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Brachioradial Pruritus: Intensely Itchy Arms
By
Michele Blacksberg RN
HERWriter
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Via Wikipedia
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
Article Sources
1) Brachioradial Pruritus. Medscape. Retrieved August 13, 2016.
http://emedicine.medscape.com/article/1355312-overview
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.
http://www.degruyter.com/downloadpdf/j/sjdv.2009.1.issue-2/v10249-011-0006-z/v10249-011-0006-z.xml
3) Thoughts about brachioradial pruritus. The Online Journal of Community and Person-Centered Dermatology (OJCPCD). Retrieved August 13, 2016.
http://ojcpcd.com/elpern-d-j/thoughts-about-brachioradial-pruritus
Add a Comment130 Comments
Hiya I live in England so the sun isn't really a problem, I've had severe itchy arms ever since I got sunburnt on holiday ( never again ) it flares up for no reason and drives me mad , I'm messaging this at 2.30am because I can't sleep with the itching , haven't been to doctors about it because last time I went he made me feel I was mad , I've brought some aver no skin releif so wish me luck , but I'll also try lime juice and some Lancôme , I'm so fed up of itching and it drives my family mad
November 16, 2015 - 7:43pmThis Comment
Hi, if you're on Facebook there's a group on there that will help. Get some ice packs as if it's this you're going to need it. You'll need to be referred to a neurologist for an mri. There's a lot of English people there so that rules out the sun being the problem.
November 30, 2015 - 6:06amMe personally, I have a degenerating spine that is causing mine, now on a trial and error medication (and lots of ice) until we find something that works. Good luck
This Comment
What is the name of the Facebook page? Thank you. Joan from Courtice, Ontario, Canada
August 27, 2016 - 9:13amThis Comment
I have had the itching since August 2009 and it really itches at night on my wrists and forearms the only relief I get is if I shave my arms and use psoriasis cream but it don't work all the time when I use cream. It lasts for 6 months at a time and there's time I rub my arms raw but I feels much better.
November 15, 2015 - 7:13pmThis Comment
I've had the same itchy symptoms for about 5 years I live in Florida my go-to medicine is the aloe plant, I rub it on my arm within minutes I get relief for a few days. It works very well for me it takes away all the uncontrollable itching. I hope it works for you
March 25, 2016 - 4:22pmThis Comment
I've had this condition the months following my honeymoon, where I suffered from extensive sun damage. That was 29 years ago. Each October, I have intensely itchy forearms for months - and the only true relief is indeed ice. I find that if I don't cover my arms enough during the previous summer, the attack the following fall is far worse. For me, there is NO doubt this is sun related. Years that I have covered my arms in the sun, I barely notice the problem.
November 12, 2015 - 3:49pmThis Comment
I have been suffering with this problem for years, but only in the fall. Every year from September through November or December. Ice has always been the only thing to help. I really don't think it has anything to do with the sun. I have a swimming pool, & spend a lot of time in the sun during summer. I don't itch then. I've begun to wonder if it has anything to do with allergies, as I have more sinus problems in fall than any other time of year. Who knows. . . I've asked my dermatologist about it on more than one occasion. She didn't know what the problem was either. Really!?!? She said it was probably eczema and suggested using perfume free detergent, soap, lotion. None of which has stopped it! I am so excited to have stumbled onto this site! Now I know I'm not crazy! I will try some of the creams suggested, and the lime juice. Thanks so much!
November 4, 2015 - 12:36amThis Comment
Hi there - try covering your arms next summer - and you will see, there will be a notable difference in the fall to your itching. It seems that the itching does not occur during the summer months for me, however if I spend a great deal of time in the sun with uncovered arms, I suffer with it terribly in the Fall. Good luck.
November 16, 2015 - 4:40amThis Comment
I have been suffering with this condition since early summer and have tried many creams, lotions, anti histamines etc all with no cure. But a friend who has a similar condition suggested I try aveeno skin relief lotion. I am ecstatic to say that after using for only one week morning and night I have had no further attacks. Apparently this product is free from an additive found in many other products. It costs around £4.60 and worth every penny.
October 27, 2015 - 4:18amThis Comment
Hi all!
About 2 years ago I was diagnosed with brachioradial pruritus after the CONSTANT itching that only ice could save me from. My doctor prescribed Triamcinolone 0.1% cream and it is a LIFE SAVER. Anytime I feel an itch coming on I lather it on and it keeps me from having an itching attack. I would really recommend it!!
October 21, 2015 - 5:24pmThis Comment