What is a neuropathic itch?
A neuropathic itch happens when there is damage to the nervous system.
Damage to either the central or peripheral nervous system can cause a neuropathic itch.
While a regular itch results from some kind of issue with the skin, a neuropathic itch has a different, deeper origin.
Symptoms
A neuropathic itch may produce an itching sensation or a feeling of pins and needles. The itching may be very severe.
Neuropathic itch may also produce the following sensations:
- burning
- wetness
- electric shocks
- pain
- numbness
- crawling
- severe cold
Some people with neuropathic itch may also experience other symptoms such as:
- prickling and chilling of the skin
- increase in skin sensitivity
- decrease in skin sensitivity
In people with neuropathic itch, scratching can also make the itch worse.
Causes
There is very little understanding of the bodily mechanisms that create itching sensations.
It suggests that lesions in the nervous system that damage itch-related neurons may cause neuropathic itch. Conditions and diseases that may cause neuropathic itch include:
-
notalgia paresthetica, which is nerve pain that may involve itching of the back
-
brachioradial pruritus, a nerve disorder that affects the arms
-
peripheral neuropathy the term for damage to the peripheral nerves that often produces symptoms in the hands and feet
-
shingles
-
stroke
-
diabetes
-
vitamin deficiencies
-
[trigeminal trophic syndrome,a rare condition that happens because of trigeminal nerve damage
-
burns or keloids
-
spinal tumor
-
brain tumor
-
multiple sclerosis
Diagnosis
Doctors may have difficulty diagnosing neuropathic itch, as they may initially assume that the problem is skin-related.
However, a dermatologist can rule out any dermatological causes of itching.
Doctors usually prescribe topical treatments to people who present with itching. They may suspect neuropathic itch when these treatments do not work.
However, it can be tough to find the exact cause. If traditional anti-itch therapies do not work, people should consult a neurologist.
Doctors may perform a skin biopsy to check for neuropathic itch.
Treatment
Treating neuropathic itch is difficult because most anti-itch medications do not provide relief.
Treatments typically involve local anesthetics or physical barriers to prevent scratching, as scratching too much or too hard can cause painful lesions or other unintentional self-injury.
Other treatments and therapies may include:
- lidocaine creams or patches
- anti-seizure drugs, such as gabapentin
- botox injections
- neurostimulation techniques
- some antidepressants
- acupuncture
- meditation and mindfulness
- cognitive behavioral therapy (CBT)
Other behavioral interventions may include:
- cutting the fingernails
- wearing protective garments
- applying moisturizer regularly
- avoiding warm or hot temperatures
- wearing loose clothing
Risk factors and complications
There is no research on the associated risk factors for neuropathic itch. It is possible for two people to have the same health condition and only one of them experience neuropathic itch as a symptom.
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