Dermatology  (Expert Forum)

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Sever arm itching

Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
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MedHelp Member's Question
Sever arm itching
by blong1717, Oct 17, 2002 12:00AM
It’s nice to see I am not alone. My problem started 20+ years ago. It started with a tingling sensation on my left arm that then turned into a prickly, needle tingling sort of a torture that kept me up all night long. No matter how much I scratch it does nothing to relieve the itching. I have tried everything and have had two biopsies sent off to labs with no results. It is back. I can go months and even years with no problem, then for no reason its back. The only relief I get is from an ice bag to numb my arm. I can go to sleep but after the ice has melted I will wake up from the itching and have to get more ice.
Another little bit of relief I get is from Zostrix cream, which has capsician and, burns instead of itches.
I have scratched until my arm bleeds but the scratch absolutely does nothing for relief.
It is driving me crazy!! The itch changed to something that I have a very difficult time describing. It felt at though someone was sticking me with a needle or it felt as though a bug was biting me. It is a combination of a sting, itch, tickle and pain!
Yes I am stressed but it is worse during the summer and heat sets it off. My dermatologist has no clue what is the problem.
I think it has to do with over sensitive nerve endings. My father has the same problem but not as bad, but his has moved up on the back of his neck.
I WANT AN ANSWER!!! I don’t some bull about it is all in my head and I should see a psychologist. This is real, and is driving me really crazy.  If someone has an answer please email me at ***@****
Doctor's Answer
by Alan Rockoff, MD, Oct 18, 2002 12:00AM
Your symptoms (and their partial response to Zoztrix) suggest a neurological basis.  I suggest you consult a neurologist or pain specialist (pain, itch, and tingling all travel along the same nerve fibers.)

Best.

Dr. Rockoff
Related discussions
Member Comments (26)
by Barend, Oct 19, 2002 12:00AM
In the meantime try Penaten, a ointment for baby diaper rash and eczema, made by Johson and Johson.  Add some vitamin-E oil to the rather stiff ointment. It helped me.  It is cheap and effective, and can't do no harm.  Also, you can try a paste of oatmeal. Barend.
by Barend, Oct 19, 2002 12:00AM
In the meantime, take only luke-warm showers.  Reduce the shower time. Use Petrophyllic soap (for baby skins).  Don't rub with a rough towel, dab it dry with a soft cloth.  Apply Penaten, a stiff ointment for diaper rash and for eczema, made by Johnson and Johnson.  Put some vitamine-E oil in the Penaten.  It cures scratches faster and makes the ointment easier to apply.  These are all little common sense helps that can't hurt  O yes, excercise regularly. Let us know if you notice any improvement. BTDT, Barend.
by blong1717, Oct 19, 2002 12:00AM
Thanks for the information. It's so strange that there are so many people that have this problem but no one knows what causes this. . I have been checking the internet and have found many others with the same problem and yes, I do think it is a neurological problem that a pain specialist can help with because I have been to other doctors and dermatologist and they do not know what is causing this.
I have been using Zostrix HP, which has capsicum (the heat in peppers) and empties the nerve receptors of the itching signal. It burns like heck but is a lot better than the itching. I also get a little relief from Sarna and  other creams that have Camphor or Menthol in them which helps sooth the prickling sensation.
The best relief is with an ice pack. I could not go to sleep last night until I got up and wrapped with an ace bandage an ice pack on my arm. I am waiting for this to end as it always does for no apparent reason.
As I sit here typing and scratching (now I have applied an ice pack) I am still wondering if someone has seen a neurologist and have received any answers. Again I welcome any emails and will forward others that have replied until we can find an answer. Signing off and scratching away. ***@****

by blong1717, Oct 19, 2002 12:00AM
I did a little more searching and may have come up with a cause and hopefully a cure.
In the 1980's thru the 1990's I had above normal hours of exposure to the sun from being a lifeguard but also have spent hundreds of hours baking under tanning lamps in tanning solons.
I found this post and think this may be the problem.

PUVA is a type of ultraviolet radiation treatment (phototherapy) used for severe skin diseases.

PUVA is a combination treatment which consists of Psoralens (P) and then exposing the skin to long wave ultraviolet radiation (UVA). It has been available in its present form since 1976.

This person wrote:

I have something to say about the comments various people have said about PUVA Itch. I have had PUVA ITCH. I refer to it as “the :itch from hell.” I sat up many nights, or should I say mornings — like 2:00 or 3:00 a.m. — rubbing ice on my arms to try to numb my skin enough for me to go to sleep. I finally had to see a neurologist because I found out that the PUVA light had damaged my nerve endings. I had no idea that PUVA treatment could do this and that I'd wind up in so much agony! Creams, lotions, baths, were a waste of time. In fact, having someone recommend some new anti-itch cream became infuriating. My dermatologist finally prescribed Lidoderm patches. The first time I used one it was like throwing water on a fire. It was wonderful.
Please don't tell people with severe, deep itching from PUVA treatments to take baths or use lotions; they don't even touch it. –Bonnim T.
*****
Ed’s Response: For more information, this site goes into detail about the patch:
http://www.lidoderm.com
This site explains that the patch contains 5% lidocaine in a compound that promotes absorption only enough to reach the damaged nerves; not deep enough to absorb significantly into the blood stream. This enables much longer-term use of the Lidoderm Patches.
Interestingly, the patch is the only product (according to this web site) “FDA approved to treat Postherpetic Neuralgia,” which is the severe pain some people experience as a post-outbreak symptom of shingles. It does require a prescription.
Another important note is that the patch should never be used over broken, or broken-out skin.
Those of you who have had shingles with postherpetic neuralgia and who have also had PUVA itch will know if there is a difference in the agony. If the PUVA problem approaches the shingles problem in severity, you might want to pursue the Lidoderm Patch with your derm.
by blong1717, Oct 19, 2002 12:00AM
Well a miracle happened today! I got a prescription for the Lidoderm (Lidocaine Patch 5%) which cost $125 for 30 patched but are very large so I cut it in half, placed it on my shaven arm and within 3-4 minutes had relief! I just woke up from a 45-minute nap and have not been bothered one bit! I can’t believe this happening. I am telling you there is not even a tingle, not one bit of anything. I feel normal, no sensation of someone poking me with a needle! I hope this is going to last and will keep you posted through the week to let you know if it is the answer, but for now it is!
Brian
by blong1717, Oct 20, 2002 12:00AM
Relief, I just woke up from a 9-hour sleep. I have not slept that long in years. The Lidoderm has done the trick! This is wonderful. I hope anyone that has this problem tries this product. After years of agonizing torture I have found a solution and probably a reason for my itch. I hope this will help others with the same problem. The answer from Dr. Rockoff would have been correct and I feel if I had visited a neurologist he may have recommended the Lidoderm  patch. May be not. I did find my answer searching the Internet, such a wonderful thing. The answer I found was on a website www. Flakehq.com. This is a sight for Psoriasis. Thanks for the emails from people with suggestions. I hope this posting of my problem and solution will help someone else with sever arm itch! I removed the Lidoderm patch in the middle of the night when I used the restroom to give my arm a rest because I had it on past the recommend 12 hours and it is 5 hours later and still no itch. I am a happy person.
by cpb, Oct 29, 2002 12:00AM
I registered to this site just to present what I have found.  I have several scars on my arms from where I scratched the skin away until I bled.  I suffered with this on and off for years.  It was usually worse in the summer but seem to rage more at night.  It seemed to never or barely affect the underside of my arm. It was impossible to sleep and I tried just about everything I could buy.

One Doctor said it was likely I had some inflamation (inflammation) that was affecting the hair follicles on my arms.  He tried an inexpensive gel and it worked!  The oitment is medically called FLUOCINONIDE and the brand is LIDEX (Gel 0.05%).  Is is manufactured by MEDIDIS The Dermatology Company.  The Gel seems to work faster and better than the cream.

When the itching starts to flair up I simply rub a dab on each arm for 2 or 3 days.  Within about 10 minutes or so the itching subsides.  If I use it for a few days the itching stays away for weeks.  If I use it for several days in a row, the skin on my arms start flaking like I was sheding an old sunburn.  

I have been grateful and using this product for a few years.  Lately I can tell when it is starting to flair up pretty early and I have been treating just spot areas of perhaps a 2 inch circle.  

My life has been radically changes since I found this and I have told many.  Everything has been great until last week when I came down with shingles.  My back has been killing me since then.  However having beat the itching problem, the shingles has not really been that discouraging yet.
by cpb, Oct 29, 2002 12:00AM
Try LIDEX FLUOCINONIDE by Medicis.  

It worked for me.

(Read previous comment for details/history.)
by blong1717, Nov 03, 2002 12:00AM
Well, more to report. The Lidoderm patch was working but not the relief I was getting in the beginning. I went to my primary care physician (required by my insurance) and he prescribed Neurontin 300mg, which is an anti-convulsing medication but helps people such as diabetics who are suffering from neurological pains. It did not help me one bit. I had double vision the next day and could not even read the newspaper.
I had someone email me and said to apply vitamin E oil and then sunscreen. This does help. The vitamin E helps from the itching but in the evening it just gets worse.
My next visit will now be to a neurologist and we will see what happens.
I will try the gel as mentioned in the last posting. Hell, I’ll try ANYTHING!!
My itching is the worst it has ever been!!! I was up all night long and had to put on ice packs. It is now on both arms and is really bothering me on the inside left upper area and inside lower forearm and wrist. It starts at night when my day has really wound down.
I was pretty excited in my last postings as you can tell when I applied the Lidoderm patch. I had instant relief and it helps on some areas but it is not working as well. Very expensive! I’ll keep reading, researching and posting. Thanks for the emails
by sjack, Nov 05, 2002 12:00AM
To: blong1717
Same problem, same symptoms, and I've tried everything listed on this site, every over the counter product, home remedies, presciption steroid creams and lotions and I've had biopsies (no results).  I've been to a family doctor, an internist, and a dermatologist and no one has any idea what is causing this.  My dermatologist said he had never seen or heard of this kind of problem so I printed 15 pages from this forum and took them to him, just to show him.......SEE I'M NOT CRAZY!  My severe, uncontrollable itching is only on my left arm, only on the top side about 6" above and below my elbow area.  The open sores and rash only come from or after the excessive scratching. I've only had this for 2 years now, summer and stress do make it worse, and it's unbareable at night causing lack of sleep. Benadryl no longer works. Last year, the itching was only about 3" above and below my elbow. My symptoms seem to progressively get worse. Since no one seems to know what causing this I am curious to know (since you have experienced this for 20+ yrs)what I have to look forward to or what we, or anyone else with this condition, may have in common. Have your symptoms spread to a larger area of your body (In this forum, see: Severe itching from head to toe)?  Someone in that forum suggested "gasoline" to control the itching.  Sometimes at night my itching is so severe I've wondered if they meant to light it after applying it....  

I am a 51 yr old female, average height/weight. I have a healthy diet and get moderate exercise, I have no known allergies. My occassional stress is no more than most people. I take prescibed medications: "hyzaar" for blood pressure (inherited problem) and "estratest" for menopause hormone replacement (female aging problem).

Please pass on any information you can.  I WANT ANSWERS TOO!!! The medical profession seems to be baffled.
***@****

by fissh, Nov 06, 2002 12:00AM
Very pleased to see I'm not on my own here. I was determined this morning (03:00am) to 'Googlise' my itching problem and here I am.

I have the night time itch on my inner forarms and neck area. It has developed over the last 5 years (I'm now 31) from a very small itch area on my left forearm to a regularly nightly occurance typically waking me up at 3 in the morning. I've read all these postings and have gained a couple of new things to try.

Has anyone had help from Clarityn (or similar antihistamine)?
I took it for hayfever and it had immediate effects relieving the night time itch. I found it best to take a couple of hours before I went to bed...
by Saltwaterfishin, Nov 24, 2002 12:00AM
Hi all,  Sounds like you all have NEURODERMATITIS as do I.  Neuro referring to nerves and dermatitis referring to inflamation (inflammation) of the skin (but not really).  Basically it's a case of "the nerves."  It's intermittant and for me only occurs a couple times a year.  It took a long time for me to find out what this was.  When I first got it, I beat the hell out of my arm with a wooden spoon hoping to replace the itch with some sort of pain....to no avail.  The BEST thing for this disorder is to IGNORE it.  Once you scratch the first itch, you are caught in a horrible cycle...the more you scratch, the worse it itches.  If it gets too bad (if I accidentally scratch that first itch), I put hydrocortisone cream on my arm and wrap it in an ace bandage and just try to ignore the itch until it goes away.  Jay
by dso, Jan 09, 2003 12:00AM
Hi..just found this site and am experiencing so many of the similar symptoms of severe itching all over my body.  It started a year ago with minor excema type rashes on the face and hands and now is totally different.  The past few weeks the itching has gotten out of control.  Especially at night...I have not slept well in 3 weeks.  I have tried ALL the creams...There are no scars or rashes anywhere that I itch.  The itching is severe on the arms, neck and back.  After I itch there is NO relief....I just want to keep on scratching....I have seen the dermatologist several times...the last time he finally ran bloodwork on me,and put me on predisone....checking liver, kidney functions, Hepatits etc...I am clean except for elevated thyroid levels (will see and endocronolist this week).  I have seen an allergist and I am not allergic to a thing!!  She has put me on Zytrec twice a day and I started another cream "protopic".  I am so frightened that this has elevated to such a terrible state and more frightened that there will be no relief for me.  I have called my friend who works for a neurologist to see if I should get an appointment to see him. I am at my wits end...has anyone ever been helped with a neurologist or even with some alternative therapies??  There are many ads in my local area that have holistic doctors and acupuncturists that claim to help people with skin disorders...I will try anything!!!  HELP!
by DARLEEN, Jan 11, 2003 12:00AM
To all you poor people that have the arm itching compliant,I HAPPEN TO BE ONE OF THOSE PEOPLE TO.I HAVE HAD THIS PROBLEM FOR FIVE YEARS AND STILL HAVE NOT FOUND OUT WHAT IT IS .Ihave tryed just aboutevery



                                             cream out there,I've gone to Dernatoogist,Ihad Accupuncture,I was tested for Allergies,
by DARLEEN, Jan 11, 2003 12:00AM
To all you poor people that have the arm itching compliant,I HAPPEN TO BE ONE OF THOSE PEOPLE TO.I HAVE HAD THIS PROBLEM FOR FIVE YEARS AND STILL HAVE NOT FOUND OUT WHAT IT IS .Ihave tryed just aboutevery



                                             cream out there,I've gone to Dernatoogist,Ihad Accupuncture,I was tested for Allergies,
by DARLEEN, Jan 11, 2003 12:00AM
To all you poor people that have the arm itching compliant,I HAPPEN TO BE ONE OF THOSE PEOPLE TO.I HAVE HAD THIS PROBLEM FOR FIVE YEARS AND STILL HAVE NOT FOUND OUT WHAT IT IS .Ihave tryed just aboutevery



                                             cream out there,I've gone to Dernatoogist,Ihad Accupuncture,I was tested for Allergies,
by Geekapoo, Jan 13, 2003 12:00AM
Nice to find this site and thread. I've also been having horrible problems with my skin: severe itching/burning without any rash. The problem has been pretty bad for approx 9 months.The main affected areas are my ankles/shins, middle of my back, my thighs and some areas on my chest. The irritation is so bad that it has (sometimes severely) affected my sleep. Cannot correlate the symptoms with anything environmental (allergy, humidity, temperature) nor is it stress/anxiety-related.

I've been to a GP three times, an allergist, immunologist and now two dermatologists. Blood work was done to rule out liver or kidney problems and had an x-ray to rule out Hodgkin's. IgE levels are normal. Nothing really striking about any blood markers analyzed.

Based on doctor recommendations, I've tried:

allegra (60mg twice a day)

Lac-Hydron lotion (Ammonium Lactate solution)

Benadryl Cream (2%)
Dermarest cream (1%)

Zyrtec (10mg once a day)
Doxipin (1omg once a day)
Ranitidine (150mg twice a day)

Oatmeal baths

Doxipin cream

Amitriptyline (10mg once or twice a day)

Capsaicin cream (0.075%)

The only thing that is of much help is the doxipin. Doxipin is an anti-anxiety drug with anti-histamine properties. Doxipin sometimes makes me drowsy enough to sleep through the pain however it does not help reduce the pain (the cream does nothing). The most recent person I've met with is a dermatologist who thinks my problem is neurological. She would like me to see a neurologist (which I'll do). She also suggests that I have my thyroid checked, my total serum protein level checked, my B12 levels checked and wants the info on my total blood count and differential. She did prescribe me the Amitriptyline.....an antidepressant that sometimes can dampen peripheral never activity. The Amitriptyline so far has not helped (though she did note that I am taking baby doses.

WHat ever you do, tread lightly if determining if a capsaicin cream will be of any use as a treatment. In my hands (and body) the cream WAS amazing in the it burned like hell when applied to afflicted areas, feeling very very similar to burning sensation I'm trying to block!! What the cream did was widen the area of discomfort (cause of how much I used) and brought the discomfort level up just a little bit. Overall, I my suggestion is to be very wary of the cream if you try it. The dermatologist who suggested it said that with some people it does completely block an itch. My feeling? Have someone put the cream on a rash or cut....watch them as they grimace with pain and inform them that is the same discomfort you are describing!!!

I don't know what more to say. I am going to work hard to solve this problem......I have to as the discomfort is pretty intense. I appreciate any and all comments. What I find out I'll post here. I'm also happy to email anyone who is interested in an update and look fwd to any feedback anyone has.

Cheers (and g'luck treating this problem!)

***@****
by blong1717, Jan 14, 2003 12:00AM
OK, I may have found a helpful solution. I just spent 32 days in the hot sun all day every day at the beach in Costa Rica. Someone emailed me with a recommendation that I try applying Hawaiian Tropic Sunscreen #45. They told me not to miss a day or it will start back itching. I applied 2-3 times daily about a month before I did a lot of surfing. I never missed a day. NO ITCHING. NONE. I have been back 2 weeks and have no problems. I do believe the sun causes the itching and mine usually starts on the left arm that is exposed to the sun from driving. Hope this helps someone. It helped me. No itching for 46 days. Brian
by Geekapoo, Jan 15, 2003 12:00AM
Thanks for the update. Working hard (sunning and surfing), eh?
No.....don't think what you have experienced works in my case. I think it pretty safe to say that my problem is not sun-related, unless it was from sun exposure over 20 years ago. I have tried my best to limit sun exposure for over twenty years.
by Lewbee, Aug 05, 2007 05:52AM
To: Lewbee
What I have found.. and I check online often for "other ideas".. Is that this itch is from nervousness.
Whether conscious nervous problems or something that is bothering me in my subconsous..It's a reaction from my brain to my body. Call it whatever you want to. It is nerves.
Now.. to make it go away and hopefully to never return so I can ditch these 3:44AM internet searches for relief. I threw on a longsleeve shirt tonight since I just moved and cannot locate the sore muscle rub cream (the menthol and the burning from that tends to help). Anihistabs no longer work all that well.. But then again, with so many meth heads.. the good antihistabs have been pulled off the market. I have scrapped layers of skin off my left forearm to try to get rid of the itchy skin areas.. Bad idea, but some time off in Costa Rica would be nice. If we could relax, we'd all be better off.
I guess itching and the scratching is better than drinking booze until we pass out and the worries (whether we know they are there or not). Sleep would be great.. So I guess it's time for my Chocolate Chip Pancakes or maybe I'll go with a huge eggs and turkey sausage meal and watch the sun come up. Maybe a pet will help? No.. then I'll worry about it when I am noit at home and the itch will show up later that night. Oh well. Goodnight.
by heartRN, Aug 06, 2007 10:46AM
To: blong1717, dr. rockoff
Thanks for all the hard work that I don't have to do now! I started with my itch when I was pregnant with my second boy. I did all the same lotions, benadryl, ice, baths, etc.. My itch is mainly on the left arm and sometimes extends from left neck to left wrist (after the initial scratch and then repeated uncontrollable scratching of course). It does seem worse after being in the sun, but can't escape it very well in sunny Tucson, AZ. I thought it was just the hormones of pregnancy at that time, because the itch stopped after delivering my baby.
Now it is back 3 years later for no obvious reason. I have long thought of it as a neurological issue because it seems to start from the inside-out and not from any "skin problem", and because nothing topical helps. A friend of mine told me that she heard it may be caused by the intake of Aspartame, you know, the artificial sweetener Equal or in most diet pop. I don't use a lot of it, and often use Splenda instead, but do have an occasional diet Pepsi or Equal in my coffee.I also know that Aspartame causes a lot of other problems in people from severe headaches to irritable bowel syndrome, so it wouldn't surprise me. Have any of you heard of this or do you use Aspartame regularly?
I also go to the chiropractor for neck issues and interestingly have missed 3 weeks of adjustments and the itch is worse, wondering if getting back on track will help since it will help keep the nerve tracts open and free flowing. I know this forum was started 5 years ago and hope some of you still access it once in a while....
by TazTaz, Aug 06, 2007 07:43PM
To: blong1717
I also have been suffering from the same itch on my arms for over 30 years.  The doctors finally called it Nero Dermitis and gave me the LIDEX FLUOCINONIDE  and yet the only real relief is ICE.  It is worse in the evening and generally last for one or two months out of the year.   Never the exact same time.   Usually beginns in Sept, Oct  or January and this year it began is July.   I know what each of you are going through and it may be best to ignore it however it is too intense and yet I have a high tollerance for pain.  This is worse than pain in my opinion.  If anyone finds something that works please let me know.   I have tried every itch cream made even bought Jock Itch and every thing works for about a day and then it is back.

HELP.................
by TazTaz, Aug 06, 2007 07:48PM
To: Lewbee
Just read your post and I am so sorry to hear you suffer from the same issue.  I don't drink anything our use anything with Equal or the Aspartame in it.   It is nerves but most of the time I don't feel nervous or upset about anything.   I just want it to go away......................
by Bob_Oso, Aug 09, 2007 07:40AM
Wow! I thought this was all in my head, and I'm the only one who has suffered. I have exactly what blong1717 described, and it's even in my left arm. The first instance was about 13 or 14 years ago. I saw a GP, then a dermatologist. Neither were of any help, but said it would probably disappear just as mysteriously as it appeared. They were right. But it's back again, for about two weeks. Ice is the only thing I've found that helps, but I've also been trying to make sure I drink 8 -10 glasses of water per day. It seems to be slowly getting better, but you all know how bad it can be when you haven't slept well for days.
by RobynWow, Aug 10, 2007 02:28PM
To: All
Bathe only with Aveeno Menthol and use the Aveeno menthol lotion.  Nothing else.  NEVER NEVER SCRATCH.  Just like with poision ivy, it just makes it worse.  Ice it at the first sign of itch and you will feel relief.  Sun makes it worse.  Not sure if the sun starts it or just kicks it up.  I am a frequent sun bed user, had to stop when the itching started.
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