Itchy arms is a common problem. When itching is limited to your forearms and relieved only by applying ice, then we often call it brachioradial pruritus. Brachioradial is the muscle just underneath the itching area and pruritus is the smarty-pants word for itching. In this video I’ll give two possible causes and tips on how to treat this terribly itchy condition.
Itchy butts are part of my everyday. It shouldn’t be part of yours.
Itching on your bottom is usually a minor annoyance, but it can be debilitating. A patient of mine was unable to work because his derrière itching was so intense. A common cause of itching bottom, called pruritus ani, is allergic contact dermatitis.
Places where your skin transitions from outside to inside, such as lips or anus, are susceptible to dermatitis because your skin’s barrier is limited in these locations. Without a thick layer of keratin, irritants on the outside easily get into your skin. Moist toilet tissues, such as baby wipes or towelettes, might seem to get you cleaner than old-fashioned toilet paper, but chemicals in the wipes cause a rash in some people.
Preservatives such as methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) or kathon CG are often used in packaged toilet wipes and are a common cause of allergic contact dermatitis. Many patients who have itching on their behinds fear that they are unclean, use more cleaning wipes, worsening their dermatitis. It becomes a vicious cycle. Avoiding all commercial wipes or towelettes usually resolves the rash and itching. If not, then see your dermatologist before you find yourself on extended medical leave.
Have you ever had an itch so bad that you thought you’d go mad?
I’ve been seeing a lot of jocks lately. The anatomical area, not the athletes. Summertime means heat and humidity, sports, and itchy groins. Jock itch is a general term for an itchy rash in the area. Heat, sweat, and skin rubbing on skin can leave the area looking like you slid into second base, groin first.
There are three main causes of an itchy groin. Classic jock itch is caused by a fungus, the same fungus that causes athlete’s foot. This fungus often causes a red scaly rash on the inner thighs. It tends to be dry and can have bumps or pimples. The fungus is often spread from your feet or from contaminated sports equipment, towels, etc. It can be treated with topical terbinafine cream 1% twice a day for 2-4 weeks. Severe cases can require oral anti-fungal medications, especially if the fungus has spread to other areas on your body.
The second cause of an itchy groin is a yeast infection (yes, the same yeast that can cause a vaginal yeast infection in women). The yeast grows well in warm, moist areas and causes a bright pink, moist, irritated rash. Unlike the fungus, yeast can spread onto the scrotum. It can be treated with topical clotrimazole cream 1% twice a day for 2-4 weeks.
The third common cause of a jock itch is a bacterial infection. Certain bacteria take advantage of the irritated skin and warm environment causing a rash called erythrasma. This can be treated with miconazole 2% cream twice a day for 2 weeks.
For all causes of jock itch it is important to keep the area clean and dry. Sometimes washing your groin with anti-dandruff shampoo such as zinc or selenium sulfide shampoos can help clear unwanted organisms. Hydrocortisone 1% cream can be added to any of the above treatments to reduce the redness and itching while the infection is being treated. Use it once to twice daily.
Remember, it is important to keep the area dry. The standard way is to use powders (some of which are medicated for an added bonus, such as Gold Bond). Once the active infection is resolved, treating your groin with your underarm antiperspirant can help keep this area dry, thereby making it less inviting for fungus and other organisms to return.
However, I don’t recommend spraying antiperspirant on your groin if you’re in the midst of a raging jock itch — you’ll spend the entire day scratching an area that shouldn’t be scratched in public.
Photo: jkstrapme (flickr)
You know that the sun increases the risk of skin cancer for most people. You probably don’t know that for some people, the sun is the source of a terrible itchy rash — they’re allergic to the sun.
The radiation from the sun triggers some response in everyone’s skin. In some, the radiation triggers an immune reaction, leading to red, itchy, burning bumps. There are several diseases that are caused by sun which lead to rashes. Here are a few:
Polymorphous Light Eruption (PMLE): This is the most common. It is usually characterized by tiny, itchy red bumps that develop on the arms, neck and face hours after sun exposure. It is often seen in the spring and occurs more frequently in young people.
Actinic Prurigo: This is seen as itchy red bumps that occur mostly in children who are sensitive to the sun. Like PMLE, it occurs mostly on the face (including lips), arms, and hands. It can be more severe than PMLE and can lead to scarring in rare instances.
Chronic Actinic Dermatitis: This usually affects adults. It starts in areas exposed to the sun, but can spread to other areas. It is often terribly itchy and can be triggered by sunlight even though car windows.
Solar hives (urticaria): These are itchy pink whelts that develop within minutes of sun exposure. The rash develops quickly and fades quickly but can be intensely itchy. Antihistamines such as Zyrtec (ceterizine) or Benedryl (diphenhydramine) can help.
There are other sun-induced diseases, including ones triggered by medications. I’ll write about them in a future post. In all of these conditions, the most important thing to remember is to avoid sun exposure as much as possible. If you develop an itchy or burning rash after sun exposure, then see your physician for an exam and for advice.
Photo: Sandman (flickr)
The forest is full of things that make you itchy: poison ivy, poison oak, mosquitoes, chiggers. But for the wise adventurer, the forest also provides a way to heal your itch. The remedy might be found in the beautiful white birch tree.
White birch trees are ubiquitous in cold climates. A photo of the white tree against white snow is iconic of New England winters. A bark extract called Betulin (a terpene like tea tree oil) has been shown in animal studies to be antimicrobial, anti-inflammatory, and to aid in wound healing. Research presented at the annual congress of the European Academy of Dermatology and Venerology showed that a cream containing betulin significantly reduced itching in red, irritated skin in psoriasis and eczema patients.
The study is only preliminary, and betulin will need to be tested in rigorous trials to see if the extract makes a cream much better than placebo cream; however, betulin is already available in creams in Europe.
So how do you get the extract out of the bark if you’re itchy while hiking in a forest? I’ll wait for Bear Grylls to show us on a future episode of Man Vs. Wild. No doubt a fire and half a plastic bottle will be needed.
Photo: Nicolas T
My skin is dry. I know, I know, I’m a dermatologist, but it’s not my fault — I went home for the holidays. Continue reading “Arctic Blast: Itchy, Dry Winter Skin”
Hives are itchy pink blotches that develop on your skin. They come up quickly, are extremely itchy, then disappear without a trace in minutes to hours. Many things trigger hives including foods, medicines, and sometimes exercise.
Exercise-induced hives (or urticaria) develop when your skin warms during exercise. Once your skin reaches a certain temperature, itchy welts suddenly bloom. The hives favor your stomach, back, or chest but can occur anywhere. One thing is for certain: They always intensify into a maddening itch.
Eating cheese, seafood, celery, or wheat within a few hours of starting exercise can trigger an outbreak. People who have exercise-induced hives also sometimes react when they take medications such as aspirin, ibuprofen, or naproxen before exercising.
In some people, exercise-induced hives occur when they exercise in cold weather. This often happens when they jog in cold weather, ski, or swim in the ocean (especially here in California where the water is always chilly).
If you’re exercising and you develop an itchy red rash, then stop exercising. If the hives don’t go away within 15 minutes, then stop your workout. Avoid eating cheese, celery, seafood, or wheat for 4 hours before your workout. Similarly, avoid aspirin or ibuprophen for 4 to 6 hours before exercising. Taking antihistamines such as Benedryl or Zyrtec an hour before exercising may help block an outbreak. Antihistamines also hasten the resolution if taken immediately when the rash occurs.
In rare cases, exercise-induced hives cause swelling of the throat, difficultly breathing, and even death. If you develop swelling of your mouth or throat, or difficulty breathing or swallowing, then seek immediate medical help. Patients with high-risk allergic reactions should carry an epi-pen at all times and should never exercise alone.
Photo: Ernst Moeksis