Looking for tips on the itch
June 6, 2016 8:57 AM   Subscribe

A member of my family has had itchy skin recently. We're trying to diagnose it. Is it the showering habit? The detergent? More inside...

Here's what we know:

1) This person gets an upper-body itch. Usually in the morning and night.
2) Main itch spots: Top of the trapezius area around the neck, sides of the lattisimus dorsi, abdomen and lower abdomen in the front of the body. Still, when they start to itch around they end up putting a ton of moisturizer all over their torso.
3) There has never been an itchy leg problem.
4) This person has lost a very significant amount of weight over the last two years, going from obese to healthy weight.
5) This person thinks they may have sjogren's syndrome: Face dryness with red patches, mouth dryness (dentist confirmed), eye dryness (corneal erosions).
6) This person stopped taking frequent showers in order to help with the sjogren's; they take a shower once a week. They do notice they need to shed a lot of dead skin during and after each shower. However, they still itch the day after the shower. And they are happy with the (facial look--less redness/dryness) results of cutting back their showering.
7) This person gets an occasional underarm itch from using antiperspirant and treats it with hydrocortizone.
8) There is no accompanying redness or hives, rash, etc. with the itch. The skin doesn't stay red for very long after it has been scratched.
9) This person hydrates very well, drinking around 128 oz. of water every day and peeing clear every 15-30 minutes or so.
10) Putting lotion like baby lotion, or hydrocortizone, or other topicals doesn't seem to make the itch go away. It lasts long enough to allow this person to, say, fall asleep, but they sometimes wake up itchy during the night time.

We are wondering if this also might be an issue with our laundry detergent. There are just a lot of things going on so we don't want to miss some blind spot.

Thought we'd ask in case anyone has ideas or suggestions based on the information above. Thanks!
posted by circular to Health & Fitness (24 answers total)
Has this person been diagnosed with Sjogren's and are they under the care of a specialist?
posted by telegraph at 9:01 AM on June 6, 2016

There is no accompanying redness or hives, rash, etc. with the itch. The skin doesn't stay red for very long after it has been scratched.

Does it appear dry, like flaky or ashy? It could be eczema.
posted by showbiz_liz at 9:02 AM on June 6, 2016

It will not hurt anything at all to rid your home of chemicals. Stop using dryer sheets and fabric softener. Use only detergent for sensitive people. Get rid of all Glade Plug ins and other scented, chemical garbage. Do not use aerosol spray ever again, for anything. Since your family member is already suffering from an autoimmune disorder, removing toxins from the environment is just a sensible thing to do. It gives them less to react to. You should also focus on keep things mellow. Stress makes everything worse.
posted by myselfasme at 9:02 AM on June 6, 2016 [6 favorites]

peeing clear every 15-30 minutes or so

Wait - really? Every 15-30 minutes? How do they have time to do anything at all besides pee? I don't think this is normal at all.
posted by showbiz_liz at 9:04 AM on June 6, 2016 [6 favorites]

I'm hoping others can help address the cause, but I would suggest that with that much application of skin lotion and the like it would be helpful to exfoliate in the shower and then apply whatever lotion they want to use. Sometimes it seems like lotions build up and exacerbate itchiness rather than relieving it. These are my personal favorite but anything of that sort ought to help.
posted by DrGail at 9:05 AM on June 6, 2016

The blind spot that seems to have been missed is consulting a doctor, I think? Since there seems to be a whole lot of concerning symptoms.
posted by poffin boffin at 9:05 AM on June 6, 2016 [10 favorites]

> Has this person been diagnosed with Sjogren's and are they under the care of a specialist?

I don't think it's official, but they visited a dentist who said, "yeah, you probably have it" and gave them samples to try for mouth dryness, and then visited an opthamologist who said the same thing. They also have a family history of it.

> Does it appear dry, like flaky or ashy? It could be eczema.

Prior to scratching I can confirm it looks normal.

> It will not hurt anything at all to rid your home of chemicals

This would really put things into upheaval here. Appreciate the individual tips though.

> How do they have time to do anything at all besides pee?

I should clarify--this is typically during a certain time of day, usually in the late afternoons when they are speeding up intake so they don't have to pee at night. Can hold it longer but seem to like the excuse to get up and move around.

> The blind spot that seems to have been missed is consulting a doctor, I think?

Yeah, that will probably happen soon actually. We just thought we'd start to rule things out as much as possible up front, because while we value the doctor visit, as a family we've had some amazingly time-wasting experiences in the past this way. To the extent that we came home and within weeks had figured out the actual problem on our own. Like if it's just detergent and fabric softener--we feel like we should just do some due diligence first. So maybe we're jaded but yeah, good advice and we'll probably do it.
posted by circular at 9:12 AM on June 6, 2016

Oh, hi. That sounds like me. It could also possibly be eczema--I have that combined with a slight fungal infection on my scalp and face.

First, dump all of the scented everything. Unscented dryer sheets, if you must (I hang 75% of my clothes up to dry), unscented baby-friendly detergent, and I use a deodorant (NOT an antiperspirant) from Tom's of Maine on the days I feel like I really, really need to have something on my armpits.

I also use unscented soap and body wash, and am trying to find an unscented shampoo and conditioner to use, but that's difficult because I have crazy curly hair, and the scalp health remedies are often in direct contrast with the curly hair care best practices.

Also, how often is this person changing their sheets and towels? I really don't change them often enough, but when they've been on the bed too long, I itch so much. Like, all over my face and scalp, and my dermatologist thinks I might be reinfecting myself through my towels and linens, so I'm trying to wash them every week. Ideally twice a week, but ...yeah. Working on that.

Showering less can help, but are they moisturizing in between? They should at least be using lotion, and possibly spot-dabbing the stinky areas with super-moisturizing sensitive skin body wash every other day, ish. And how are they toweling off after drying? Vigorous rubbing can irritate skin more than a gentle pat. I also have a little gentle exfoliating mitt that I use in the shower to help work off dead skin without trying my skin out too badly.

Get this person to a dermatologist, if they haven't gone yet. Some skin issues look remarkably similar to an untrained person, and what I thought was an eczema issue is actually a fungal issue, and the treatments are different enough that I had to get new prescriptions and change my routine just enough.
posted by PearlRose at 9:16 AM on June 6, 2016 [2 favorites]

According to my pelvic floor physical therapist, no matter how much you drink, you shouldn't need to urinate more than every two hours.

Nthing dermatologist recommendation. But also, This sounds like me when I get overheated or sweaty. Never my legs, just where my shirts tend to touch my body.
posted by dpx.mfx at 9:29 AM on June 6, 2016

This person hasn't been properly evaluated for Sjogren's. My mother has it, and it took quite a bit of evaluation to get a diagnosis and a treatment plan. This person needs to address that issue, and see a rheumatologist. And my mother's case of Sjogren's is considered very severe, but she does not have an itching problem. (She has just about every other possible problem, though.) Even if this person does have Sjogren's, it might not be causing the itch. But if it is, shouldn't it be properly addressed by a specialist?

The itchiness thing is so vague that this person really does need to see a dermatologist, too. I'm a very itchy and allergic person with dermatographic urticaria, but it does nothing for me to ditch whatever people are currently referring to as "chemicals" or "scents". There are so many causes of itching.

I know these suggestions are all a real pain in the ass, and I'm tired of going to specialists, too. Having seen the progressive effect of Sjogren's on my mother, though, I don't think it should be left as a "eh you probably have it" sorta-diagnosis.
posted by Coatlicue at 9:37 AM on June 6, 2016 [1 favorite]

Agree with myselfasme that switching to unscented home and body products is a really easy way to try to reduce skin irritation. There's really no downside to switching to unscented shampoo, soap, laundry care products (in fact, dryer sheets and fabric softeners are terrible for your clothes and linens!) and to not using air fresheners, etc. They exacerbate allergies and sensitivities, and in terms of hygiene they just mask odors instead of addressing them. You can MeMail me if you'd like a list of easy-to-find unscented products.
posted by radioamy at 10:12 AM on June 6, 2016

Water is a chemical. You can't rid your house of chemicals.

I think it's fairly urgent to get some specialist eyes on this, in part because sometimes idiopathic itching is vascular/circulatory, but also because the Sjogren's issue needs pursuit.

Showering once a week is probably not a great solution or even helpful, but as you are eyeballing all the detergent etc you should assess what shower products they are using. Plain old bar soap, even unscented, can be hell on sensitive skin because it's so...soapy. Cetaphil liquid soap is generally the dermatologist's go-to for cleansing, probably used after any hair products to make sure those get washed away.

My derm has me use oil immediately after showering. I put a travel spray bottle (like these, from the drugstore) in the shower with unscented Neutrogena Body Oil (she rec'd that or the drugstore version of it, but said if I was super devoted to jojoba or avocado or macadamia or similar I could go with that instead, but the important part was put it in the spray bottle, mist your hand, apply, mist hand, apply, etc until you get everything on your body lightly coated but not the shower floor so you don't slip) over wet skin and air dry if possible or gently pat dry if you must.

They should talk to the dermatologist about proper exfoliation.

If your area is known for especially hard/soft/grotty municipal water, you might look into a filtered shower head. Additionally, very hard or soft water can affect laundry, so you might need to look into that.

Cetaphil lotion is probably the only lotion they should be using until a doctor suggests otherwise. These mentions of showering making their face worse and using things like baby lotion on their body suggests they may not be terribly well-informed on skin care, which means the thing they have decided is Sjogrens symptoms might be something else (fungus, eczema, something else that's not going to go away by accident). I would think a dermatologist would be the best person to escalate to a rheumatologist anyway, if it's necessary, and in the meantime should be able to help them be more comfortable, which is important.
posted by Lyn Never at 10:13 AM on June 6, 2016 [4 favorites]

If the person has eczema, they may want to consider products free of Sodium Laurel/Laureth Sulfate.

The problem is that it's in nearly everything -- shampoo, toothpaste, soap, and detergent. Choices for SLS free products are limited and expensive.

Also make sure the washing machine has been cleaned with a washing machine cleaner -- this was not only a huge problem for Mr. Moonlight and I, but my In-law Moonlights too.
posted by Ms. Moonlight at 10:22 AM on June 6, 2016

Eliminate known allergens (dust? animal hair? pollen? wool clothes?).
Reduce/eliminate potential irritants (perfumes in detergent, in the air, in bath products. Some people also like to use sulfate-free shampoo; I seem to do better with that but never had severe itching of this sort).
Shower with cooler water.

Investigate treatment-- you're doing this. But just to be sure, even if the doc says there's no known cause for the itching, there may still be treatment.
posted by nat at 10:23 AM on June 6, 2016

I have problems with torso itchiness when I wear anything that's seen a dryer sheet. Doesn't seem to matter which brand, including the "chemical-free" hippie ones. Nightly whole-body application of lotion helps with dryness (I like Udder Balm types) but in my case, the itchiness is definitely about irritation.
posted by teremala at 10:28 AM on June 6, 2016

IANYD, but as a person suffering from eczema (which gets worse in the heat of summer), I can add a +1 to nat's comment about showering cooler water. Actually I shower in hot water, but after I'm done, I turn on the cold water and splash it on areas that I feel are itchy. This has helped immensely with the itch so far.

Another thing I haven't tried, but may work for your family member is rubbing on calamine lotion, instead of normal body lotion on the problem areas.
posted by ThatSox at 10:34 AM on June 6, 2016

when they are speeding up intake so they don't have to pee at night.

This person sounds, from your description, like they may hold some unconventional beliefs about medicine, etc. I'm also presuming (with little data) they you may have limited ability to divorce them from those beliefs. In short, this sounds like too much water (twice what is suggested as "normal") and/or not enough salt intake. Only mention it because it's possible to become DEhydrated if you drink a lot but don't hold on to it.

My sister had an itch that was difficult to straighten out. Here are things that helped

- ending showering with a cold water rinse as people have mentioned
- no scented anything in the laundry and rewashing sheets/pillowcases (the location of the itch very strongly suggests something in the clothing environment, maybe also check clothing storage as well?)
- antihistamine such as benadryl to work on allergies generally
- some people get relief from oatmeal baths (again, in cooler water)
- exfoliating in showers and toweling off vigorously

And then, of course, actual medical attention as soon as is practicable once you've established some of the "what makes it better, what makes it worse" stuff.
posted by jessamyn at 10:46 AM on June 6, 2016 [1 favorite]

On top of what everyone else has mentioned, have you screened your house for mold/mildew? Sjorgren's does sound like the most likely thing, but if it's not, eye and mouth irritation is a sign of something harmful in the air supply.

Also, if they are peeing clear, they are OVER hydrated. Peeing clear is not a good thing for your kidneys long term, and there's not a whole lot of evidence to suggest drinking water helps with itching.
posted by InkDrinker at 11:00 AM on June 6, 2016

I think personally that it is doctor time now. However, it is not that hard to try eliminating fragrances and such in products now to see if it helps, by using products that be found at the average supermarket or drugstore. Arm and Hammer and Tide both have laundry detergent for sensitive skin/unscented. Dryer sheets are not good for clothes anyway, so can be eliminated. Dove soap bars come in a sensitive skin/unscented ("fragrance free") type. There are also sensitive skin/unscented deodorants from Toms of Maine, Almay, etc.. Just check the labels well and make sure they say for sensitive skin and also unscented or fragrance free (some of the "sensitive skin" products are not unscented, and the scents can bother people's skin). As for lotion, you can try Eucerin or Aveeno or Curel or Cetaphil etc., etc., again checking labels to ensure no fragrance as some of these brands have various product lines.

One final note, some people have recommended exfoliating. As a person with eczema, exfoliating makes my skin go nuts, so I would use caution, as it is possible your family member might be similar to me. Also, I don't shower every day due to the eczema (more like every other day or every couple of days), but once a week sounds a bit infrequent to me and that would probably irritate my skin if I showered that infrequently (eczema is a balancing act sometimes.)
posted by gudrun at 11:13 AM on June 6, 2016

Was the weightless intentional?
If so then yay, but if not this person should consult a physician about that alone. Unintentional weight loss is a symptom of things, even if the person is not underweight.

Actually, that much drinking (128 ozs =16 cups!) and that much peeing and that much weight loss is a sign of diabetes, even if the drinking does get passed off as volitional.
posted by SLC Mom at 11:41 AM on June 6, 2016

> Also, how often is this person changing their sheets and towels?

Sheets every month at least; towels every time they shower I think.

> And how are they toweling off after drying?

"Semi-vigorously?" Vigorously in areas where skin has built up, not so vigorously (or at all, or just spotting) in sensitive areas.

> Showering less can help, but are they moisturizing in between?

Yes, they have tried Cetaphil extreme something-or-other, hydrocortizone, baby moisturizer, and some other OTC moisturizer. Soothing effect seems to last around 3 hours max.

> In short, this sounds like too much water (twice what is suggested as "normal") and/or not enough salt intake.

OK, we'll look into the water.

I checked on their salt intake by running down an average daily meal plan (easy since they are into fitness). Seems like they're getting between 800 and 1000 mg daily; salsa that's being poured on top of beans, cauliflower, and broccoli being the biggest contributor.

The rest of the diet is high in protein (chicken, beans, some basic protein drinks) but looks to me like something out of a magazine for people who eat the ideal diet or something. Tons of veggies, fruit, etc. Egg whites.

> Was the weightless intentional?

Yes, intentional, this is a very healthy person who made some lifestyle changes. Like I said above, the peeing is happening during a specific period late in the afternoon. No diabetes and passes basic physicals easily. Blood pressure always gets compliments.

I also forgot to mention that this person has consulted other medical professionals that I had forgotten about, a GP and a Rheumatologist for the Sjogren's. No diagnosis yet but they are on top of that.

We are going to rule out the laundry stuff next because it's an easy change, but are also thinking an allergist visit might be good. They have had issues with allergies in the past (respiratory though).
posted by circular at 2:16 PM on June 6, 2016

nthing the removal of fragrance-containing items for laundry, soaps, etc. For people who are sensitive to it, fragrance can be super irritating to skin.

I have dry and itchy skin with a bonus prize of mild eczema, which gets much worse during the winter, and my dermatologist recommended Excipial Healing Lotion, which is available over the counter. It is basically magic. I only need to use a small amount after I shower as it is incredibly hydrating, and my dry patches have disappeared. They may want to try it for a couple of weeks and see if it helps.
posted by bedhead at 2:18 PM on June 6, 2016 [2 favorites]

This is purely anecdotal, but my mother-in-law had a bad case of stomach flu and then for over a month afterwards she would get extremely itchy all over her torso every evening, usually near dusk. Nothing she tried helped (topicals, soap changes, etc), so eventually she gave up and went to her doctor, even though she expected him to say she was crazy.

As soon as he heard that the itch was tied into a specific time of day, he told her that her electrolytes were imbalanced and she just needed to drink pedialyte for a few days. She thought *he* was crazy, but she tried it and the itch disappeared.
posted by Brody's chum at 5:12 PM on June 6, 2016

Could it be a yeast infection?

I would absolutely change the sheets often (more than once a week) and wash towels and bedding in hot water until this clears up.
posted by Riverine at 7:06 AM on June 7, 2016

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