Neurodermatitis – also known as atopic dermatitis – is much more than just a dry skin condition. It affects not only the skin but the entire life of those affected. The chronic itching can rob people of sleep, the inflammation is often visible and mistakenly associated with poor hygiene, which places an additional strain on their mental well-being. Therefore, more and more people are looking for effective, long-lasting solutions. The key question is: What really helps with neurodermatitis – without having to take cortisone long-term?
The answer to this question is complex, as atopic dermatitis is unique to each individual. While a simple change in skincare routine can work wonders for some patients, others require a combination of modern biologics, an anti-inflammatory diet, and consistent stress management. This blog post provides an in-depth overview of current medical options, natural home remedies, modern skincare, and new findings from atopic dermatitis research—with the goal of noticeably improving your quality of life.
Why do people suffer from neurodermatitis?
Atopic dermatitis is a chronic inflammatory skin disease in which a genetic weakness of the skin barrier combined with an overreacting immune system leads to symptoms such as itching, redness, scaling, and weeping eczema. The disease often occurs in flare-ups, with certain triggers—such as stress, sudden changes in weather, allergens, or skin irritants—being able to trigger new phases of inflammation.
A key problem in atopic dermatitis is that the skin is unable to retain moisture sufficiently. This is due, among other things, to a deficiency of so-called barrier lipids and a reduced level of the structural protein filaggrin. At the same time, immune defense cells are overactivated, releasing pro-inflammatory messengers such as interleukin-4 and interleukin-13. This is precisely where many modern therapies now target.
Daily skin care – the essential foundation
Daily skin care is the most important and yet most underestimated component of any atopic dermatitis treatment. Neglect in this area quickly risks new flare-ups. Skin care should always be tailored to the individual skin condition and age. Dry, flaky skin requires rich, moisturizing creams or ointments with ingredients such as urea, glycerin, ceramides, and panthenol. For people with sensitive facial skin, lighter water-in-oil emulsions are often more pleasant and sting less upon application.
A common search query online is: "Which cream helps with facial atopic dermatitis without cortisone?" – The answer is: Depending on your skin type, products with skin-identical lipids, ceramides, and natural moisturizing factors are suitable. It's important that the products do not contain fragrances, essential oils, or alcohol-based preservatives, as these can further irritate the skin barrier.
Regularly applying cream to the entire skin at least twice a day—even symptom-free areas—can significantly reduce the frequency of flare-ups. Studies show that consistent care is effective even when no acute eczema is visible. This maintenance care is just as important in the treatment of atopic dermatitis as acute therapy.
Cortisone – effective, but not always the first choice
Cortisone preparations remain among the most effective treatments for acute flare-ups of inflammation. When used correctly, they provide rapid, reliable, and safe relief. Nevertheless, many sufferers prefer to avoid them in the long term – often out of fear of side effects such as thinning skin or pigmentation changes. It is therefore important to always use cortisone under medical supervision, at the appropriate strength, and, if possible, only for a limited time.
However, alternative active ingredients are now available that also have an anti-inflammatory effect without causing long-term skin damage. These include, in particular, so-called calcineurin inhibitors such as tacrolimus or pimecrolimus. They specifically target the inflammatory immune reactions in the skin and are particularly suitable for sensitive skin areas such as the face, neck, or eyelids.
Modern therapies: biologics and JAK inhibitors
A real breakthrough in the treatment of severe atopic dermatitis has been the arrival of new biologics. These are genetically engineered antibodies that specifically target the inflammatory process. The best-known example is dupilumab (Dupixent®) , which inhibits the effects of the pro-inflammatory messengers IL-4 and IL-13. It is injected subcutaneously every two weeks and can be used in adults and children six months and older. The results are impressive: Many patients report significantly reduced itching, improved sleep, and an almost complete resolution of their eczema.
Lebrikizumab (Ebglyss®) , another biologic that specifically blocks interleukin-13 and requires only one monthly injection, has been on the market since 2024. It is particularly suitable for people who prefer less frequent injections and are looking for a manageable therapy.
In addition to biologics, JAK inhibitors such as upadacitinib (Rinvoq®) and abrocitinib (Cibinqo®) are also gaining importance. These tablets act internally, specifically inhibiting inflammatory signaling pathways and demonstrating rapid improvement in skin appearance and itching. However, regular blood tests are necessary, as side effects such as elevated cholesterol levels or infections can occur. A herpes zoster vaccination is also recommended.
What role does nutrition play?
Although there is no universally applicable diet for atopic dermatitis, experience shows that certain foods can promote or intensify flare-ups. Common suspects include cow's milk, egg whites, wheat, nuts, and histamine-rich products. It's important not to avoid everything altogether, but rather to specifically identify potential triggers in consultation with a nutritionist trained in allergology. Elimination and provocation tests can help with this.
Many sufferers report positive effects from an anti-inflammatory diet rich in vegetables, omega-3 fatty acids (e.g., in flaxseed oil or fatty fish), fermented foods, and low sugar. The gut microbiome also appears to play a role – probiotics such as Lactobacillus rhamnosus GG or Bifidobacterium longum can have a positive effect on the immune system in some patients.
Stress reduction – an underestimated lever
Stress is one of the most common triggers for atopic dermatitis flare-ups. The skin and the brain are closely connected: Stress hormones like cortisol influence the immune system and can exacerbate inflammation. This makes it all the more important to integrate targeted stress management into therapy. Breathing exercises, meditation, mindfulness, yoga, and even professional psychotherapy can help.
Many sufferers benefit from so-called scratching alternatives, such as cool gels, mental distraction techniques, or wearing gloves at night. A regular evening routine with relaxing rituals can also help better manage the itching—a topic that frequently appears in searches such as "What helps with atopic dermatitis against itching at night?"
What helps with atopic dermatitis in everyday life?
In addition to skincare and medication, everyday life also plays a key role. For example, wearing appropriate clothing for atopic dermatitis provides additional protection for your skin. Smooth, breathable materials such as cotton or bamboo are best. Synthetic fabrics or wool can irritate the skin. When washing, you should also use fragrance-free, sensitive detergents that do not contain dyes or enzymes. The air in your room should not be too dry – a humidifier can be helpful, especially during the heating season, to prevent the skin from drying out.
Products containing Lactobacillus paracasei LP-33 and GMNL-133 , a probiotic bacterial strain that not only strengthens the oral microbiome but can also reduce inflammatory processes, are particularly helpful for many sufferers. Initial studies indicate that a stable microbiome also plays a crucial role in atopic dermatitis.
Conclusion: The combination makes the difference
The treatment of atopic dermatitis is now more individualizable than ever before. Whether it's a mild form or a severe, chronic condition, those who consistently follow skin-type-appropriate care, avoid known triggers, use modern medications such as biologics or JAK inhibitors when needed, and also pay attention to diet, stress reduction, and lifestyle can sustainably reduce symptoms. The path to flare-free skin is not a sprint, but a marathon – but it's worth it. Modern medicine, combined with holistic thinking, makes a quality of life possible that was unthinkable just a few years ago.
