Itchy Arms No Rash: Brachioradial Pruritus

Brachioradial pruritus (itchy arms) is a localized intense itching on the outer aspect of the upper arm, elbow, and forearm. This is commonly seen in fair-skinned individuals who are often exposed to sun. The itching may gradually be more widespread and intense but may still look normal without any rash. The itching may be so intense that may result in bleeding due to scratching.

Although there are several other conditions that are associated with itchy arms, most of them are associated with rash on the arms and probably on other areas of the body too. Most common cause of severe itching with rash is atopic dermatitis, which is characterized by severe itching, redness, scaling and lichenification of the skin. Other common conditions include dry skin, neurodermatitis, allergic contact dermatitis, eczema, psoriasis etc.

Brachioradial prurituis is commonly seen in middle aged individual, however, it may start during adulthood and increase its intensity as individual in exposed to chronic sun. The most common area of itchy arm is the outer aspect of forearm but can be experienced on elbow, upper arms, neck and back. Itching can be intense associated with prickling, burning or stinging sensation. The involve area may be hypersensitive to touch.

Unlike other parts, arms can be easily access in anytime anywhere either private or public so patients will be habitual due to frequent itching. This chronic itching may result in secondary skin changes like scarring and hypo or hyper-pigmentations.

Itchy arms often involve one arm that is frequently exposed to sun but can be experienced on both arms too. In case of bilateral itching it may be suggestive of spinal tumour, so prompt investigation may be needed.

itchy arms

Itchy arms no rash

What Causes Brachioradial Prutitus?

It has been suggested that brachioradial pruritus is cause by nerve damage due to cervical spine abnormalities. Prolonged long-term exposure to sun has also been suggested in the etiology of brachioradial pruritus. Minor injuries and abnormalities of cervical spine like calcium deposit, disc prolapse or bulging, and degenerative changes of spine and skin that occurs due to normal aging or disease and excessive sun exposure can also cause the problem.

Treatment for Brachioradial Pruritus

There is no cure for such itchy arms but ice pack and cooling lotions may be beneficial. Beside symptomatic relief, it is very important to find out the case and treat any underlying systemic cause especially spinal origin. Other therapy like topical capsaicin cream, anesthetic creams, anticonvulsant medications (gabapentine) and antidepressants have also been used with success. Avoiding chronic sun exposure may also help relief the symptoms.

Comments

  1. Brachio-radial pruritis, in my particular situation, is caused by Phase III arthritis in C-5, C-6, and C-7.
    In my opinion, this condition has little to nothihg to do with sun exposure-if so, it would occur over my
    entire body. Impingment of the nerves that ennervate these three dermatomes cause intense, episodic, unpredictable, maddening itching/burning sensationsof being stuck with millions of needles. absolutely insane. Have your doctor prescribe some Gabapentin/Ketoprofen cream (do not take Gabapentin orally). It helps tremendously, along with icing the affected areas. I currently see an upper C-spine chiropractor, and hopefully I will get some relief soon. Good luck to you

  2. This post led me to some relief! I have had this itchy arm problem for years, but this is the first time I have been able to put a name to it. For me, it has been sporadic; it seems to come and go with no discernible pattern. I thought at first that it was an allergic reaction, so I tried changing things like my laundry detergent. Only once did I have a doctor–a dermatologist–suggest that it might be nerve related, but that did not seem to help much. I have tried various topical treatments such as Benadryl and Calamine lotion with little effect.

    This was the first time I heard about trying topical capsaicin cream. After reading the post, I went out and found some cream with 1% capsaicin and tried it out. It worked! However; let me give a few tips to anyone who wants to try this as well so you don’t make my mistakes:

    Tip # 1: READ THE INSTRUCTIONS FIRST!

    Tip # 2: Only use capsaicin if there is a nearby sink to wash your hands. I ran out to the nearest CVS and picked up the capsaicin cream and then popped the tube open in my car and applied a liberal amount to each arm. Only afterward did I notice that the instructions on the tube said to “wash hands thoroughly after application.” Since I was in my car, running errands, I did not have access to a place to wash my hands right away. Big mistake! Capsaicin–as I learned later–is a component that is found in chili peppers. It is a skin irritant. You don’t want it on your hands because your hands will inevitably come in contact with your eyes, nose or mouth. Ouch! In my case, the cream got under my wedding ring and started burning like heck!

    Tip # 3: Be prepared for some discomfort. As mentioned above, capsaicin is a skin irritant. It seems counter-intuitive, but that is why it works to relive the itching. The area where you put the capsaicin cream is going to feel hot! If you go out in the sun, the effect is magnified. Use it sparingly at first to gauge your tolerance for it. The burning sensation lessens (at least for me) after a couple of days use. In my case, I applied it once a day and on the second day noticed a marked reduction in the itching.

    Tip # 4: For goodness sake; if it is on your forearm, don’t wipe sweat out of your eyes with your forearm!

  3. Many thanks for this.
    I took it to show my gp who had never heard if it before. The picture of the woman trying not to scratch says it all.
    I now have amitriptyline and capsaicin cream and am hoping for some relief

  4. After weeks of itching I saw this online, called my Orthopeadic back Dr. For an spot. He had never heard of this. Neck ex Rays showed severe arthritis and compression of discs in C5,6,7. He recommended dry needling(similar to acupuncture) at the PT clinic. Tah-Dah! NO MORE ITCHING. It’s been 2 weeks. PS ice packs were the only thing that worked instantly prior to needling. Creams, lotions, medications do NOTHING so don’t waste your $

  5. I have had this on and off for years (since my early 40s and I am 64 now)and out of desperation put an ice pack on it and it helped . seeing a dermatologist when it first occured was a waste of time as were the hydrocortisone , mentholatum and calimine creams. It is the arm that sticks out the window when I drive so maybe it is sun related, but I will definately talk to the dr. next time I go in,thanks so much for giving this a name

  6. I have very similar symptoms to this. It only seems to happen in late fall and winter though. Is this consistent with any particular cause?

  7. since my dr prescribed GABAPENTIN 100 MG CAP… I HAVENT HAD ANY OF MYT USUALLY HORRIFIC ITCHING… IT A GOD SEND…

    TELL YOU DR TO GIVE YOYU GABAPETIN 100 MG CAPS

  8. Carl C. Hybels says:

    Thanks! I think this is what I have. Itchyleft forearm, no rash –unless I go at it too much. Sarna anti-itch lotion helps a lot as does shaving my forearm so no ‘hair triggers’ for itch.
    The link to disc problem was startling and confirming! I have just started PT for a disc problem bulging likely caused by repeated back strain in moving house, manifests as severe nerve pain in hip-back of butt but docs say is really a back problem. The hurt disc sends pain out along its nerves.
    Wouldn’t have thought a skin problem had any connection! But there you go. Thanks. I will share with my PT person.

  9. Has anyone had relief with chiropractic manipulation?

  10. I also have these same symptoms! Which I only get in early fall through early winter. The itch keeps me awake at night (or wakes me up) and drives me absolutely crazy at times! I’ve tried all the lotions and creams but never heard of capsaicin cream. I have looked for it but cannot find. Can you only get it with a perscription from your doctor?

  11. It’s nice to know I am not the only one. My Husband thought I was just crazy.. The itching is maddening!!! I have also tried the capsaicin cream, it seemed to just aggravate the itching more. Ice is the ONLY relief!! Headed to the Ortho. I know I have back issues and maybe that is the cause.

  12. I just started having the insane itching of my upper left arm. Did a round of prednisone, capsaicin cream, benadryl, oral Atarax, every other OTC topical cream, lotion, and spray. Running extremely hot water over my arm helps as well as placing an ice pack directly on my skin. I’ve had a few chiropractic adjustments, saw a dermatologist and had a skin biopsy done, and now I have an appointment with a neurologist this week. I’m now getting scars on my arm from scratching so much. I’m going to see about the gabapentin!

  13. Extreme problem for years – but it’s a food allergy. The culprit for me is xanthan gum. Check it out – cheap ice cream, many sauces, ie, teriyaki, some barbecue, a latte at Starbucks with Coconut milk, many sausages. Xanthan gum is used as a thickner and, thanks to a suggestion from my doctor as this being a possible cause, as I watched ingredients, within 3 to 5 hours of eating anything with xanthan gum, I was in trouble. Track it for yourself. I think there may be another ingredient yet that is causing this but start with this one once! Feel free to repost and pass along once you test and prove it.

  14. The itching on upper arm was so intense…..and yes, I’ve been in the sun a lot for the last few days (with sunscreen). Anyway, always had a “hotspot” on left arm. Itching so bad that I tried Everything, even anti-itch med., and oregano oil.
    Desperate, I finally tried Miconazole – the cream for yeast infections. Thanking God right now that it worked! It was the worst Ever.

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