Atopic dermatitis of the scalp

introduction

Neurodermatitis, also known as atopic eczema, is a chronic, mostly intermittent skin disease. It usually occurs repeatedly in the same skin area. In addition to the elbows, hollows of the knees, extensor sides of legs and arms and hands, the scalp can also be affected. Atopic dermatitis also shows up in the scalp area through chronically dry skin, whereas in the acute episode it comes to weeping and often very itchy eczema.

In infants, the onset of neurodermatitis can appear as a so-called cradle cap. However, not every child with cradle cap develops neurodermatitis over time.

The reasons

The causes of neurodermatitis of the scalp are the same as those of neurodermatitis in other locations. Various factors play a role in the development of neurodermatitis. In addition to a hereditary predisposition, which means that children of affected parents have an increased risk of developing atopic dermatitis, various allergies are suspected to be possible triggers of atopic dermatitis. These include food allergies, for example to nuts, soy, fish, eggs, cow's milk and wheat. An allergy to animal hair or house dust mites can also increase the risk of developing neurodermatitis.

If neurodermatitis is present, various triggers can trigger an acute attack. This includes the consumption of certain foods such as tomatoes or strawberries, but also heavy sweating or certain cosmetic ingredients. In the case of neurodermatitis in the scalp area, the choice of shampoo and protection against dehydration play a decisive role in containing acute attacks.

Find out all about the topic here: Causes of atopic dermatitis

The diagnosis

The diagnosis is made clinically, i.e. based on the anamnesis (recording of the medical history) and the complexion. A positive family history, i.e. the occurrence of atopic dermatitis in first-degree relatives, can provide initial clues.

In the acute episode, the often weeping eczema, accompanied by dry skin at intervals, are usually sufficient to be able to diagnose neurodermatitis. If the medical history suspects that certain foods lead to worsening of the skin condition, it can be useful to carry out blood tests for food allergies. If there are accompanying illnesses such as asthma or hay fever, it can also be useful to rule out other allergies, for example to animal hair or house dust mites, by means of blood tests.

The treatment

In principle, neurodermatitis of the scalp requires the same treatment as neurodermatitis in other areas. However, due to the localization on the hairy scalp, care is more difficult, since, for example, heavily greasy creams lead to greasy, unkempt hair, which then quickly becomes an aesthetic problem. This is why the shampoo is very important for neurodermatitis of the scalp. Only shampoos should be used that provide sufficient moisture and thus protect the skin from drying out. Products with silicones or fragrances should generally be avoided, as these also have an irritating effect on the scalp, which is already ailing.

Shampoos that contain urea (urea) are recommended. Urea has moisture-binding properties and thus ensures optimal moisture regulation of the scalp. There are also shampoos available on the market that contain linoleic acid. Linoleic acid is one of the unsaturated fatty acids and stabilizes the skin barrier and thus reduces moisture loss. There are also special tonics that are not rinsed out like a shampoo, but remain on the scalp and are used for care. Here, too, urea is one of the most important ingredients.
The brands Eucerin® and Linola®, for example, carry products that specialize in hair care for dry, flaky scalps.

Find out more about the topic here: Treatment of atopic dermatitis.

This helps against the itching

To get the itching in the scalp under control, the use of special, moisturizing shampoos and care products are recommended. In addition, water temperatures that are too hot, blow-drying your hair and washing your hair too often should be avoided.

All of this counteracts dehydration of the scalp and thus relieves itching in the long term.

When do i need cortisone?

In the case of neurodermatitis in the scalp area, the same applies to cortisone treatment as in the case of neurodermatitis in a different location: in the case of an acute neurodermatitis flare-up with crimson, sometimes oozing, extremely itchy eczema, cortisone therapy is usually unavoidable.

In the scalp area, however, different preparations are usually used than on other parts of the body, since when using conventional ointments, a clear film of fat would disturb the aesthetics of the hairy scalp. For this reason, solutions or emulsions are usually used.

For more information, see: Cortisone in atopic dermatitis.

These shampoos can help

In the case of neurodermatitis in the scalp area, shampoos containing urea have proven particularly effective. Urea binds moisture and thus ensures a more balanced moisture regulation in the scalp area. Shampoos that contain linoleic acid also have a positive effect. They stabilize the skin barrier and thus counteract the loss of moisture in the scalp.

Brands that specialize in problem scalps in atopic dermatitis include Eucerin® and Linola®.

Home resources can help

In the scalp area in particular, the use of typical home remedies for neurodermatitis is more difficult due to the growth of hair. In men with short hair, black tea or table salt compresses or pads can have a soothing effect on the inflammation and soothe itching in the acute episode. However, it is difficult to apply to long hair. Therefore, there are hardly any effective home remedies.

When it comes to neurodermatitis of the scalp, different behavioral instructions are more important. For example, shampoos that specifically target dry, flaky scalps should be preferred. Shampoos that contain urea (urea) have proven particularly effective. The hair should be washed as often as necessary but as seldom as possible to avoid skin irritation and dehydration from contact with water. When washing the hair itself, the softest possible water jet should be selected and the temperature should not be set above 37 ° C. After washing, the hair in the scalp area should not be rubbed but only dabbed or the towel should be wrapped around the head. Blow-drying should - if possible - be avoided or only on the lowest heat setting.

Also read the article: Home remedies for atopic dermatitis.

Olive oil

Although oils are tried and tested home remedies in the treatment of dry, brittle skin in atopic dermatitis, their use is clearly limited in the scalp area. Applying oil to longer hair results in greasy and unkempt-looking hair. Leave-in care products - so-called tonics - should therefore be used, which have a caring effect without being too greasy.

Applying baby oil to the scalp can help babies and young children with cradle cap. The oil should be left on for a few minutes to soak the scabbed areas of the skin. Then the scalp can be gently freed from the residues with a soft brush.

The coconut oil

Coconut oil is said to be very effective in treating dry skin associated with neurodermatitis. In the scalp area, however, its use on long hair is very limited.

Prognosis

Neurodermatitis occurs most frequently in childhood. In small children in particular, it appears for the first time as a so-called cradle cap. But neurodermatitis can also appear in the scalp area in adolescents and adults.

If atopic dermatitis begins in early childhood, there is a relatively high probability that the severity of the disease will be significantly reduced by the time it reaches adulthood. About 60% of those suffering from childhood are symptom-free in young adulthood. However, hypersensitivity of the skin remains in almost all neurodermatitis patients so that adequate care of the skin is necessary for life.

Also read the article: Can you cure neurodermatitis?