The Neurology Of Itch
Management of neuropathic itch begins with non-pharmacological measures used for itch in general, followed by other therapies tried in a stepwise approach. Non-pharmacological treatments are the mainstay of initial management and should continue even if drug therapies are required. They include behavioural interventions (e.g., educating the patient about itch effects, nail-cutting and wearing protective garments) (Oaklander, 2011), use of moisturizers, wearing loose clothing, and avoidance of warm temperatures (Class IV evidence) (Twycross et al., 2003). Phototherapy with narrow-band ultraviolet B has been shown to help in five cases of notalgia paraesthetica, but its use has not been explored in other neuropathic itch conditions (Class IV evidence) (Prez-Prez et al., 2010). As neuropathic itch is often induced without the involvement of histamine, it is not surprising that antihistamines are generally unhelpful in treatment. Any benefit appears related more to the somnolent side effects of H1-antihistamines than to a more specific antipruritic effect (Summey and Yosipovitch, 2005). There are several medications reported for use in neuropathic itch. Capsaicin cream and topical anaesthetics such as a lidocaine patch (Sandroni, 2002) are commonly used initially (Class IV evidence). The mechanism of capsaicin is TRVP1 activation that leads to receptor desensitization and depletion of substance P from sensory nerve terminals in the skin (Ikoma et al., 2006). In a meta-analysis of six randomized controlled studies testing capsaicin for diverse itch conditions, there was no convincing evidence in favour of the treatment. Methodological and statistical problems limited the validity of these controlled studies. Specifically, it is difficult to design experiments because the bu Continue reading >>
Genital Itching – Symptom Of Diabetes
Itching and irritation around the genitals can be a sign of high blood glucose levels (hyperglycemia) and diabetes. Causes Possible causes of genital itching include: Diabetes Eczema Low estrogen levels in women Psoriasis Pubic lice Reactions to chemicals used to wash clothes Yeast infections Itching as a symptom of diabetes If diabetes is causing the itching in men, it tends to lead to itching under the foreskin of the penis. In women, it can lead to itching of the vulva, the skin on the outside of the vagina. If diabetes is the cause, you may notice other symptoms of diabetes, such as needing to go to the toilet more often than normal. If you suspect you may have diabetes, see your doctor for a diagnosis. Genital itching and diabetes Itchy privates can occur if blood glucose levels run high, causing sugar to be passed out in the urine. Sugar makes a fertile breeding ground for bacteria and it is a buildup of bacteria around the genitals that causes the itching. If you’re getting itchy down there as a result of high sugar levels, wash the affected area to clean away any build up of bacteria. Don’t use any harsh soaps that might lead to irritation. If you can bring your blood glucose levels back to normal, this also should help the itching to subside. Type 2 diabetes is a metabolic disorder that is characterized by high levels of glucose in the bloodstream which leads to hyperglycemia if untreated. It is strongly linked to obesity and unhealthy lifestyle habits such as lack of physical activity, poor diet and smoking. How common is type 2 diabetes? Type 2 diabetes is by far the most common form of diabetes mellitus, accounting for roughly 90% of all cases of diabetes. It affects an estimated 330 million people worldwide, including over 29 million people in the Unite Continue reading >>
Can’t Sleep Because My Feet And Hands Itch So Bad. What’s Causing This?
Q: I am a type 2 diabetic. Just recently I have not been able to sleep because my feet and hands itch so bad. What is causing this? I've tried lotions but that doesn't help. Please help. I'm sorry to hear that you are having a problem with itching in your hands and feet. It could possibly be a symptom of nerve damage known as peripheral neuropathy, a common complication of diabetes. However, you would likely have other symptoms as well, such as pain and numbness. A more likely cause could be that your blood sugar levels are too high. If you've noticed that your blood sugar readings have been increasing, it's important to get them under control before permanent nerve damage occurs. On the other hand, if your blood sugar levels are consistently less than 140 mg at all times (fasting and after meals), the itching probably isn't related to diabetes. At any rate, it's important to follow up with your doctor to discuss your symptoms, receive a definitive diagnosis, and potentially have your diabetes treatment changed (along with making lifestyle changes like cutting back on carbs) if the cause is determined to be elevated blood sugar levels. I wish you the best of luck with everything. Answered By dLife Expert: Franziska Spritzler, RD, CDE Certified diabetes educator and registered dietitian living in Southern California. Disclaimer The content of this website, such as text, graphics, images, and other material on the site (collectively, “Content”) are for informational purposes only. The Content is not intended to be a substitute for, and dLife does not provide, professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard prof Continue reading >>
Neuropathic Itch
Go to: What causes neuropathic itch? The anatomical pathways that mediate normal itch sensation were mentioned previously in this issue (see “Anatomy and Neurophysiology of Pruritis”, page XXX). Among somatosensory sensations, itch is the least understood, and the underlying neural circuits are still in the process of being identified. Virtually nothing is known about the cellular and molecular bases of itch under pathological circumstances, so this review is based on fragmentary understanding gleaned from clinical experience and manuscripts largely restricted to case reports. Findings so far suggest that lesions anywhere in the peripheral nervous system (PNS) or central nervous system (CNS) that damage itch-transducing, conducting or processing neurons appear capable of causing neuropathic itch. It is logical to look for the cause of pruritis in the symptomatic area but the causative lesion may be half a meter away in a nerve, nerve root, spinal cord or the brain. Like most other neurological symptoms, what matters is the anatomical location of the lesion, not its etiology. Neuropathic itch has been associated with most of the major categories of neurological disease ranging from stroke, tumors and vascular malformations, to demyelinating disease and radicular compression. This review attempts to summarize the known causes of neuropathic itch, organized by anatomical location. Like neuropathic pain, only a fraction of patients with these neurological conditions develop chronic itch. It appears that neuropathic itch and pain, like many other chronic conditions, are likely complex conditions in which a specific trigger, neuronal damage, increases risk for symptoms in individuals with underlying susceptibility. There are no data about what the environmental and geneti Continue reading >>
Diabetes And Your Skin
Want another reason to get your blood sugar levels under control and keep them that way? Doing so can help you avoid many diabetes skin problems. Still, skin conditions related to this disease are common. As many as 1 out of 3 people with diabetes will have one. Fortunately, most can be or successfully treated before they turn into a serious problem. The key is to catch them early. Common Skin Conditions Linked to Diabetes Itching skin, also called pruritus, can have many causes, such as dry skin, poor blood flow, or a yeast infection. When itching is caused by poor blood flow, you’ll likely feel it in your lower legs and feet. Lotion can help to keep your skin soft and moist, and prevent itching due to dry skin. Bacterial infections: Staphylococcus skin infections are more common and more serious in people with poorly controlled diabetes. When hair follicles are irritated, these bacteria can cause boils or an inflamed bump. Other infections include: Styes, which are infections of the eyelid glands Nail infections Most bacterial infections need to be treated with antibiotic pills. Talk with your doctor. Fungal infections: Warm, moist folds of the skin are the perfect breeding ground for these infections. Three common fungal infections are: Jock itch (red, itchy area on the genitals and the inside of the thighs) Athlete's foot (affects the skin between the toes) Ringworm (ring-shaped, scaly patches that can itch or blister and appear on the feet, groin, chest, stomach, scalp, or nails). A yeast-like fungus called "Candida albicans" causes many of the fungal infections that happen to people with diabetes. Women are likely to get this in their vaginas. People also tend to get this infection on the corners of their mouth. It feels like small cuts and is called "angular ch Continue reading >>
Peripheral Neuropathy
What is peripheral neuropathy? Peripheral neuropathy is disorder of nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy may have tingling, numbness, unusual sensations, weakness, or burning pain in the affected area. Oftentimes, the symptoms are symmetrical and involve both hands and feet. Because the symptoms are often present in the areas covered by gloves or stockings, peripheral neuropathy is often described as having a “glove and stocking” distribution of symptoms. Peripheral neuropathy can involve different nerve types, including motor, sensory, and autonomic nerves. Peripheral neuropathy can also be categorized by the size of the nerve fibers involved, large or small. Neuropathy can present with many differing symptoms, including numbness, pain of different types, weakness, or loss of balance, depending on the type of nerve involved. Because the autonomic nerves control bodily functions that we do not consciously think of, such as heart rate, digestion, and emptying of the bowel and bladder, autonomic neuropathy manifests with symptoms affecting the loss of control of these functions. Symptoms may include problems with blood pressure, voiding, passage of stools (diarrhea, or constipation), heart rate, or sweating. Cranial neuropathy is similar to peripheral neuropathy, except that the cranial nerves are involved. Any of the cranial nerves can be involved. One of the more common causes of cranial neuropathy is loss of blood flow from the optic artery to the optic nerve, causing ischemic optic neuropathy. Amyloidosis is one of the more common causes of this rare disorder. Specific nerves can be involved in neuropathy. When a specific nerve is involved, the symptoms are limited to the distribution of that nerve. The most commonly i Continue reading >>
Barely Scratching The Surface
Itching or pruritus is an unpleasant sensation that evokes the desire or reflex to scratch. Itching in people with diabetes for the most part suggests a skin condition such as psoriasis, eczema, sunburn, athlete's foot, hidradenitis suppurativa, pruritus vulvae from monilial infections, xerosis and diabetic eczema, necrobiosis diabeticorum, allergies to medications, drug eruptions, and many other conditions. Most are inflammatory disorders. In addition, there are generalized medical conditions that need to be excluded such as obstructive jaundice (bilirubin is a skin irritant at high concentrations), polycythemia that can cause generalized itching, myxedema, hypoparathyroidism, uremia, iron deficiency anemia, and malignancy or systemic internal cancers such as lymphoma or Hodgkin's disease (1). When all have been considered and excluded, the question that needs to be answered is, Does the itching derive from a peripheral or a central mechanism? Sensations associated with scratching Pain and itch have very different behavioral response patterns. Pain evokes a withdrawal reflex that leads to retraction and is therefore a reaction trying to protect an endangered part of the body. Itch creates a scratch reflex that draws one to the affected skin site (2). It has been hypothesized that motivational aspects of scratching include the frontal brain areas of reward and decision making. These aspects might therefore contribute to the compulsive nature of itch and scratching (2). It is clear, therefore, that itching is not skin-deep. Unmyelinated nerve fibers for itch and pain both originate in the skin; however, information for them is conveyed centrally in two distinct systems that both use the same peripheral nerve bundle and spinothalamic tract (3). It is surprising, then, tha Continue reading >>
Does Diabetes Cause Itching?
People with diabetes experience skin itching at higher rates than those without the condition. Ultimately, itching can lead to excessive scratching, which can cause discomfort and pain. A study of nearly 2,700 people with diabetes and 499 without diabetes found that itching was a common diabetes symptom. An estimated 11.3 percent of those with diabetes reported skin itching versus 2.9 percent of people without diabetes. A person with diabetes should not ignore itchy skin. Dry, irritated, or itchy skin is more likely to become infected, and someone with diabetes may not be able to fight off infections as well as someone who does not have diabetes. There are a variety of treatments available that can help to reduce diabetes-related skin itching so that a person can be more comfortable and avoid other skin complications. Causes of diabetes itching There are many reasons why a person with diabetes might experience itching more often than someone else. Sometimes itching can result from damaged nerve fibers located in the outer layers of skin. Often, the cause of diabetes-related itching is diabetic polyneuropathy or peripheral neuropathy. This condition occurs when high blood glucose levels damage nerve fibers, particularly those in the feet and hands. Before the nerve damage occurs, the body experiences high levels of cytokines. These are inflammatory substances that can lead to a person's skin itching. Sometimes, persistent itchiness may indicate that someone with diabetes is at risk of nerve damage, so the itchiness should never be ignored. Also, people with diabetes can experience associated disorders that include kidney or liver failure. These conditions may also cause itching. A person with diabetes can experience skin itching related to a new medication they are takin Continue reading >>
How To Stop Itching From Diabetes
Edit Article Three Methods:Stopping the Itch with Lifestyle ChangesStopping the Itch with Home RemediesStopping the Itch with MedicationCommunity Q&A Diabetics frequently experience horrible itching. It is a common side effect of elevated blood glucose levels, which is the defining factor of diabetes. If you suffer from unbearable itchiness, this wikiHow article explains ways that you can soothe your irritated skin. 1 Prevent skin from getting dry. Keep your skin moist and healthy by using moisturizers and skin creams. Avoid scented creams and lotions, BECAUSE you could have a reaction to them, causing more itching. Moisturize twice a day. Every time you shower, use one ounce or two tablespoons to moisturize your whole body, or use as needed.[1] You should also avoid using scented soaps BECAUSE the chemicals in it can cause skin to get dry and irritated. Use mild, unscented soaps instead. 2 Change your bathing style. Too frequent bathing can cause itching to get worse. Limit baths to once every 2 days. Bathing frequency can vary depending on climate, weather and your activities. However, once in two days should suffice. Avoid using very hot water; it tends to make the skin more irritated. Use water at room temperature or lower. Hot water dilates vessels speeding up metabolism of insulin, which can trigger hypoglycemia.[2] Another reason why diabetics should not use hot water is diabetics suffering from nerve damage lose sensitivity to pain and temperature and may unknowingly burn themselves with hot water. 3 Care for your skin in the summer. Summer is a time of sun and fun, but sun can also seriously irritate skin. To lessen itching in the summer, wear clothes made from light materials like cotton, chiffon or linen. Certain cloths like wool and silk can cause irritation Continue reading >>
Itchy Feet And Diabetes
Itchy feet and Diabetes often accompany one another. Even though there are plenty of other symptoms that disturb a diabetic, many people will tell you that the itchy feet — particularly at night — are simply intolerable! According to Diabetes.org, as many as 33 percent of diabetics suffer from a skin disorder. What Skin Conditions Cause Itchy Feet In Diabetics? If your feet are itching to high heaven, you may be suffering from one of the following conditions… Bacterial Infections – Usually a bacterial infection of the foot will be evidenced by liquid-filled boils. Inflamed tissue is red, hot, swollen and sometimes itchy. It is especially important that people do their best to avoid a diabetes foot infection, as unchecked infections can lead to amputations. Fungal Infections – Fungal infections like Athlete’s Foot usually starts with an intensely itchy red rash between the toes. Germs can enter cracks in the skin and cause a more widespread infection. Toenail fungus is also common in diabetics, which can be identified by a thickening and yellowing of the nail that results in crumbly edges. Yeast Infections – A common side effect of a yeast infection can be itchy skin — not just in the genital region, but also on the hands, feet, ears and scalp — where candida tends to accumulate. Doctors prescribe antibiotics for this. Peripheral Neuropathy – One of the most common causes of itchy feet for people with diabetes is a dysfunction of the nerves called “peripheral neuropathy.” Numbness, tremors, tingling, pain, pins-and-needles, itching — these are all words used to describe what diabetics face. Some people are prescribed drugs like morphine or oxycodone to deal with these symptoms. Liver Failure – According to Livestrong, “Liver diseases with bi Continue reading >>
What Causes Itching & Burning In A Diabetic?
[an error occurred while processing this directive] If you are diabetic and have been experiencing itching and burning sensations in parts of your body like your feet, legs, or hands, you almost certainly have a condition called diabetic neuropathy. Neuropathies can be caused by other problems besides diabetes, but if you're a diabetic, your neuropathy is very probably related directly to your disease (but note that itching and burning can also be caused by something as simple as dry skin and poor circulation, both common in people with diabetes). Neuropathies are a family of nerve disorders. It's typical for people who have diabetes to develop nerve damage throughout their bodies over time. Some diabetics who get this nerve damage will have it show up as symptoms like itching, burning, strange and sometimes uncomfortable tingling sensations, or loss of feeling in their extremities. Diabetics are susceptible to developing nerve problems at any time. As one might expect, however, the risk of it occurring goes up with age and the longer the time they have had diabetes. Diabetic neuropathies are much more common in those who have trouble with controlling their blood sugar levels. Diabetics who are significantly more prone to neuropathy include people who have elevated levels of blood fat or high blood pressure, and people who are overweight or obese. Proximal neuropathy begins as pain in the hips, thighs, legs, or buttocks, and typically on just one or the other side of the body. Eventually, this kind of neuropathy will lead to weakness in the legs and from there cause the person to degenerate to the point where they are unable to stand up from a seated position without aid. At first, the symptoms of neuropathy may be barely noticeable. At other times, the symptoms might b Continue reading >>
Itchy Skin May Be A Warning Sign Of Type 2 Diabetes
It’s winter, and one of the tell-tale signs of the season often emerges as dry and itchy skin. However, did you know that these symptoms can also be warning signs of Type 2 diabetes? It’s true. Pruritus, which simply means “itching,” is a common symptom of diabetes. While it’s always a good idea to keep your skin moisturized, there are common conditions associated with diabetes that may cause your skin to itch, crack, and peel. There are various underlying causes that can lead to diabetic pruritus. Here are three of the most common chronic conditions. Poor circulation. Individuals who experience itching in the feet and lower legs may be experiencing the result of poor circulation. Poor circulation causes narrowing and hardening of the blood vessels, which, in turn, causes noticeable itching on the surface of the skin. To lessen the severity of the itching, consider taking the following action steps: • Eliminate the use of tobacco • Adopt a regular exercise routine • Keep blood glucose levels in check Fungal infections. Fungal infections are common in individuals with diabetes and are treated with medication. Because different fungi respond to different medications, it’s best to discuss the best course of action to take with your medical care provider. Common symptoms of fungal infections include dry, red, and cracking skin, blisters or breaking down of the skin, and itching. Because high glucose levels in the body enhance the growth of these infections, you’ll want to be diligent about keeping your glucose under control to prevent fungal growth on the skin. Also, keeping your skin clean and dry will go a long way in warding off fungal infections. Fungal infections commonly thrive in these areas on the body: • Armpits • Groin area • Between fing Continue reading >>
10 Diabetic Skin Problems
1 / 11 Are You Suffering From a Diabetes-Related Skin Complication? About a third of people with diabetes will develop skin problems at some point. In fact, some skin issues can be warning signs of diabetes. The good news is that most skin conditions can be treated easily if they’re caught early. Keeping proper control of your blood sugar (glucose) can prevent skin problems and many other diabetes symptoms from happening in the first place. “For the most part, control of diabetes can help with related skin issues,” says Justin Ko, MD, the medical director and service chief of medical dermatology at Stanford Health Care, in Redwood City, California. “I’m always adamant that my diabetic patients take aggressive care of their skin and health in general. For the skin, moisturization, checking feet and legs daily for any blisters, sores, and skin breaks (especially between the toes), and nail care is extremely important. Nail and foot fungus can lead to skin cracks and breaks, allowing bacteria to enter and cause infection.” Continue reading >>
Does Diabetes Make You Itch?
Diabetes can affect your skin in itchy ways. It can change your nervous system to sense itching you otherwise wouldn’t. How does this happen, and what can you do about it? Itching should not be ignored. It can lead to excessive scratching, which can cause discomfort, pain, and infection. According to the American Diabetes Association (ADA), the higher-than-normal blood sugar levels common in diabetes promote skin infections. The causes can be ordinary fungi, yeast, or bacterial rashes like anyone can get. Some other skin diseases only happen to people with diabetes or happen mostly to people with diabetes. These tend to have long names such as diabetic dermopathy and eruptive xanthomatosis. WebMD says as many as one out of three people with diabetes will have some kind of skin condition. Diabetes increases skin dryness and damages circulation. “Localized itching can be caused by a yeast infection, dry skin, or poor circulation,” says WebMD. “When itching is caused by poor blood flow, you’ll likely feel it in your lower legs and feet.” Genital itching Diabetes can itch more than your skin. Diabetes.co.uk highlights genital yeast infections as a major problem in diabetes. This is because high glucose levels “provide ideal conditions for naturally present yeast to grow and diminishes the body’s ability to fight infection.” Diabetes can also deposit glucose in the urine, helping yeast to grow. Other causes of genital itching include lice, scabies, herpes, various skin diseases, chemical irritants, and allergies. These can affect anyone, but may be felt more strongly in people with diabetes. According to an article on Everyday Health, “diabetes affects the nervous system and alters the perception of sensation in the body.” A piece by Rachel Nall, RN, BS Continue reading >>
Diabetes: Foot & Skin Related Complications
How can diabetes affect feet and skin? For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot and skin problems, as well as heart disease, stroke, kidney disease, eye damage, and other problems. How can diabetes affect my feet? Diabetes can cause two problems that can affect your feet: Diabetic neuropathy — Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold or pain. This lack of feeling is called diabetic neuropathy. If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. Peripheral vascular disease — Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called peripheral vascular disease. (The word "peripheral" means "located away from a central point," and the word "vascular" refers to the blood vessels. Peripheral vascular disease is a circulation disorder that affects blood vessels away from the heart.) If you have an infection that will not heal because of poor blood flow, you are at risk for developing gangrene, which is the death of tissue due to a lack of blood. To keep gangrene from spreading, the doctor may have to remove a toe, foot, or part of a leg. This procedure is called amputation. Diabetes is the most common, non-traumatic cause of leg amputations. Each year, more than 56,000 people with diabetes have amputations. However, research suggests that more than half of these amputations can be prevented through proper foot care. What are some common foot problems of people with diabetes? Anyone can get the foot problems listed below. For people Continue reading >>
