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Suggest Treatment For Recurrent Pruritus

Posted on Wed, 9 Mar 2016

Question: I have had severve itching on and off for for over 4 months. I consulted both my doctor and a dermatogist. My dermatologist thought it sounded like scabies, and at her request I took the permethrin cream treatment and for about 4 weeks I felt much better. Now the itching is back. It returned slowly till it became very intense again. I tried the permethrin cream again and finished the second treatment five days ago. but it is only getting worse. I itch so bad in the evening and at night. I have a great deal of trouble sleeping. Now I am beginning to itch during the day just as much. I getting very depressed. I have changed soaps, detergents, deodorants, beds and nothing seems to help. I went to my doctor and she did not blood work, but nothing unusual showed up. Could I be allergic to something? My friends have suggested I live with them for a week to see if it is something in my home environment that I am reacting to. I do not believe I am under any unusual stress. Nothing major has changed in my life. I am desperate for help.

Answered by Dr. Dr. Kakkar (5 hours later)

Brief Answer:
Do you have any skin lesions?

Detailed Answer:
Hello. Thank you for writing to us

I have read your query and i have noted your concern.

I would like to know whether you have any visible skin lesions??

I would keep a possibility of Xerosis i.e severe dryness of skin.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (41 minutes later)

I have no skin lesions.

At first my dermatologist treated me for dry skin. For several weeks I moisturized my skin 3 times daily and used Triiamcinolone. I had been an avid swimmer and swam 2-4 times a week. I have completely given that up. I also use to bath 2 times a day, now I just bath once in mild water with Dove soap.

Could I be allergic to something in the environment I live in? (mattress, carpet, furniture, air conditioning system) All of these things I have had for over 20 years.
Should I try living with friends for a week to see if things get better?

Should I see an allergist?

Should I go back to my dermatologist?

Answered by Dr. Dr. Kakkar (4 hours later)

Brief Answer:
I suggest you to try the following treatment plan

Detailed Answer:
Hi.

I suspect that itching is due to senile xerosis. I suggest you to use an ammonium lactate based moisturiser e.g Amlactin 12% lotion, twice daily. Ammonium lactate is hydrating as it holds and traps moisture within the skin.
Orally you may take a tablet of cetrizine 10 mg twice daily.
Use a non-drying soap, twice daily e.g dove or oilatum soap.
I also suggest you to take a tablet of Gabapentin+Methylcobalamin for a few days e.g Tablet Nova-M 75 Or Pregaba-M 75, twice daily for a few days. This can be specifically useful for patients who do not respond to conventional antihistamines like cetrizine.
These are prescription medications and I suggest that you visit either a dermatologist Or a physician for the needful.
I don't think you have scabies because patients of scabies usually have some skin lesions and it is hard to believe that scabies has persisted for 4 months without any skin lesions.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar