Neurodermatitis usually occurs in phases. There are acute phases in which itchy, inflamed areas dominate your skin, and chronic phases in which you have few or no symptoms.

In a flare-up-free phase, you live largely symptom-free. However, even in these phases, the chronic disease has not completely disappeared. The skin does not have any acute, externally visible inflammation, but is still dry, irritated and possibly slightly flaky.

During an acute attack of neurodermatitis, the skin is very red, inflamed and plagued by intense itching, often accompanied by weeping patches of skin and open wounds. This triggers a vicious circle: scratching provides short-term relief, but further damages the skin barrier, which in turn triggers a new inflammatory reaction.

In infants and babies, one often finds flat, firmly adhering, yellowish scales or reddish, sometimes weeping patches of skin on the face, on the scalp (then known as cradle cap) and on the extensor sides of the arms and legs.

In older children, the dry, scaly eczema appears mainly on the extremities, the bends of the joints and the neck; in severe cases, the skin thickens with coarser skin patches (so-called lichenification).

In adolescents and adults, neurodermatitis often occurs on the crooks of the arms, backs of the knees, wrists, neck, face and décolleté.

Initial consultation : During the first consultation, the doctor conducts a detailed conversation to record the patient's medical history (anamnesis). Typical questions relate to the onset and progression of symptoms, family history and possible triggers such as allergies or stress.

Visible signs and their interpretation : The doctor examines the skin for typical signs of neurodermatitis, such as redness, dryness and flaking. The skin areas are assessed for their distribution and severity, which contributes to the diagnosis and helps to assess the severity of the disease.

Differential diagnosis : In order to differentiate neurodermatitis from other skin diseases such as psoriasis or contact dermatitis, differential diagnoses are made. The doctor compares the symptoms and skin changes with those of other diseases to ensure an accurate diagnosis.

Blood tests : Blood tests can measure IgE levels, which are often elevated in allergic reactions. Other relevant parameters may include inflammatory markers or specific antibodies that help with diagnosis and treatment planning.

Biopsy : In some cases, a skin biopsy may be required to take tissue samples and examine them under a microscope. This examination helps to confirm the diagnosis and rule out other skin diseases by analyzing the cell structure and possible inflammatory processes.

Prick test : The prick test is used to test for allergic reactions to certain substances. It involves introducing allergens into the skin and observing the immediate reaction. The results help to identify allergens that may be contributing to the worsening of atopic dermatitis.

Patch testing : Patch testing is used to diagnose contact allergies. It involves applying various allergens to the skin and observing the reaction over a period of 48 to 72 hours to detect allergic reactions.

Imaging techniques : Dermatoscopy is an imaging technique that allows the skin surface to be examined in detail. This method can help to precisely assess and document skin changes.