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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19310
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I suffer from terrible itching around my neck and shoulders.

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I suffer from terrible itching around my neck and shoulders. I have had it on my ankles, forearms and back too. No visible rash, and it's not insect bites. Is it eczema?
Hello from JustAnswer.
It will help if you could provide some further information.
How long has this been bothering you?
Did you notice any benefit from the betamethasone valerate?
Have you had any other evaluation for the itching?
Customer: replied 3 years ago.

The problem started approximately three years ago, first on my ankles and lower legs, then on my forearms and back. About a year ago, it has been my neck that has been itching so much (the condition appears to have gone from my forearms).

The betamethasone valerate helps considerably, but I wondered if there was any other medication which might be more effective?

I visted my GP when the problem started and he told me that it was 'eczema', and that it was 'a life-long incurable condition'. I would love to know what causes it (is it caused by stress?), and whether or not it is indeed 'incurable' (my GP has since retired and I have not yet consulted his replacement).

Also it may provide you with more help if I explain that the problem is by far at its worst when I am in BED, so much so that I now try to avoid going to bed as much as possible. It has been suggested to me that the reason for it being so bad in bed is due to warmth (bodily warmth - held in by the duvet etc.). If I am cold, the itching is far less.

Thank you for the additional information.

Part of the issue is that the term, eczema, can actually mean many different conditions. It is commonly used to describe an allergic inflammation in the skin, but it also can be used to reference another common condition of chronic dryness of the skin that can cause irritation and itching.

With the absence of a rash, itching is most often related to the type of eczema that is related to chronic dryness of the skin. The history of worsening of the itching when the skin is hot is also more commonly seen with this type of skin problem.

All of the various forms of eczema are a chronic condition. There are no true cures of the condition, although there are interventions that may help. The condition may wax and wane over time, and someone may notice complete resolution of symptoms at times, but it will typically recur periodically.

I ask about other evaluation because there usually would be some consideration of other causes. In the absence of a rash, the other major considerations would be certain systemic conditions that can cause itching, such as liver or kidney disease or thyroid dysfunction. If you have had recent blood tests, then your doctor may have been able to exclude these other possibilities without a specific evaluation.

So, it is most likely eczema, and most likely the type of eczema that is related to excessive dryness of the skin. The betamethasone valerate is a common treatment for eczema, and has the advantage of helping several of the common types of eczema, but there are some other options to consider. It is not that these other interventions are overall better, but they are oriented towards the specific type of eczema and some people find that different interventions may work better for them.

For the type of eczema that is related to allergic inflammation of the skin, it may help to use an oral antihistamine. The oral antihistamines also have a direct action on relief of itching from any cause. However, since the antihistamines are taken systemically, they are more likely to cause side effects, such as sedation.

For the type of eczema that is related to dryness, it may help to apply a moisturiser to the skin. Many of my patients also find relief in soaking in salt water, such as by adding table salt or Epsom salts to bath water. Soaking in plain water tends to dehydrate the skin, but the salt water is hydrating to the skin.

If I can provide any further information, please let me know.
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