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Suggest Treatment For Itchy Hands, Fingers And Wrists
Question: Hi
I have severely itchy hands, fingers,palms and wrists. Also, the tops, sides and bottom of my feet itch too. I occasionally get an itch on my the nape of my neck as well. It can be accompanied by mild chills as well. The itching is extreme and only ice packs seem to calm it. Creams and lotions are of no help and Benadryl had no impact. The skin has no lesions or visible signs of a rash and they my feet and hands get swollen. This condition flares up randomly with no obvious triggers and worsens at night. Hydration and temperature do not seem to have an effect.
I am on Synthroid and thought it might be that but I went off of it to test and no immediate relief has occurred. Sometimes the itching can also be in other parts of my body as well but the itchiness always starts in the hands and foot. I am miserable and am hoping someone can help direct me. Thank you!
I have severely itchy hands, fingers,palms and wrists. Also, the tops, sides and bottom of my feet itch too. I occasionally get an itch on my the nape of my neck as well. It can be accompanied by mild chills as well. The itching is extreme and only ice packs seem to calm it. Creams and lotions are of no help and Benadryl had no impact. The skin has no lesions or visible signs of a rash and they my feet and hands get swollen. This condition flares up randomly with no obvious triggers and worsens at night. Hydration and temperature do not seem to have an effect.
I am on Synthroid and thought it might be that but I went off of it to test and no immediate relief has occurred. Sometimes the itching can also be in other parts of my body as well but the itchiness always starts in the hands and foot. I am miserable and am hoping someone can help direct me. Thank you!
Brief Answer:
Pruritus, most likely due to thyroid disease.
Detailed Answer:
Hello,
Well this sounds perfectly miserable.
I've noted that you said you have no rash and I will assume you have thyroid disease since you take Synthroid. Causes of chronic itching (pruritus) with no rash includes autoimmune disease, lymphomas (but with this you would usually get night sweats) but also thyroid disease, which you do have.
Treatment of chronic pruritus is similar to treatment of chronic urticaria (hives).
Here is an article about evaluation of chronic pruritus: http://www.medscape.com/viewarticle/729938_1
If you can't open it, I can copy the important points here.
I see that you have tried Benadryl. Allergists and dermatologists usually use much higher dosages of antihistamines for pruritus and urticaria than for nasal allergies. Zyrtec is commonly used because it is less sedating, but usually 2 - 6 (10 mg) pills/day.
If you want to try this, start slowly, increasing gradually as needed.
Although you have a medical condition that can predispose to itching, it would still be a good idea to go to your doctor, or an allergist, or a dermatologist, to have a thorough evaluation. This should include a CBC, blood chemistry, liver and kidney function tests, iron, ferritin, ESR ("sed rate") to start with. Further tests are listed in the last paragraph of page 4 of the article I linked.
I can provide next steps after this, but this will get you started.
So...
1. See a physician with experience in evaluating and managing pruritus such as a dermatologist or allergist.
2. Try Zyrtec and gradually increase the dose as tolerated.
There are other medications that can be added on or substituted for Zyrtec but an H1 blocker in a higher dose is usually the place to start.
I do hope you get some relief. Please let me know if I can provide further information.
Pruritus, most likely due to thyroid disease.
Detailed Answer:
Hello,
Well this sounds perfectly miserable.
I've noted that you said you have no rash and I will assume you have thyroid disease since you take Synthroid. Causes of chronic itching (pruritus) with no rash includes autoimmune disease, lymphomas (but with this you would usually get night sweats) but also thyroid disease, which you do have.
Treatment of chronic pruritus is similar to treatment of chronic urticaria (hives).
Here is an article about evaluation of chronic pruritus: http://www.medscape.com/viewarticle/729938_1
If you can't open it, I can copy the important points here.
I see that you have tried Benadryl. Allergists and dermatologists usually use much higher dosages of antihistamines for pruritus and urticaria than for nasal allergies. Zyrtec is commonly used because it is less sedating, but usually 2 - 6 (10 mg) pills/day.
If you want to try this, start slowly, increasing gradually as needed.
Although you have a medical condition that can predispose to itching, it would still be a good idea to go to your doctor, or an allergist, or a dermatologist, to have a thorough evaluation. This should include a CBC, blood chemistry, liver and kidney function tests, iron, ferritin, ESR ("sed rate") to start with. Further tests are listed in the last paragraph of page 4 of the article I linked.
I can provide next steps after this, but this will get you started.
So...
1. See a physician with experience in evaluating and managing pruritus such as a dermatologist or allergist.
2. Try Zyrtec and gradually increase the dose as tolerated.
There are other medications that can be added on or substituted for Zyrtec but an H1 blocker in a higher dose is usually the place to start.
I do hope you get some relief. Please let me know if I can provide further information.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi! Thank you so much for responding! I am so appreciative as i have been so inconfortable and not sure where to turn. It is sp frustrating because i eat super healthy - i don't eat grains or gluten at all and stay away from sugar too.
This gives me a place to start and some hope there is relief or management of the symptoms.
I will contact a local Dr to have tests run and then i woild cery much like to circle back with you. Do tou have any thoughts as to why tge itching increases at night or why chills can also be present?
Thank you again for your thorough and professional response!
XXXXXXX
This gives me a place to start and some hope there is relief or management of the symptoms.
I will contact a local Dr to have tests run and then i woild cery much like to circle back with you. Do tou have any thoughts as to why tge itching increases at night or why chills can also be present?
Thank you again for your thorough and professional response!
XXXXXXX
Brief Answer:
About increased itching at night...
Detailed Answer:
Hello XXXXXXX
Yes, I know from personal experience how demoralizing severe, ongoing itching can be.
Of the two types of doctors I recommended, the more I think on it, an allergist might be best. If you live near a university hospital/clinic, consider going to one there as they might be more up on the research. Sometimes you can find their interests and research areas if they are posted online by the hospital (on the hospital's or clinic's website under allergists). One that studies chronic urticaria would be best. If the allergist's recommendations don't help, then go to a dermatologist.
About the chills - it may be an autonomic nervous system reaction - but I do not know for sure. The autonomic nervous system is the same one that can cause people to faint when seeing something upsetting, or with pain.
About it being worse at night: I do know that itching, and any inflammatory or infectious problem can feel worse at night because of the diurnal cortisol pattern. Cortisol rises in the morning, giving us energy, and decrease aches, pains, itching, inflammation. Then it starts to drop in the late afternoon/early evening, which allows us to sleep better at night.
Another thought: Zyrtec is expensive and you may be taking a lot of it. If you are willing to take generic, cetirizine (Zyrtec's generic) is inexpensive.
I would be happy to talk with you after you get some help (or anytime). You can reach me by asking a direct question to me.
Good luck to you!
About increased itching at night...
Detailed Answer:
Hello XXXXXXX
Yes, I know from personal experience how demoralizing severe, ongoing itching can be.
Of the two types of doctors I recommended, the more I think on it, an allergist might be best. If you live near a university hospital/clinic, consider going to one there as they might be more up on the research. Sometimes you can find their interests and research areas if they are posted online by the hospital (on the hospital's or clinic's website under allergists). One that studies chronic urticaria would be best. If the allergist's recommendations don't help, then go to a dermatologist.
About the chills - it may be an autonomic nervous system reaction - but I do not know for sure. The autonomic nervous system is the same one that can cause people to faint when seeing something upsetting, or with pain.
About it being worse at night: I do know that itching, and any inflammatory or infectious problem can feel worse at night because of the diurnal cortisol pattern. Cortisol rises in the morning, giving us energy, and decrease aches, pains, itching, inflammation. Then it starts to drop in the late afternoon/early evening, which allows us to sleep better at night.
Another thought: Zyrtec is expensive and you may be taking a lot of it. If you are willing to take generic, cetirizine (Zyrtec's generic) is inexpensive.
I would be happy to talk with you after you get some help (or anytime). You can reach me by asking a direct question to me.
Good luck to you!
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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