Itching and Brain-Injured People: It Wasn’t As Bad As My Anxious Self Thought

I got an intense itch a couple of weeks ago that came on suddenly, so I visited the PCP (primary care physician) right away. The PCP had me purchase Benadryl and a moisturizer, all over-the-counter stuff. So I want home and was happy to try them, but the itching got worse that night.

I ruled out food allergies and new medication because I swallow the same things every week. I had a stroke 15 years ago and thought was some connection. However, nope. No connection. To my anxious, sometimes demented, and overtly creative self, I thought medical journals worldwide would feature me as the first unknown itching phenomenon. Unfortunately, I can be dramatic.

It wasn’t even neuropathic which is common for brain injury, a blog post I wrote in September last year which is an intense itch for a person with a brain injury and is often a medical condition called, like its name, neuropathic itch. Unlike common itches caused by skin irritation, this sensation originates from damaged or malfunctioning neurons in the central nervous system that send false “itch” signals to the brain. This condition irritates nerve endings just below the skin surface, triggering the itch sensation. The skin barrier makes it more sensitive to irritate.

I had those slightly raised marks on both arms that presented itself like a drug addict. Itching “whatever it was” propelled me to seek further advice. So two days later, I went to the dermatologist.

“Oh,” he  said, “it’s nothing more than the winter itch. It’s dry skin,” he uttered, in that casual way he has. “I’ve had eight cases this week.”

Uh-oh. My appointment was Wednesday afternoon. And it was only since Monday. Somehow, that statement “had eight cases this week” didn’t make me feel better. What did make me feel better was I wouldn’t be featured in medical journals worldwide. I like attention but not like that.

Here’s why it happens. Itching caused by dry skin, clinically known as pruritus hiemalis, commonly known as winter itch, is more than just an annoyance. It’s a signal that your skin’s protective outer layer lost moisture, and allow moisture to get out. Scratching the itch feels good, but it makes you itch even more, damaging the skin’s “armor” even further. 

So moisturize regularly, ideally right after bathing or showering while skin is still damp, not wet, to lock in moisture. Look for these three types of ingredients in only one product: humectants that retain water into your skin, like glycerin or hyaluronic acid, emollients that fills the fissures among skin cells, like shea butter or mango butter, and occlusives that create a physical seal to stop evaporation, like Vaseline or Aquophor.

Here’s how to tell how thick the cream is: If it comes in a pump bottle, it’s a lotion that’s mostly water. If it comes in a jar or a tube, it’s a cream (ointment) that’s more oil than water. Therefore, jar or tube is your go-to, like a greased pig (an 1800s expression at a festival that makes the pig hard to catch! That sounds like no fun.) 

Anyway, if you’re moisturizing but still itching after your shower, moisturize again. Use a humidifier, especially the bedroom in winter or in dry climates because otherwise, the air will literally pluck the moisture out of your skin. Keeping a humidifier in the bedroom can prevent the nighttime itch. I know because the itch was g-o-n-e completely! 

If the itch is waking you up at night, you possibly have Xerotic Eczema. So in that case, you might need a prescription for a topical steroid to stop the immune response so the skin can heal.