Hi there, I understand your frustration, and I have to admit that we as a medical community sometimes struggle to treat conditions which we can t categorise well, or do not fully understand, like in the case of brachioradial pruritus. We are still not able to pinpoint the exact cause of it, which makes treatment very tricky, because there are no set guidelines and not enough research - everyone is still flying blind. What we would basically do in situations like these is to take it on a case-by-case basis, and personalise treatment for each patient on a trial-and-error method. Now that you understand how management will proceed, I am really interested to find out what kinds of treatment you have tried. The easiest way to soothe it would be cold packs, which you can fashion yourself at home, anytime you like. Be careful not to fall asleep with ice against your skin, because it may cause a burn. Make sure you avoid sunlight whenever you can, and try to avoid hot showers, which might flare up the itch. If you want to try anti-histamines, try the really sedating type like chlorpheniramine or hydroxyzine (Atarax) to help you sleep at night. Further steps would be going the route of assuming that it is a neck problem, and visit either an orthopaedic surgeon or a chiropractor, who might be able to recommend some imaging to see if indeed there is some nerve irritation at your cervical spine. Some people respond quite well to chiropractic manipulation of the neck. Other types of medication would require that you get a prescription and be monitored regularly by a doctor, for example like amitriptylline or gabapentin. Note that all these methods are to be tried personally, and if you don t respond just move on and try the next thing. Do not give up and despair, just keep looking for a doctor who will be willing to walk with you on this difficult journey. Be patient, because it is not a common problem and he/she may need some time to perform their own research and study before they are prepared to plan out steps for you. Hope this helps, and all the best to you. Regards, Dr. Teh