Brachioradial pruritus (BP) is a condition where the person experiences intense itching, burning and/or stinging to one or both arms. The itching often occurs between the shoulder and the elbow on the sides of the arms but can also extend up to the shoulders.
Scratching can make the itching feel worse, rather than bringing relief. Using ice packs is one treatment that may calm the itch.
Why brachioradial pruritus occurs is unclear. There are two basic mechanisms that are thought to be the cause of this uncontrollable itch.
The first is the solar hypothesis. It is thought that people who have had chronic sun exposure develop an allergic type of histamine response in their skin.
This theory receives some support from the fact that people usually report more left-sided symptom over right-sided. This could be explained by the sun shining more on the left arm while driving.
In South Africa, where drivers sit on the right side of the car, the incidence of BP more frequently affects the right arm. Symptoms also often are worse in the summer and improve in the fall.
The second hypothesis is that BP may be caused by a neuropathy (problem with the nerves), specifically some type of irritation or compression of the cervical nerves in the neck. Treatments for cervical arthritis have shown to improve those with the condition.
This type of itching is called a neuropathic itch. Impulses are sent due to hypersensitivity of the nerve fibers. Sometimes people feel both pain and itching, as well as some type of sensory disruption such as altered sensation in the area.
A 1987 study even suggested that BP may be caused by a combination of the two stating that, “brachioradial pruritus is a photoneurological disorder caused by sun-induced damage to nerve endings that results in pruritus and altered sensation in susceptible individuals.”2
Another dermatology blog suggests that exposure to wind may also contribute.3
However, there are critics to both main theories.
The solar critics point out that people’s faces get just as much sun as the arms, so why doesn’t one’s face develop this problem?
The cervical nerve damage critics point out that cervical neck degeneration occurs in 70 percent of elderly women and 95 percent of elderly men. So without further studies it doesn’t make sense that many other older adults don’t develop this condition.1
Regardless of cause, there are some treatments that may help brachioradial pruritus.
For most people with BP, the itching is prickly and burning, and that can keep them awake at night.
Ice packs are the first best therapy to try to stop the itch.
Capsaicin is a topical cream that is believed to help with pain-related nerve conditions by interfering with the sensory nerves' perception of pain. It may take several weeks for the capsaicin to work.
Sometimes a topical steroid cream can take the edge off.
With a doctor’s prescription, a lidocaine 5% gel or patch can be applied to the skin. Lidocaine provides relief by blocking nerve impulses.
Other oral medications that act to block erroneous nerve impulses such as gabapentin, lyrica or amitriptyline can also be tried. However, they are also fairly sedating and have other side effects, so they may not be well tolerated.
Alternate treatments include acupuncture and topical anti-itch oils such as menthol or spray-on antihistamines, which may give some relief. Oatmeal or black tea tannin compresses may also be of help.
Chiropractic adjustments of the neck have also been found to be helpful by some. Wearing protective clothing such as long-sleeved shirts to protect your arms from wind and sun may help.
Brachioradial pruritus is a very frustrating and difficult condition that requires understanding from others, as well as patience and persistence to come up with some amount of relief.
Michele is an R.N. freelance writer with a special interest in women’s health care and quality of care issues.
Originally written March 2, 2011
Updated August 16, 2016 by Michele Blacksberg RN
Edited by Jody Smith
1) Brachioradial Pruritus. Medscape. Retrieved August 13, 2016.
2) Berny-Moreno , Joanna, Szepietowski Jacek C.. Neuropathic itch caused by nerve root compression: brachioradial pruritus and notalgia paresthetica. Serbian Journal of Dermatology and Venereology 2009; 2: 68-72.
3) Thoughts about brachioradial pruritus. The Online Journal of Community and Person-Centered Dermatology (OJCPCD). Retrieved August 13, 2016.
Add a Comment130 Comments
ALLEGRA, ALLEGRA, ALLEGRA
I have suffered from severe itchy left arm for probably 6-7 years. I am a 50 year old female. It comes between September and October and lasts until December or January. Through the years I have seen chiropractors, neurologists, and dermatologists. No one has been helpful at all. No cream or ice can even begin to control my symptoms. Recently I was at our local medical clinic for an unrelated issue, with a generic family doctor, and he said it has to be a seasonal allergy because if it was neurological, or stress, or skin damage, why wouldn't I have it all of the time. Totally made sense. I have never considered myself one to suffer from seasonal allergies (sneezing, congestion), but he said that is not always the case. We moved to the northern part of Mississippi 10 years ago from Wisconsin. I hind sight, my symptoms started not too long after our move to the south. Anyways, he said Allegra (the allergy medicine) should help because it is a histamine blocker. He said Claritin and Zyrtec are crap, don't even try them. I was amazed! My symptoms are probably 80% better, almost instantly. I still feel a tiny bit of tingling, but not the 1,000 needles pricking me, uncontrollable itching that keeps me up all night, want to rip my arm off, crazy that I have experienced for years. I still believe there can be many causes for this problem, but hopefully this will help someone!October 4, 2018 - 9:13am
I'm very hopeful, now that I've read your comment! I'm so glad that you took the time to relay your experience!!! This is my 2nd Fall of experiencing intensely itchy arms. Mine seems to start in September, but I don't recall when it stopped last year, although I do remember not suffering with it during the winter months. The itch started on my left arm, and now the right is also affected. It wakes me up at night, so I'm also tired and cranky during the day. My arms are now peppered with scabs, and I'm worried about scarring, as I'm also fair, but the itch is just too intense to keep myself from scratching. Anyway, I'm hoping we have Allegra here in Canada. Hitting the pharmacy is now first on my 'to do' list, for the day. THANK YOU so much for posting; I'm very hopeful about trying Allegra and will keep my fingers crossed. That is, when I'm not scratching, ha, ha.November 14, 2018 - 5:53am
Thanks. I have the same burning itch predominately during summer/fall. It's winter now and virtually no symptoms. I will ask my Doctor about Allegra. Thanks!January 6, 2019 - 2:53am
I absolutely agree with you. For me, at least. Mine always starts around September or October & goes through December. I will try Allegra! Thanks for the input!October 4, 2018 - 3:14pm
I'm wondering if this is what I have. My arms start to itch from my shoulders down every night, sometimes during the day but night time is the worst! Now my forearms are starting too but mostly the upper arm. The itching is so intense that I will sometimes make myself bleed and I get no relief. It drives me crazy! I cry sometimes because I don't know what to do to get it to stop. I've tried anti itch cream, lotion, ice packs and a nylon bristle hair brush. None of these work the brush is the best but it seems like as soon as I scratch it itches even worse it feels like a 1000 needles pricking me. I have resorted to slapping myself because the the sting of the slap relieves the itching the best although it doesn't last that long. I do t know what to do, I want to rip my skin off!!!September 9, 2018 - 6:12am
Have you seen a dermatologist? I saw one about 3 months ago and she prescribed some topical stuff as well as recommend I switched soap to Dove and uses lotions that are sold in tubs like Cetaphil. I was like you and was taking the max amount of Benadryl every day and putting on anti-itch lotion. I don't know what made it go away, but I think the harsh soap I used (Dr Bronner's bar soap) may have made it worse. Also, the type of lotion I used may have helped too. I feel you pain! BTW, I'm a 48 year old man. Didn't realize this was a women's health page!October 3, 2018 - 7:19pm
I had this too several years ago and would scrape my arms on the stucco or with a steak knife. It is maddening. Mine went away but has just come back on top of my shoulders and upper arm--not as severe but super annoying. I am being treated for hormonal issues and thyroid and believe it may be related--get checked out for thyroid/hormones and see if it is related...good luck and hang in there. I will ask my doc as well...not sure why it went away on it's own the first time and now has recurred.October 3, 2018 - 12:01am
I totally understand, my left forearm does the same thing. I have tried ice, ice packs, creams, nothing works it’s awful. I feel helpless, I’m up very late with this right now and it sucks due to I have to be up in a few hours and haven’t slept much due to this.September 25, 2018 - 11:18pm
Try the ice again. It works. Ice cubes in a ziplock. Maybe 20min.October 3, 2018 - 4:25pm
I'm sorry you're dealing with this - it sounds miserable. Please seek an evaluation from a dermatologist and talk about treatment options.
SusanSeptember 26, 2018 - 4:15pm