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Dr. Andrew Rynne

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Suggest treatment for severe itching on the arms

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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2243 Questions

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Posted on Thu, 9 Mar 2017 in Mental Health
Question: My sister Meryl has a Dermatologic problem. She is nearing 60 years of age. She has very severe itching on just her upper and lower arms that begins and subsides at intervals throughout the day. She has had a psychiatric condition and is prescribed Haldol peridol 2mg. and has been on this medication for 40 years. She is allergic to Thorazine, she has had severe swelling. At one time she was given cogentin 0.5 for side affects of the Haldol for about 30 years. She was taken off it about 10 years ago as it was felt that she was on it too long as Cogentin is dangerous and her body should be used to the Haldol without any side-affects. She takes the Haldol every evening because it could have a tranquilizing effect during the day.

Because of the itching she sometimes has to shower twice during the night. She was prescribed Triamcinolone Acetonide 0.1%. She was recommended only to use it 2 to 3 times per week. It was recommended that she use Sarna, Aveeno, Ceravae. The itching is still persistant.
There is some relief, but it comes right back shortly after. Claritin and Benedryl help to some extent. Her psychiatrist who has been her Dr. for 20 years has refused to give her Cogentin again even as a trial to see if it helps the itching. She has been itching for at least 10 years. Her dermatologist who has not helped the condition called it severe dry skin. This sounds absurd to me.
My sister Meryl said to mention she smokes a pack of cigarettes and drinks beer daily. She is current on all her preventative Medicine. No other medications. Her Psychiatrist works in a state run clinic.

Please help her, It would be a god send as she has been living with this torturous condition for way to long.
Maybe a Dermatologist with a consult of a Psychiatrist might have an anwser.
Thankfully,
XXXX XXXXXXX
doctor
Answered by Dr. Alexander H. Sheppe 41 minutes later
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Cogentin is an anticholinergic medication, and as such will not help with the itching unfortunately. Her psychiatrist was right not to offer this. Benadryl at higher doses may be a better idea, as it is an antihistamine which combats itching. One thing that could be contributing is the daily cigarette use, which dries the skin, and also has several toxins in it that can cause itching. Another is the daily alcohol use, which can harm the liver and cause a buildup of bilirubin which can cause skin itching. I recommend she stop both these activities and see if the itching improves.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Alexander H. Sheppe 6 hours later
Dear Dr. Sheppe,



Thank you for your response. Corresponding with your private e-mail is this a more secure private sight that will not be viewed by Health Magic?



Regarding Meryl's discomfort, Easier said than done in regard to eliminating cigarettes and alcohol. Is it possible that the Haldol is contributing to the itching, it itching a side effect? If so, is there an alternative to the Haldol that might be equivalent these days.



What about lowering mg. of Haldol, or taking it in two smaller doses per day? Meryl is doing very well these days emotionally. She lives on her own for the 1st time in her life, as my Mom is very ill and is living in my home this past year. She hardly sleeps because of the discomfort. She also believes that when she feels a stressful moment, the itching begins. It reminds me of my experience with migraines, when I feel stress the migraine may begin. Is it possibly a reaction to the fear of the itching beginning. Like a vicious cycle.



Something has to be causing the itching. She has been smoking and drinking beer for 45 years. The itching is only the last 10 years, since she stopped taking the Cogentin. What would the Cogentin have been prescribed for along with the Haldol?

I am not saying that smoking and drinking may not be a contributor, but the primary cause? Doubtful.

Thoughts?



Thank you
XXXXXXX


Thank you Dr. Sheppe, maybe we can get through to Meryl regarding the smoking and Beer. She just had her 4th cup of coffee today, Ha,ha.

Maybe she will agree to begin the patch. I will keep you posted on her progress.

Much appreciated,
XXXXXXX
btw: I tried 2 times to send you a private email and it is not going through. The website address noted is : tinyurl.com/DrSheppeAnswers
doctor
Answered by Dr. Alexander H. Sheppe 5 minutes later
Brief Answer:
Followup

Detailed Answer:
Haldol does not cause itching. Cogentin is prescribed to prevent extrapyramidal symptoms (a movement disorder sometimes caused by Haldol), which she no longer needs. However, alcohol and cigarettes both are often primary causes of itching. As I explained above, alcohol affects bilirubin levels in the liver that can cause itching of the skin. Cigarettes contain over 80 chemicals that are toxic to the body and can causing itching of the skin as well. I strongly recommend she sto both in order to stop the itching.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers



Brief Answer:
Followup

Detailed Answer:
You're very welcome.

That is a web site, not an email address. Type it into your web browser.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Prasad
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