Neurodermatitis - Protect Against New Attacks

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Neurodermatitis: Protect from new attacks

Anyone who has already suffered from neurodermatitis can protect themselves from further attacks (secondary prevention). If provocation factors are known to trigger or intensify the disease, they should - if possible - be consistently avoided. These are determined during the initial anamnesis or by allergy testing.

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Avoid triggers and amplifiers

In any case, it is important to reduce the burden of house dust mites. Some sufferers are sensitive to wool and should therefore rather avoid clothes and blankets made of wool. It is essential to avoid cigarette smoke because the smoke exacerbates the disease. Avoiding detergents containing enzymes has so far not had any effect on neurodermatitis.

Atopic dermatitis and job

A very pronounced neurodermatitis or a special localization of the skin changes (e.g. on the hands) can lead to a considerable impairment of the professional activity and in extreme cases make it necessary to change jobs or occupations. Therefore, patients with atopic dermatitis should seek qualified professional advice. This is especially true for young people before they decide on a job or a certain training. Occupations in a damp environment, with heavy skin soiling or frequent hand washing as well as the frequent handling of skin-irritating substances should be avoided: e.g. hairdresser, bricklayer, nursing, flower-making, gardening. Individual recommendations for skin protection and skin cleansing are necessary.

Whom can I ask?

An occupational disease exists if and as long as complaints force you to give up harmful activities. If there is a suspicion that a patient suffers from atopic dermatitis due to their work, the treating doctor is legally obliged to report this to the responsible insurance company (for example, the general accident insurance company AUVA is responsible for occupational diseases of workers and employees). A specialist medical report determines whether there is a reduction in earning capacity. If this is the case, the person concerned can apply for rehabilitation in an appropriate center. If the insurance company approves the rehabilitation stay, it will also cover most of the costs. The patient pays a deductible depending on the income.

If necessary, the AUVA supports retraining measures. In extremely severe cases, the patient can apply for a disability pension.

Specific immunotherapy

If the triggering allergens are known, specific immunotherapy, hyposensitization, is possible in certain cases (e.g. house dust mite allergies). It has a firm place in the therapy of allergic respiratory diseases (allergic runny nose, mild allergic bronchial asthma). Specific sensitizations can also be detected in most patients with neurodermatitis. There is nothing to prevent the use of subcutaneous specific immunotherapy for allergic respiratory diseases and at the same time existing neurodermatitis. Whether the therapy is justified solely because of neurodermatitis with a high degree of sensitization is currently still being scientifically examined.

Goals and forms of specific immunotherapy

The aim of desensitization (desensitization) is to reduce the excessive reaction of the immune system to an allergen. The success of the therapy is shown in the decrease in symptoms.

There are different forms of therapy. Currently, subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are mainly used.

• With subcutaneous immunotherapy, the allergens are injected under the skin. The dose is continuously increased at the beginning of therapy. After reaching a certain dose, the therapy is continued at regular intervals. The disadvantages of this method are the great amount of time it takes and the possible side effects, which in extremely rare cases can range up to life-threatening anaphylactic shock (shock due to hypersensitivity to repeated intake of the same protein by injection). Therefore, the doctor must always have appropriate emergency medication ready during the treatment.
• In sublingual immunotherapy, the allergens are absorbed through the oral mucosa through drops or orodispersible tablets. It is taken daily and can be done at home.

Further therapy methods are currently still being researched or have not yet become generally accepted (e.g. nasal desensitization).

Whom can I ask?

Desensitizations are offered at the following locations:

• Special facilities, e.g. allergy outpatient departments and hospital outpatient departments
• Specialists in dermatology

The costs for specific therapies are covered by the health insurance providers.