Neuropathic itching is itchiness triggered by nerves. The itch feels deep, like it's under the skin, making the sufferer scratch especially hard.
Neuropathic itch should be suspected in patients with chronic itch on normal appearing skin without a relevant systemic condition causing itch. A detailed medical history, especially in relation to the sensory symptoms, can further suggest the presence of a neuropathic origin.
A neurological itch (also called neuropathic itch) is caused by injury to nerve fibers in the brain, spinal cord, skin, or other parts of the body. Unlike many other types of itch, neuropathic itches often involve nerve pain and often get more intense the more you scratch.
Topical anesthetics: Topical application of an anesthetic ointment may reduce the itching. Oral medication: Some oral anti-itching medicines, such as Zyrtec, Benadryl, or a prescription for Atarax (similar to Benadryl) to provide relief.
Although pruritus has not been considered as serious a symptom as pain, it is difficult to treat and--if chronic--can severely impair quality of life.
Neuropathic itch is a potent trigger of reflex and volitional scratching although this provides only fleeting relief. Rare patients whose lesion causes sensory loss as well as neuropathic itch can scratch deeply enough to cause painless self-injury. The most common location is on the face (trigeminal trophic syndrome).
At night our body temperature fluctuates and goes down a bit. Most people tend to sleep in a cooler room as well. The thought is that damaged nerves might interpret the temperature change as pain or tingling, which can heighten the sense of neuropathy.
Treatment for neuropathic itch is similar to that for neuropathic pain and includes such medications as anticonvulsants, antidepressants, and capsaicin. In addition, ondansetron, cyproheptadine, antihistamine agents, and opiate antagonists can be effective.
Although it is not always the case, anxiety and itching can sometimes share a very close relationship. An anxiety disorder may cause the sensation of itching. If this happens, the itching is not due to an underlying skin condition or irritant, but instead, appears as a symptom of anxiety.
Not only is itch associated with greater anxiety, but stress has also be shown to exacerbate itch, leading to a true itch-anxiety cycle. Many chronic itch patients report that psychological stress is a factor that aggravates their itch.
But researchers do know that when the body's “fight, flight, or freeze” response is activated under stress, it releases a flood of hormones and other chemicals, such as cortisol and adrenaline. Stress also activates the immune system to release histamine, a compound known to play a role in signaling itch sensations.
In other words, because many people don't know that itch is a fibromyalgia symptom, they may not have thought to mention it. Many people with these conditions have abnormal nerve sensations, a symptom called paresthesia . It can cause pinprick, burning, zinging, shooting, and tingling sensations, as well as itchiness.
Capsaicin or heat greater than 43°C degenerates or desensitizes sensory neurones expressing transient receptor potential vanilloid 1 (TRPV1) and relieves neuropathic pain as well as itch (5, 6).
Neuropathic itching, however, won't go away. Worse than that is the fact that it's common, underrecognized, and often misdiagnosed.
Diphenhydramine may be useful in the treatment of neuropathic and nociceptive pain that has failed to respond to treatment with opioids and adjuvant analgesics. We suggest a starting dose of 25 mg of oral or parenteral diphenhydramine every 6 to 8 hours, with titration to effect.
Several conditions affecting the peripheral nervous system are associated with neuropathic itch (Table 1). In small-fiber neuropathy (SFN), which results from injured C- and Aδ fibers (4), itch and pain may occur localized (mostly distally at the feet) or generalized.
Stress rashes or hives usually disappear within a few hours or days. It's important to avoid scratching your hives rash so that it heals and doesn't leave behind marks. Sometimes, stress rashes and hives can come back repeatedly for weeks or months. When hives last longer than 6 weeks, it is called chronic urticaria.
Itching on the whole body might be a symptom of an underlying illness, such as liver disease, kidney disease, anemia, diabetes, thyroid problems and certain cancers. Nerve disorders. Examples include multiple sclerosis, pinched nerves and shingles (herpes zoster). Psychiatric conditions.
Which antihistamine is best for allergic skin rashes? The best antihistamine to take during the day to help with allergic skin rashes is Curist Allergy Relief (levocetirizine) or another antihistamine like fexofenadine or loratadine, which can provide 24-hour symptom relief without making you feel sleepy.
Try relaxation techniques:
Relax your muscles by first tensing them while breathing in, then breathing out and releasing the tension. Use the power of your mind: imagine lying down, gently falling asleep, staying asleep during the night, and feeling rested in the morning. Try 10 minutes of meditation before bed.
Vicks Vapor Rub® – Massaging one's feet with Vicks, particularly at night, soothes neuropathic pain and distress in one's feet and legs. It is also excellent for softening your toe nails and diminishing common toe nail problems. Warm/Cool Baths and Showers - Excellent de-stressors and can help with reducing pain.
Some recommended sleeping positions include sleeping in a recliner, sleeping on the back with a pillow underneath the legs, and sleeping on one side of the body with a pillow between the thighs.
Itching and rashes often occur together, but itchy skin alone can happen with dry skin, bug bites, some health conditions, or as a reaction to certain medications. The causes of skin itching, or pruritis, are usually harmless. They are often temporary issues such as dry skin or a bug bite.