What's irritating the skin on my upper back?

November 18, 2017 2:59 PM

Several years ago, the skin on my upper back (on and around the shoulderblades; not in the middle) started getting dry, flaky, bumpy, red, and mildly itchy. What might be causing this? Could it be my shampoo? Or a reaction to some other irritant? You are not my dermatologist.

I did see a dermatologist, and he spent about ten minutes staring silently at my back, obviously unsure what he was looking at. He ended up prescribing triamcinolone acetonide cream (a corticosteroid), and it definitely helps – if I apply it every day for several days, then the irritation disappears almost entirely.

But, it's a bit of a pain – and if there's some environmental cause, I'd like to solve the problem at the root.

My best guess (and it's only a guess): I wash my hair in the shower every morning, and when I rinse it out, the water runs down my back. Could the shampoo-water be drying out my back? Or causing a reaction to some ingredient in the shampoo?

The thing is, I've never had any problems with scalp irritation, or skin irritation elsewhere on my body. I've heard of adverse reactions to sodium laureth sulfate – but that's in lots of things (and much of the talk about supposed SLS sensitivity comes out of the anti-science "healing"/"wellness" scene, which makes me skeptical).

I never soap up my back in the shower. I don't have any particular brand of shampoo; I just buy whatever's at the store and not too expensive. Similarly, I'm not loyal to any brand of laundry detergent – I've used a lot of different things over the years. (I don't use fabric softener, dryer sheets, or anything else in my laundry – just detergent.)

The water in my town is pretty heavily chlorinated (you can often smell it when you run the faucet). Could that be the cause? Maybe I could try a shower dechlorinator?

Last thought: I sit a lot, and I have a tendency to slump low in my chair, with my upper back pressed against the chair. Maybe my shitty posture is just abrading my shirt against my back?

I have no known allergies.

I've looked at photos of every skin condition I can find, and none of them are a great match. (But even photos of the same condition seem to vary a lot – I guess they present differently depending on the individual.)

I realize that it's difficult to diagnose something like this over the Internet, but perhaps you've experienced (and solved) something similar? I'm willing to experiment with different shampoos / laundry detergents / dechlorinators / whatever; I just need to know what's worth trying.

Thanks!

posted by escape from the potato planet to Health & Fitness (14 answers total)

You say you "never soap up my back in the shower."

Maybe try using something neutral (Dove or something) to actually "wash" your back and see how that goes?
posted by kuanes at 3:26 PM on November 18, 2017 [1 favorite]

I have very sensitive skin and eczema and everything, this happens to me when I regularly where anything that's not 100% cotton, pretty much. that area is a contact point for any fabrics, whereas your lower back may not touch them.
posted by smoke at 3:32 PM on November 18, 2017 [1 favorite]

Oh also, use the cream until it disappears entirely.
posted by smoke at 3:32 PM on November 18, 2017 [1 favorite]

How about clothes? Start with the easy stuff: no fragrance in your detergent (I like 7th generation) but are you getting your shirts starched or dry cleaned? Also what materials do you wear? Tight or loose? All can be factors.
posted by stewiethegreat at 4:19 PM on November 18, 2017

Latex in your bra.
posted by Oyéah at 4:35 PM on November 18, 2017 [1 favorite]

If I was in this situation, this is the first thing I'd try: I'd get a long, rectangular, mildly abrasive washcloth, apply soap to it, and gently scrub my back after rinsing the shampoo from my hair. I'd make sure to wash all the soap off, and then I'd thoroughly dry my back with a clean towel.
posted by Iris Gambol at 4:38 PM on November 18, 2017 [1 favorite]

yeah, i'm confused as to why you didn't just try washing your back. i've had to eschew washing various parts of my body as post-surgical care and every single time, i've had the skin in the unwashed area exhibit the same symptoms your back is having.
posted by poffin boffin at 4:50 PM on November 18, 2017 [2 favorites]

I get this from exercising a lot. The sweat sits against my skin until I can get home and shower. I wear 100 percent cotton shirts to work out, which I'm told actually cause this problem. I can't stand synthetics like Under Armor, however.

So I soaped and cleaned with a brush and the blemishes subsided, but then my skin became so dry I had to put lotion on it. My guess: it's kind of a picky area of the body and needs a little TLC to stay happy. Maybe try out different fabrics, astringents, etc, and see if that helps.
posted by Crystal Fox at 5:34 PM on November 18, 2017

I would not wash the area with a cloth or with soap, it will dry it out or irritate it more. I'd recommend turning the temp of your shower water down to cool, if you can stand it (not cold but definitely not hot). And I'd recommend getting a skin patch test if it continues. For me, the patch test showed things I was completely unaware of, like formaldehyde sensitivity. If you wear a bra try not wearing it or wear a strapless one for a week or so and see if that helps. If it doesn't clear up though do go back to your doctor, and if they're not helpful you can always go to a different one. Good luck!
posted by Rufous-headed Towhee heehee at 5:49 PM on November 18, 2017

This was my only symptom of head lice. Double check for that just in case; your doctor may not have thought to.
posted by metasarah at 5:58 PM on November 18, 2017

Sometimes the areas are just random. I️ get stuff on the back of one hand but not the other. The back of my knees but not my calves. There are steroids way stronger than the stuff you have if you want to try that route.
posted by kerf at 8:07 PM on November 18, 2017

You should try soaping up and scrubbing your back lightly with a brush or washcloth in the shower daily for a while and see what happens. Then if it doesn't improve, go to a dermatologist who's willing to have a conversation with you about what they think it might be, then do a patch test to check for contact dermatitis. All kinds of things can be causing irritation, and there are way too many factors for us to rule out remotely. But the fact that it keeps happening suggests that a habit (not washing your back), something environmental, or some kind of skin disorder is causing this to recur.

I was just diagnosed with 2 more contact dermatitis allergies last week after having my second patch test done. One of them was to something in my environment (a common ingredient in super common household cleaners) and the other was to something likely in my shoes or sporting equipment (an industrial adhesive resin). I would never have thought of either of those on my own. You need a dermatologist to have a conversation with you about what's there and what they think it might be, since the triamcinolone seems to be only a temporary fix.
posted by limeonaire at 12:30 AM on November 19, 2017

I had a similar issue caused by taking too-hot showers and standing with my back towards the water for too long. It resolved itself when I started stepping out of the water stream and turning around to lather up and apply shampoo or conditioner.
posted by arcolz at 6:22 AM on November 19, 2017

I had a similar issue - all of a sudden, it started, and I have no allergies. Switched shampoo (now I use Trader Joe's) and it went away. Mg back felt irritated most right after the shower.
posted by bluesky78987 at 7:15 AM on November 19, 2017