycle again.


Neurodermatitis - The cycle of chronic itching and scratching that can cause the affected skin to become thick and leathery. It is also known as lichen simplex chronicus or scratch dermatitis.

Bullous - A large blister (a thin-walled sac filled with clear fluid).



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