Do you experience an itch in the middle of your back daily?
Did your itchy back manifest as you aged?
Do deeply moisturizing creams and lotions provide no relief?
The Itchy Back PhenomenonIf you answered yes to all these questions, it is possible your itchy back is not due to traditional dry skin issues. Your itchy back may be a result of notalgia paresthetica, a nerve condition. Dr. Bailey originally discussed this subject in her blog post, "What Causes Itching in the Middle of the Back?".
10% of people will develop an intense itch in the middle of their back over their lifetime!
As Dr. Bailey says, an intense itch in the middle back is common. However, the medical community disagreed over the cause of a persistent itch at the middle of the back. Now the scientific community have identified notalgia paresthetica as the culprit to persistent and localized itch on the back. When Dr. Bailey attended an itch seminar at the 2011 American Academy of Dermatology annual meeting, they discussed how to diagnose notalgia paresthetica and how it caused itch sensations. Dr. Bailey used this information to develop methods to help relieve the symptoms associated with notalgia paresthetica. First, you will need to understand the mechanics of notalgia paresthetica.
What is Notalgia Paresthetica?Notalgia paresthetica is result of a nerve impingement in a spinal nerve. Here is Dr. Bailey's explanation:
As the nerve exits the spine, a small branch curves around to innervate the skin. It travels through a big muscle to reach the skin and on its journey it gets squeezed. The squeeze usually happens in or around the spine.
Dr. Bailey stresses that this condition does not mean your nerves or anything else is damaged in the spine. Spinal calcified spurs naturally form as we age and may cause an impingement in a spinal nerve. This is why an itchy back manifests suddenly in your later years.
When an itch occurs from a spinal level it is called a neuropathic itch or by the medical community as neuropathic pruritus.
The impinged nerve will make one perceive an itchy spot in the middle of their back when in fact the skin is normal. The skin upstream from the "tweaked" nerve may be hypersensitive to clothing, shirt tags, dry skin, etc. Dr. Bailey has seen patients that suffer from this condition develop a darkening of the skin from years of scratching a singular area.
The itchy skin area is usually a diameter of a tennis ball and found in between the spine and a shoulder blade. If you suspect notalgia paresthetica may be the cause of your itchy back, consult a local dermatologist to accurately diagnose the issue.
Is There a Treatment for Notalgia Paresthetica?There are treatments for the associated symptoms or skin issues for an notalgia paresthetica itchy back skin problem.
Skin hydration and softening with AHA's: Dr. Bailey considers alpha hydroxy acid containing moisturizers the best skin hydrators. AmLactin Cream (over the counter) or even better and more effective is Dr. Bailey's Ultra-Fast Triple Action Body Smoothing Kit with glycolic acid (AHA) to treat itchy, dry, and scaly skin. AHA moisturizer both hydrates the skin and removes dead skin scales, the triggers for an itchy back.
“My barnacles are WAY better. Those ugly old age spots are gone, there was one on my chest, my shoulder and leg that are gone. I didn’t take the Body Kit on vacation and I noticed a difference. It’s a maintenance issue.” DPP 2009
- Wear Soft Fabrics: Avoid wearing rough fabrics and even remove the clothing tags from your shirts and sweaters.
- Cold Compress: Place an ice pack over the itchy area. The cold sensation will override the itch sensation the impinged nerve is causing. Do not use heat. Heat localizes and intensifies the itch.
- Avoid Scratching: Scratching strengthens and thickens the nerve. The more a nerve is engaged and receives messages from contact, it will strengthen and thicken over time.
- Apply Anti-Itch creams with Pramoxine or Menthol: Keep them in the fridge for added relief
- Prescription Cortisone Creams: Useful for intense itchy periods. Consult a local dermatologist if this might be useful
- Oral Medication: There are several oral medication for neuropathic pruritus. However, there are complex side effects that require a dermatologist consultation and supervision.
- Alternative Treatments: A safer option. Dr. Bailey has found acupuncture and bio feedback work for some patients.
These are Dr. Bailey's most common practices, but she always encourages people to contact their local dermatologist to determine what treatment will best suit their skin condition. For a more in depth discussion on notalgia paresthetica, read the original article "What Causes Itching in the Middle of the Back."
Dr. Bailey Skin Care Team
Photo attribution: Thanks and gratitude to © Doable/amanaimages/Corbis