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What Causes Severe Itching With Skin Redness On Leg
Question: Hello,
I am a 42 year old female who has been recently suffering with profuse itching on my legs. Sometimes they turn a little red, like they have fever, but mostly itching. The only thing that will stop the itching is when I take an antihistamine. I've treated it as an allergy and changed laundry detergent and don't use a softener anymore but the upper part of my body does not react the same way and I'm still itching. Any suggestions?
Brief Answer:
? Eczema
Detailed Answer:
Hello,
Welcome to healthcare magic.
From your history, I understand that you have itching mainly confined to your lower limbs.
The differential diagnosis I can think of with your history and description include venous or stasis eczema, asteatotic eczema and xerosis (dryness of skin).
Venous or stasis eczema occurs due to the presence of varicose veins, especially if you have the habit/occupation of standing for a prolonged duration.
Asteatotic eczema occurs with increasing age as the skin gets depleted of the normal fatty layer. It could be worse if you have any thyroid abnormalities or if you are on cholesterol lowering medications like statins.
Xerosis is a term used for exaggerated dryness of skin which could worsen with changes in weather, use of harsh soaps, etc. Legs are more prone for xerosis as they have poorer circulation due to gravity.
Could you give me some more history so that I can assess better and recommend treatment appropriately?
1. Are you on any other chronic medications like cholesterol lowering agents (statins)?
2. Do you have any thyroid abnormalities?
3. Did you have eczema in your childhood days?(I see that you have mentioned that you are an asthmatic. Such individuals might have associated dry skin which could get worse with age and medications).
4. Do you have varicose veins / prominent veins on your legs?
5. Do you use any moisturizers and if so, do you feel better on using them?
You have an option of uploading a clinical photograph and it would be good if you could do the same.
Regards,
Dr. Johny Chacko
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Chacko,
To answer your questions, I am not on any chronic medications like statins. I've been tested before for thyroid abnormalities, but at the time, everything looked normal. I did not have eczema during my childhood, just asthma. I do not have varicose veins in my legs but recently tried a new moisturizer that triggered this. I stopped immediately thinking this was the cause. I've done everything I know to do that would be related to allergies, but the itching continues. The itching gets so bad that it feels like it comes from the inside my leg - not just on the outside that is an easy scratch/fix.
Thanks, XXXXXXX
Brief Answer:
? Asteatotic eczema
Detailed Answer:
Dear XXXXXXX
Thank you for the clarifications.
From the additional history you have given me, I would like to consider the diagnosis of Asteatotic eczema.
As I mentioned in my previous reply, it occurs with advancing age as the skin slowly gets depleted of the lipid/ fatty layer. This could worsen with harsh soaps and external triggers ( could be the moisturizer as in your case).
I would have also considered xerosis, however it is unlikely to cause such severe itching.
I would recommend you the following-
1. Use a mild corticosteroid cream like hydrocortisone or fluticosone twice a day on your legs for 10-15 days. This will help relieve the eczema component and hence relieve your itch.
2. Follow this up with the regular use of an emollient ( moisturizer) . You should use a bland emollient which is fragrance free and colour free. You could use petroleum jelly also. Colloidal oatmeal containing moisturizers are also a good option( e.g.- Aveeno) Remember to apply the moisturizer within 3 minutes of your bath on damp skin so that that moisture is trapped within your skin. Repeat the application at bedtime and whenever you feel itchy.
3. Use a soap free cleansers like Cetaphil cleansing lotion to have bath. Avoid bar soaps.
4. Use lukewarm water for bathing and avoid hot water.Hot water may temporarily relieve your itch, but it strips the skin off the normal fat and makes the eczema worse.
5. You could continue antihistamines for another 10 days.
5. Avoid rubbing/ scratching your legs.
Hope these recommendations help you.
If you have any further queries, I will be glad to assist.
Take care.
Regards,
Dr. Johny Chacko
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I will do what you suggested.
Brief Answer:
Asteatotic eczema
Detailed Answer:
Dear XXXXXXX
I am glad I could help.
Take care.
Regards,
Dr. Johny
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
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