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
I have had BRP for over 5 years and when I have flare ups (at least 3 times a year) it is maddening. Until I realized others suffered from this condition I assumed it was in my head and had been told by doctors that it was caused by stress (the most annoying thing to here!). I thought I was the only person to use the ice packs for relief before scouring the internet for clues to this condition. No creams work and I come close to inflicting myself with pain (cutting or scratching until bleeding) because pain is preferable to the maddening itch. I am only responding because I recently came across something that does bring me some relief. I borrowed a TENS unit from my friend and as I dialed up the “shocks” to the nerve endings I did find relief! I am ordering one through Amazon and pray that it’s nit temporary. I also may order an inversion table to help with my neck but will wait until I have an MRI done to confirm any cervical issues. The TENS unit is only $30 and I was willing to pay much more if it works. Crossing my fingers for long term relief...October 4, 2017 - 7:14pm
I am wondering if I have the same thing going on. Intense itching on both upper arms to the point that I want to claw them. Even scratching til they bleed seems preferable. I am going to try the ice packs. Can you let me know if the tens unit is ongoing relief for you? I have been diagnosed in past with fibro and neuropathy. I know I do have nerve damage from several years ago. I anxiously await your resultssOctober 5, 2017 - 5:42pm
I am actually using one right now as I type this. It does work to alleviate the pain at the time which helps me get some sleep. The one I am borrowing shuts off after 15 minutes so I do have to turn it back on. I’m going to check some other units before purchasing one (I’m currently on vacation visiting friends). Unfortunately while out during day I was going insane with the itch. I caused bleeding which my husband had to point out. I do carry a T-gel spray with me that is put out by Neutrogena which is an overnight dandruff treatment with Salicylic acid 2%. It does help me but it’s impossible to find. I saw it on the internet recently and my mom happened to have it - not a cream but a spray. The tens unit is working temporarily but I am desperate for long term relief. Good luck because others either don’t believe you or don’t understand!October 7, 2017 - 7:46pm
I have also suffered with this so called BP condition over the past 3 years,and have found it so so frustrating to the point of itching my skin off!.August 15, 2017 - 7:13pm
I believe i have cured this with the use of a cream called eumovate...it works for me and i have had nothing whatsoever now for over 3 weeks. Hope this helps
Im going to try this . I just started with this so called BP and im like so depressed. Funny how i was suffering from chronic neck pain and right arm pain for so long until i started doing some PT. Worst part is this is all from anxiety . Been suffering from anxiety as well. :-(October 11, 2017 - 2:50pm
I’m so sorry to hear how this has been affecting you but understand it 100%. I never sleep and suffer terribly on some days. The ice packs are the only sure fire temporary “cure” at this point. I have also discovered some relief with any liquid product with 2% or 3% salicylic acid such as Scalpicin which is a scalp relief product. Works for people with eczema and I read about someone trying it - it did provide some relief so I carry it with me always (easier than finding ice while I’m out!). My new TENS unit should come today ($30 on Amazon) so I have high hopes for trying to sleep with that. Good luck. It’s a long journey on trying to find what may work for you. It made it easier for me to know I wasn’t the only one with this maddening condition!October 16, 2017 - 2:24am
Hi, I have been dealing w/ BP for over 3 yrs also &f and have tried everything the stuff you mentioned is a RX or over the counter & I'm still miserable plz let me know plzSeptember 8, 2017 - 3:52pm
I have all of these symptoms and also on the legs. When the dermatologist diagnosed me with BP, she could tell me the reason that I also have it on my legs. I'm getting acupuncture treatment right now and i also had to take out all dairy products in my diet. after 10 days i was expose to the sun and it happened again. I'm really frustrated. I understand the arms but legs...???August 14, 2017 - 11:52am
Hi. After experiencing again this as you describe it, googling this and finding your forum, reading your possible causes, pondering my own problem and then remembering where it all started for me. Short answer, I am allergic to a certain famous washing powder. I probably am not allowed to use the name of the product.August 2, 2017 - 1:06am
Recently my better half switched to this certain clothing washing powder again just because the store was not stocking the alternative, forgetting that I have this problem, never telling me of course. The times of my terrible itchy and scratchy bouts coincide with the wrong washing powder being used.
The worst spot is my right arm just below the elbow. I use a right hand steering vehicle if you wish to argue the sun burn thing. At night I wake finding myself progressively trying to rip the flesh off my bones.
I get up, get burnt skin lotion, 1ste aid stuff, and try get to sleep again, desperately trying to ignore the pain.
My other arm on the same place has it too, but lesser. In fact, is on all the joints.
As a child my mom took my for allergy tests because of the itching. Atropical Eczema they said, getting older it was Winters Feet, could not wear those military boots when I was supposed to. Now it's back again, it all correlates to using the wrong washing powder on my clothes at times. When I roll up my sleeves,the itching subsides almost instantly.
If my better half does not finish rewashing everything, I'll start burning all my clothes soon.
Hope this helps you.
I found something that is working for me!July 30, 2017 - 7:05pm
Have had this problem for 10-15 years, starts in the summer and goes away late fall. Worse when I am at rest, if I am keeping busy with my hands then not so noticeable. Tried the creams-ointments-home remedies-chiropractors, MRIs - lyrica, etc. Ice helps but is only temporary relief. Avoiding the sun also helped as did avoiding caffeine which seemed to exacerbate it . Trying to sleep was awful and thought I would lose my mind!
This summer it started again, used wet cloths and lyric to fight it off. Then spoke with my primary care physician and asked her if she would give me a kenalog injection in my arm. This has worked for me, been 3 weeks, have some slight sensations from time to time and have not taken any lyrica since 4 days after the injection. Able to work outside in the sun, drink a cola once in awhile, and sleep through the night. Life is good again.