What’s this itchy area on my back? - Appalachian Spring Dermatology

Notalgia parasthetica

Many times a week, I am asked, “What’s this itchy area on my back?” Often patients are not only bothered by the itching but also worried that there is an abnormal mole or growth causing the sensation. If you talk to and examine as many patients as I do, you know that this VERY common.

Many patients have an area about the size of the palm that itches on the back. In addition to being itchy, the area is also sometimes extra sensitive, tingly, painful, or tender. Chronically scratching the back in the affected area often leads to a thickened and darkened appearance to the skin.

Of course, there are long scientific explanations on notalgia parasthetica, but when seeing patients, here’s my simple explanation. Most patients are familiar with diabetic neuropathy, where diabetic patients have neuropathy on their feet where they feel pain, even though there is nothing painful there. In the same way, in notalgia parasthetica, there is a “misfire” of the itch nerve fibers sending itch signals even though the skin is normal. While notalgia parasthetica is by definition located on the back, there are other conditions where there is a similar “misfire,” including meralgia parasthetica, are more numbness on the thigh and brachioradial pruritus itching on the forearms.

What causes notalgia parasthetica? In most cases, there is a nerve that is being twinged or pinched. Now honestly, this part is beyond my area of expertise. However, I often recommend patients discuss this with their primary care physician and even possibly a neurologist or chiropractor. If there is no knowledge of spinal problems, I sometimes recommend patients talk to their primary care physician about imaging their spinal area.

What can be done to treat notalgia parasthetica? Don’t scratch! The more the area is scratched, the more the nerve endings hypertrophy and send even more itch signal. I often recommend topical CERAVE ITCH RELIEF CREAM or LOTION. This particular topical has pramoxine as its active ingredient and “numbs” the itch sensation within 2 minutes and lasts 8 hours. This can be applied as needed for symptomatic relief. Again, not my area of expertise, but there are reports of osteopathic manipulation helping as well.

So,if you have a family member or friend who is always asking you to scratch their itchy area on their back, do them a favor. Share this article with them, stop scratching and try Cerave itch relief cream or lotion.

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