What are the treatments for eyelid neurodermatitis?

Neurodermatitis can cause paroxysmal skin itching and lichenification. It is a chronic skin disease. Eyelid neurodermatitis is also very common. It requires symptomatic medication. During treatment, pay attention to eye hygiene and do not scratch with your hands.

1. General treatment

Pay attention to skin hygiene and live a regular life. Avoid scratching, washing with hot water, drinking alcohol, strong tea and eating spicy and irritating foods. Those with systemic diseases should actively treat the primary disease; for patients with neurasthenia, sedatives and hypnotics can be appropriately used.

2. Systemic treatment

(1) Antihistamines: They are the first-line drugs. Various H1 receptor antagonists can be used. H2 receptor antagonists can also be used in combination. Calcium supplements, vitamin C, etc. can enhance the efficacy of antihistamines.

(2) Procaine hydrochloride intravenous blockade: Procaine 4 mg/(kg·d) dissolved in 500 ml of normal saline is intravenously dripped for 10 days as a course of treatment. In severe cases, intravenous lidocaine injection is effective, but the effect lasts only a few hours and may cause hypotension. Long-term use of procaine hydrochloride, lidocaine, etc. requires attention to the possibility of contact allergies.

(3) Sex hormones: Commonly used for elderly patients. Male patients can use testosterone propionate 25 mg/d intramuscularly twice a week, or methyltestosterone 5 mg/d orally. Female patients can use diethylstilbestrol 1 mg/d orally in 2 doses, or progesterone 10 mg/d intramuscularly. Patients with reproductive system tumors or liver and kidney dysfunction should avoid using this medicine or use it with caution.

(4) Others: Naloxone injection is effective for patients with cholestasis. If it is ineffective, amitriptyline can be used.

3. Topical treatments

(1) Topical medications: such as phenol calamine lotion, glucocorticoid ointment or cream; patients with vulvar pruritus or anal pruritus should avoid the use of irritating drugs.

(2) Local blockade therapy: Use 25 mg of diphenhydramine plus an appropriate amount of procaine to subcutaneously infiltrate the lesions once every other day. Alternatively, use triamcinolone or dexamethasone plus an appropriate amount of procaine to block the lesions subcutaneously 1 to 2 times a week.

(3) Physical therapy: Systemic pruritus can be treated with ultraviolet irradiation, subcutaneous oxygen delivery, starch bath, bran bath or mineral bath, etc.; when localized pruritus is ineffective after multiple treatments, isotope or superficial X-ray therapy can be considered.