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dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4124
Experience:  30 years practice in general and cosmetic dermatology
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I have had chronic itching on my arms last 18 months.

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I have had chronic itching on my arms for the last 18 months. There doesn't appear to be a rash and I have seen 2 dermatologists at the hospital who said it was dry skin. It can't be as I put cream on at least 4 times a day. It wakes me up and is like someone sticking needles in. I have tried at least 4 types of cream but nothing helps.
Thank you for asking your question.This sounds like a condition called Brachioradial Pruritus.If using an icepack on the area, causes relief that pretty much clinches the diagnosis.
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We do not know what causes this although some authorities feel it is caused by irritation of the nerves which innervate that area of the arms.
Some physicians recommend Capsaicin Cream. In the United States this is Zotrix HP. Apply this twice a day for at least two weeks. It takes about two weeks for this to work, if it does work, so be patient. This works by depleting the skin of Substance P. Substance P is a neurotransmitter which causes itching. It takes at least two weeks to deplete the skin of Substance P. Oral Gabapentin ( Neurontin) may also work. Your physician should begin at a dose of 300 mg. at night and gradually increase. Lamictal and Elavil have also been tried.
Although I am not a big fan of chiropractic, this has been tried also and occasionally been useful. I have also tried Botox injections with success.
Acupuncture has also been tried.
Some experts attribute damage by sun exposure may be the cause.So, in sum, put an ice pack on the area when you are having symptoms. If you obtain relief, the cause may be Brachioradial Pruritus. Then try Zostrix HP. This is over the counter. If this does not work, seek medical help.I would be happy to answer any further questions.