How To Treat Neuropathic Itching

From bug bites to dry skin, there are many reasons why a person may feel an urge to scratch itchy skin. While most times a sensation of itchiness arises due to an issue involving the skin itself, other times itching and feeling the need to scratch may be due to a condition involving the nervous system called neuropathic itching, according to MedicalNewsToday. This type of itching is often a side effect of a plethora of underlying conditions including, but not limited to, shingles, diabetes, tumors of the brain or spine, multiple sclerosis, nerve damage or irritation, and peripheral neuropathy. Treating the underlying condition is often the first step in treating neuropathic itching.

Harvard Medical School reports that neuropathic itching, also known as neuropathic itch, is a form of chronic itch caused by the brain rather than by a topical issue affecting the skin. In many cases, neuropathic itch is a form of insatiable itching that can range from bothersome to painful for people who experience it. 

Scientific specialists including neurologists, neuroscientists, and neurobiologists have studied the sensation of itching and believe that it is a primitive protective sensation that alerts us to localized threats like insects biting parts of our skin. But when itching becomes widespread and chronic, the primitive protective service it provides is no longer properly helpful. In the case of neuropathic itching, the itching sensation can be more intrusive than beneficial. 

Here are the best ways to treat this type of itching.

To treat neuropathic itching, first identify the cause

When it comes to treating neuropathic itching, identifying the underlying condition causing the chronic itch is the first step in pursuing appropriate treatment. 

There are two prominent conditions causing neuropathic itching that frequently present in patients over the age of 40 (via HealthCentral). These diagnoses are brachioradial pruritus and notalgia paresthetica. Primarily affecting the arms through sensations of tingling and itching, brachioradial pruritus can be the result of injury to the cervical spine or the peripheral cutaneous nerves. Notalgia paresthetica results in itching around the shoulders and back and is also related to damage to the cervical spine. 

For neuropathic itching resulting from these two conditions, treating the damage to the spine and nerves is the best route for getting rid of neuropathic itch, which in the case of these two diagnoses is often referred to as a deeply intense and unreachable itching sensation. For brachioradial pruritus, effective treatments for both neuropathic itch and the underlying condition include cool compresses and topical anesthetics, as well as prescription medications like benzodiazepines, anticonvulsants, and pregabalin. Similarly, for notalgia paresthetica, prescription medications such as gabapentin (which inhibits nerve damage pain), anticonvulsants, and antidepressants are commonly used to treat neuropathic itching and other symptoms of the larger diagnosis.

In the meantime, there are many ways to holistically manage neuropathic itch, including practicing mindfulness and meditation, wearing loose-fitting clothing, keeping fingernails short, and regularly applying moisturizing lotion to the skin (via MedicalNewsToday). Over-the-counter lidocaine patches, creams, and ointments can help to temporarily relieve itching.