What is Neurodermatitis or Lichen Simplex Chronicus of Scalp (LSC)?
Neurodermatitis or Lichen Simplex Chronicus of the Scalp is a disruptive skin condition that starts as a patch of itchy skin. With continued scratching, this skin becomes a very thick, almost leathery patch. The most common area of Neurodermatitis on the scalp is the middle of the top of the scalp, followed by the nape or nuchal area at the back of the hairline.
What is the cause of Neurodermatitis or LSC?
There is no official cause of Neurodermatitis or LSC. Anxiety or stress aggravates the condition in many individuals, but it is hard to say that stress causes the condition to develop.
What are the symptoms and findings?
Severe itching with or without tenderness localized to a specific area of the scalp is the most common complaint of individuals with this condition. With prolonged scratching, the area can become thickened and leathery. In very chronic cases, the skin can also become darker in coloration. .
How is it diagnosed?
A physician can determine Neurodermatitis or LSC visually based upon a localized area of shorter broken off hair associated with hardening and thickening of the skin on the scalp.
What tests are needed?
No tests are necessary, but sometimes a skin biopsy is done for stubborn persistent cases to check for other medical disorders of the scalp that could cause similar symptoms.
What is the expected duration?
The recovery from Neurodermatitis or LSC can take a few weeks, months and even up to a year. If there is an ongoing stressful situation in life contributing to the condition, it can come and go for years.
How can it be prevented?
There is no known way to prevent Neurodermatitis or LSC
Treatment can include topical anti-inflammatories and anti-itch medications. Intralesional corticosteriod injections directly into the affected areas may be successful at relieving the symptoms and getting the areas to heal. Anti-anxiety drugs can also help break the cycle of extreme itching.
When to contact a professional
A physician should be consulted at the first sign of any localized area of extreme itching on the scalp that never goes away.
Successful treatment can take a few weeks to a few years. Stress management can also be of benefit to interrupt the cycle of recurrent itching and scratching. Behavior modification is important because scratching the area gets to be a habit and even though medications stop the itching a person continues to rub or scratch the area anyway. Once treatment is effective, the hair grows back, but if the scalp is scratched again, the breakage can start all over again.