Do you get very itchy arm yet your skin looks completely normal? If so, you may be suffering from a condition known as brachioradial pruritus. The patient usually gets itchy forearms, but the irritation can spread to the upper arms and shoulders. You may also feel a stinging, burning, or tingling feeling, with the irritation on one or both of your arms. Although it is very tempting to scratch your arms, this will usually make the itching worse. Many patients find that applying ice packs to the affected areas of the skin improves their symptoms.

What Can Cause Itchy Arms?

1.       Brachioradial Pruritus

Brachioradial pruritus can make you feel itchy, tingling or stinging or a changed sensation on the skin of either or both arms. Brachioradial pruritus develops due to damage to nerves in the cervical spine (neck). This may be caused by:

• Cervical spine tumors
• Cervical rib
• Compression of the nerves
• Cervical vertebral osteoarthritis
• Other spinal cord conditions

Continuous pressure on the spinal neurons conveying itch impulses can activate sensitization processes. When nerves transmitting light touch and pinprick sensations are over-stimulated, the patient may develop sensitive or sore skin, with intense responses to touch and pain (conditions known respectively as hyperesthesia and hyperalgesia).

Brachioradial pruritus will typically affect one particular area of the skin (a dermatome), but may spread to other regions. The condition is more common in sunnier climates, as prolonged exposure to sunlight may harm nerve fibers in the skin.

Brachioradial pruritus is usually diagnosed by taking a biopsy of a small piece of skin. This is then examined under a microscope, and doctors may see reduced skin tissue (skin atrophy) and damaged nerves.

2.       Other Causes

• Eczema is a long-term non-infectious condition resulting in itchy inflamed skin, which gets worse at night. Eczema can develop anywhere, but is most frequent behind the knees and on the arms. It appears as red, dry and cracked patches, and you may see fluid-filled bumps on the skin.
• Lichen planus is a chronic non-infectious inflammatory skin ailment. Patients usually get itchy forearms and inner wrists. There may be groups of lesions that are purple-colored, flat, have defined borders, and are covered with white lines, known as Wickham striae. The skin may look shiny and become scaly.
• Contact dermatitis is a common skin condition caused by contact with irritants or allergens. It appears as an itchy rash, and you may also experience blisters, red bumps, thick scaly skin, and soreness in the affected region.
• Ringworm infection appears as a circular itchy rash that is inflamed and reddened at the borders and normal skin-colored in the center. The rash is usually raised, and you may experience sores and blisters. Ringworm infection is very contagious.
• Hives is a common non-infectious condition with a welt-like rash, which may be extensive. The rash is red or pink, with raised itchy spots, and can last anything from a day up to 6 weeks. The itching can be intense, and occasionally patients experience burning or stinging.
• Certain drugs may cause some people to develop itchy skin rashes, either as an allergic reaction to or as a side effect of the medicine. You may also notice red spots propagating all over the body, scaly or thick skin, and shortness of breath.
• Shingles affects previous sufferers of chickenpox, caused by the herpes zoster virus. When the virus becomes reactivated, patients feel tingling, pain, and numbness in one particular skin area, which develops into a red itchy rash. This rash will eventually become blistered; the blisters will then burst and dry out.

How to Deal With Itchy Arms

1.       Avoid Exposing Your Arms to Sunlight

Sun exposure can exacerbate the itching, so try to keep out of the sunlight, wear long sleeves, or apply a zinc oxide-based sunscreen.

2.       Keep Your Arms Moisturized and Avoid Skin Scales

Dry flaky scales on the skin can easily be irritated by the movement of air and clothing. Both nerve damage and dry skin become more common as we get older, so it is important to frequently apply moisturizer to the skin on your arms.

3.       Use Ice Pack

Ice packs will help to counteract the itching effects of heat, and can inhibit itch nerve impulses from your arms.

4.       Rub Some Anti-Itching Lotions onto Your Skin

Products containing ingredients such as pramoxine, menthol, and/or camphor can help to soothe itchy irritated skin. For further relief, try storing these products in the fridge so that when you apply them, they feel nice and cool on your skin.

5.       Avoid Scratching Your Skin

Scratching will only worsen your symptoms and damage your skin, making it thick and leathery. It also increases the size of the nerves in the skin, exacerbating sensitivity.

6.       Apply Creams

You can also try using the following creams to relieve itchy arms:

• Creams containing capsaicin, a compound that removes chemical transmitters from nerve endings
• Creams with local anesthetics
• Creams and gels containing anticonvulsant agents, for example gabapentin and pregabalin
• Topical ketamine and amitriptyline creams

7.       Other Remedies

As an alternative to traditional treatments, try spraying some antihistamine onto your arms to ease the itching. Topical anti-itching remedies, such as menthol, may also help. Oral tricyclic anti-depressant medications, such as amitriptyline, taken at night can provide some relief. Some patients use oatmeal or tannin (found in black tea) compresses on their arms, whereas others find acupuncture relieves their symptoms.

Itchy arms or brachioradial pruritus is a frustrating and difficult ailment to manage. Finding the right treatment for you requires try-and-error, and a lot of patience, both from yourself and those around you.