WHAT IS IT?Brachioradial pruritus is a form of severe itching on the outer side of the upper arms, likely caused by nerve overstimulation in this area. Itching, burning, or altered sensation occurs in the arms, especially the outer side of the upper arms. It can be triggered by touch and can affect one or both sides.
The name comes from a muscle (the brachioradialis muscle) that runs along the outer side of the arm. The itch often begins where this muscle attaches to the upper arm. The itch can spread to the entire upper arm, but also to the shoulders and forearms.
It is a very bothersome condition, severely itchy, can disrupt sleep, is chronic and difficult to treat, and is aggravated by scratching.WHAT DOES IT LOOK LIKE?It's just itching; initially, there's no visible skin irritation. But over time, excessive scratching can cause skin lesions such as wounds, scabs, scars, thickening of the skin, bruising, and light or dark discoloration.WHAT CAUSES BRACHIORADIAL ITCH?The exact cause of the itching is unknown, but damage to the nerves in the skin is thought to be involved. There is a correlation with sunlight exposure and sunburn: brachioradial pruritus is more common during the summer months and in sunny climates, and is more commonly seen in people with fair skin and in Caucasians living in sunny climates (Australia, Africa).
Sunburn and excessive sunlight exposure are known to cause severe itching, and this is likely the most common cause of brachioradial pruritus.
Brachioradial pruritus has also been described in cases of damage and compression of the nerves in the neck. This can occur when wear and tear on the spine causes bony spurs to form, pressing on the nerves. It is also seen after accidents.HOW IS BRACHIORADIAL PRUNING TREATED?Given the link with sunlight, it's important to prevent further sun damage by using effective sunscreen and staying out of direct sunlight. Protective clothing that blocks UV light and long sleeves can also help.
Cold compresses can relieve itching.
In addition, there are topical remedies and medications that affect the nerves and/or nerve impulse transmission
.Capsaicin creamApply capsaicin cream 0.025% or 0.075% FNA to the itchy skin 3 to 4 times daily. Capsaicin is a pepper extract that produces a heat sensation in the skin. It irritates the nerves, thus suppressing the itching stimulus. The downside of this cream is that it can cause skin irritation.Menthol productsMenthol inhibits the transmission of itch signals in the nerves. Menthol creams and gels are therefore used for various types of itching, and can also be used for brachioradial itching.
Examples of menthol products are 1% levomenthol in carbomer water gel FNA and 1% levomenthol in lanette cream I FNA.Lidocaine gelLidocaine gel is an anesthetic gel. It is used for pain relief but also inhibits the nerves that transmit itching. The disadvantage is that it has a short duration of action, so it must be applied several times a day.
MedicationsAntihistaminesAntihistamines are tablets used to treat itching and allergies. Older versions (hydroxyzine and polaramine) have side effects such as drowsiness and other effects on the nervous system that can be beneficial for brachioradial pruritus. However, their effect is not as strong, and the side effects (drowsiness) can be bothersome.AmitriptylineAmitriptyline is a medication prescribed for nerve pain. It is also used for depression (gloom). It has also been shown to be effective against brachioradial pruritus. Amitriptyline is usually started with one 25 or 50 mg tablet at bedtime, and if this is insufficient, the dose is gradually increased to a maximum of 150 mg per day (divided throughout the day). Amitriptyline can have side effects; please read the patient information in the package leaflet.NeurontinNeurontin (gabapentin) is a medication prescribed for nerve pain. It is also used to treat epilepsy. It has also been shown to be effective against brachioradial pruritus. The initial dose is usually one 300 mg tablet, and if this is insufficient, the dose is gradually increased to a maximum of three 300 mg tablets per day. Gabapentin can have side effects; please read the patient information in the package leaflet.WHAT ARE THE OUTLOOK?Brachioradial pruritus is considered a chronic condition. It doesn't go away on its own. However, it can gradually subside and be suppressed by using the aforementioned topical remedies or medications. |
